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IT安全性詐騙偵測

市場調查報告書

商品編碼

1519742

2024-2032 年按組件、類型、交付模式、應用程式、最終用戶和地區分類的醫療保健詐欺檢測市場報告

Healthcare Fraud Detection Market Report by Component, Type, Delivery Mode, Application, End User, and Region 2024-2032

出版日期: 2024年07月01日 | 出版商:

IMARC | 英文 143 Pages | 商品交期: 2-3個工作天內

價格

簡介目錄圖表

IMARC Group年，全球醫療保健詐欺檢測市場規模達到 25 億美元。

醫療保健詐欺偵測有助於在索賠流程的每個階段檢測和防止醫療保健詐欺、浪費和濫用，並減少不當付款。它連接現有的支付完整性解決方案，並整合來自內部和外部來源的資料，例如索賠系統、觀察列表、第三方和非結構化文本，以實現高效的資料管理。它依賴各種先進的分析和人工學習 (AI) 技術，包括現代統計、機器學習 (ML)、深度學習和文字分析演算法。除此之外，它還使用靈活的流程來協助操作、臨床和調查評估並儲存所有相關的病例資訊。

醫療保健詐欺偵測市場趨勢：

由於尋求健康保險的患者數量增加，對醫療詐欺檢測解決方案的需求也隨之增加。這與醫療保健行業不斷成長的預付款審核模式一起，是推動市場的關鍵因素之一。此外，全球範圍內與藥品索賠相關的詐欺行為不斷增加正在推動市場的成長。此外，對具有生物識別感測器來識別詐欺的解決方案的需求也在增加。再加上醫療詐欺分析的日益普及，尤其是在發展中國家，正在對市場產生正面影響。除此之外，人工智慧 (AI) 在醫療保健詐欺檢測中的日益整合為行業投資者提供了利潤豐厚的成長機會。除此之外，一些國家的政府正在採取措施審查醫療保險索賠並為消費者和國家節省資金。與此一致的是，蓬勃發展的醫療保健產業正在推動市場的成長。其他促進成長的因素包括投資報酬率 (ROI) 的增加、社群媒體使用的增加以及為實施多個資訊和技術 (IT) 平台提供的資金。

本報告回答的關鍵問題：

迄今為止，全球醫療保健詐欺偵測市場的表現如何？
COVID-19 對全球醫療保健詐欺偵測市場有何影響？
主要區域市場有哪些？
基於組件的市場區隔是什麼？
依類型分類市場是怎麼樣的？
基於交付模式的市場區隔是什麼？
基於應用程式的市場區隔是什麼？
基於最終用戶的市場區隔是什麼？
產業價值鏈的各個階段是什麼？
該行業的關鍵促進因素和挑戰是什麼？
全球醫療保健詐欺檢測市場的結構如何？
產業競爭程度如何？

市場結構
關鍵參與者
關鍵參與者簡介
- CGI Inc.
- Conduent Inc.
- ExlService Holdings Inc.
- Fair Isaac Corporation
- HCL Technologies Limited
- International Business Machines Corporation
- Northrop Grumman Corporation
- RELX Group plc
- SAS Institute Inc.
- UnitedHealth Group
- Wipro Ltd.

簡介目錄圖表

Product Code: SR112024A5536

The global healthcare fraud detection market size reached US$ 2.5 Billion in 2023. Looking forward, IMARC Group expects the market to reach US$ 14.0 Billion by 2032, exhibiting a growth rate (CAGR) of 20.7% during 2024-2032.

Healthcare fraud detection aids in detecting and preventing healthcare fraud, waste, and abuse at every stage of the claim process and reducing inappropriate payments. It connects existing payment integrity solutions and consolidates data from internal and external sources, such as claims systems, watch lists, third parties, and unstructured texts for efficient data management. It relies on various advanced analytic and artificial learning (AI) techniques, including modern statistical, machine learning (ML), deep learning, and text analytics algorithms. Apart from this, it uses a flexible process to assist operational, clinical, and investigative evaluations and store all relevant case information.

Healthcare Fraud Detection Market Trends:

Due to an increase in the number of patients seeking health insurance, there is a rise in the demand for healthcare fraud detection solutions. This, along with the growing prepayment review model in the healthcare industry, represents one of the key factors driving the market. Moreover, the increasing number of pharmacy claims-related frauds across the globe is propelling the growth of the market. In addition, there is a rise in the demand for solutions that have biometric sensors to identify frauds. This, coupled with the growing adoption of healthcare fraud analytics, especially in developing countries, is positively influencing the market. Besides this, the increasing integration of artificial intelligence (AI) in healthcare fraud detection is offering lucrative growth opportunities to industry investors. Apart from this, governments of several countries are undertaking initiatives to review healthcare insurance claims and save money of consumers and nations. In line with this, the burgeoning healthcare industry is bolstering the growth of the market. Other growth-inducing factors are the increasing returns on investment (ROI), rising use of social media, and funding for the implementation of several information and technology (IT) platforms.

Key Market Segmentation:

IMARC Group provides an analysis of the key trends in each sub-segment of the global healthcare fraud detection market report, along with forecasts at the global, regional and country level from 2024-2032. Our report has categorized the market based on component, type, delivery mode, application and end user.

Breakup by Component:

Software

Services

Breakup by Type:

Descriptive Analytics

Predictive Analytics

Prescriptive Analytics

Breakup by Delivery Mode:

On-premises

On-demand

Breakup by Application:

Insurance Claims Review

Payment Integrity

Breakup by End User:

Private Insurance Payers

Government Agencies

Others

Breakup by Region:

North America

United States

Canada

Asia-Pacific

China

Japan

India

South Korea

Australia

Indonesia

Others

Europe

Germany

France

United Kingdom

Italy

Spain

Russia

Others

Latin America

Brazil

Mexico

Others

Middle East and Africa

Competitive Landscape:

The competitive landscape of the industry has also been examined along with the profiles of the key players being CGI Inc., Conduent Inc., ExlService Holdings Inc., Fair Isaac Corporation, HCL Technologies Limited, International Business Machines Corporation, Northrop Grumman Corporation, RELX Group plc, SAS Institute Inc., UnitedHealth Group and Wipro Ltd.

Key Questions Answered in This Report:

How has the global healthcare fraud detection market performed so far and how will it perform in the coming years?
What has been the impact of COVID-19 on the global healthcare fraud detection market?
What are the key regional markets?
What is the breakup of the market based on the component?
What is the breakup of the market based on the type?
What is the breakup of the market based on the delivery mode?
What is the breakup of the market based on the application?
What is the breakup of the market based on the end user?
What are the various stages in the value chain of the industry?
What are the key driving factors and challenges in the industry?
What is the structure of the global healthcare fraud detection market and who are the key players?
What is the degree of competition in the industry?

1 Preface

2 Scope and Methodology

2.1 Objectives of the Study
2.2 Stakeholders
2.3 Data Sources
- 2.3.1 Primary Sources
- 2.3.2 Secondary Sources
2.4 Market Estimation
- 2.4.1 Bottom-Up Approach
- 2.4.2 Top-Down Approach
2.5 Forecasting Methodology

3 Executive Summary

4 Introduction

4.1 Overview
4.2 Key Industry Trends

5 Global Healthcare Fraud Detection Market

5.1 Market Overview
5.2 Market Performance
5.3 Impact of COVID-19
5.4 Market Forecast

6 Market Breakup by Component

6.1 Software
- 6.1.1 Market Trends
- 6.1.2 Market Forecast
6.2 Services
- 6.2.1 Market Trends
- 6.2.2 Market Forecast

7 Market Breakup by Type

7.1 Descriptive Analytics
- 7.1.1 Market Trends
- 7.1.2 Market Forecast
7.2 Predictive Analytics
- 7.2.1 Market Trends
- 7.2.2 Market Forecast
7.3 Prescriptive Analytics
- 7.3.1 Market Trends
- 7.3.2 Market Forecast

8 Market Breakup by Delivery Mode

8.1 On-premises
- 8.1.1 Market Trends
- 8.1.2 Market Forecast
8.2 On-demand
- 8.2.1 Market Trends
- 8.2.2 Market Forecast

9 Market Breakup by Application

9.1 Insurance Claims Review
- 9.1.1 Market Trends
- 9.1.2 Market Forecast
9.2 Payment Integrity
- 9.2.1 Market Trends
- 9.2.2 Market Forecast

10 Market Breakup by End User

10.1 Private Insurance Payers
- 10.1.1 Market Trends
- 10.1.2 Market Forecast
10.2 Government Agencies
- 10.2.1 Market Trends
- 10.2.2 Market Forecast
10.3 Others
- 10.3.1 Market Trends
- 10.3.2 Market Forecast

11 Market Breakup by Region

11.1 North America
- 11.1.1 United States
  - 11.1.1.1 Market Trends
  - 11.1.1.2 Market Forecast
- 11.1.2 Canada
  - 11.1.2.1 Market Trends
  - 11.1.2.2 Market Forecast
11.2 Asia-Pacific
- 11.2.1 China
  - 11.2.1.1 Market Trends
  - 11.2.1.2 Market Forecast
- 11.2.2 Japan
  - 11.2.2.1 Market Trends
  - 11.2.2.2 Market Forecast
- 11.2.3 India
  - 11.2.3.1 Market Trends
  - 11.2.3.2 Market Forecast
- 11.2.4 South Korea
  - 11.2.4.1 Market Trends
  - 11.2.4.2 Market Forecast
- 11.2.5 Australia
  - 11.2.5.1 Market Trends
  - 11.2.5.2 Market Forecast
- 11.2.6 Indonesia
  - 11.2.6.1 Market Trends
  - 11.2.6.2 Market Forecast
- 11.2.7 Others
  - 11.2.7.1 Market Trends
  - 11.2.7.2 Market Forecast
11.3 Europe
- 11.3.1 Germany
  - 11.3.1.1 Market Trends
  - 11.3.1.2 Market Forecast
- 11.3.2 France
  - 11.3.2.1 Market Trends
  - 11.3.2.2 Market Forecast
- 11.3.3 United Kingdom
  - 11.3.3.1 Market Trends
  - 11.3.3.2 Market Forecast
- 11.3.4 Italy
  - 11.3.4.1 Market Trends
  - 11.3.4.2 Market Forecast
- 11.3.5 Spain
  - 11.3.5.1 Market Trends
  - 11.3.5.2 Market Forecast
- 11.3.6 Russia
  - 11.3.6.1 Market Trends
  - 11.3.6.2 Market Forecast
- 11.3.7 Others
  - 11.3.7.1 Market Trends
  - 11.3.7.2 Market Forecast
11.4 Latin America
- 11.4.1 Brazil
  - 11.4.1.1 Market Trends
  - 11.4.1.2 Market Forecast
- 11.4.2 Mexico
  - 11.4.2.1 Market Trends
  - 11.4.2.2 Market Forecast
- 11.4.3 Others
  - 11.4.3.1 Market Trends
  - 11.4.3.2 Market Forecast
11.5 Middle East and Africa
- 11.5.1 Market Trends
- 11.5.2 Market Breakup by Country
- 11.5.3 Market Forecast

12 SWOT Analysis

12.1 Overview
12.2 Strengths
12.3 Weaknesses
12.4 Opportunities
12.5 Threats

13 Value Chain Analysis

14 Porters Five Forces Analysis

14.1 Overview
14.2 Bargaining Power of Buyers
14.3 Bargaining Power of Suppliers
14.4 Degree of Competition
14.5 Threat of New Entrants
14.6 Threat of Substitutes

15 Price Analysis

16 Competitive Landscape

16.1 Market Structure
16.2 Key Players
16.3 Profiles of Key Players
- 16.3.1 CGI Inc.
  - 16.3.1.1 Company Overview
  - 16.3.1.2 Product Portfolio
  - 16.3.1.3 Financials
  - 16.3.1.4 SWOT Analysis
- 16.3.2 Conduent Inc.
  - 16.3.2.1 Company Overview
  - 16.3.2.2 Product Portfolio
  - 16.3.2.3 Financials
  - 16.3.2.4 SWOT Analysis
- 16.3.3 ExlService Holdings Inc.
  - 16.3.3.1 Company Overview
  - 16.3.3.2 Product Portfolio
  - 16.3.3.3 Financials
- 16.3.4 Fair Isaac Corporation
  - 16.3.4.1 Company Overview
  - 16.3.4.2 Product Portfolio
  - 16.3.4.3 Financials
  - 16.3.4.4 SWOT Analysis
- 16.3.5 HCL Technologies Limited
  - 16.3.5.1 Company Overview
  - 16.3.5.2 Product Portfolio
  - 16.3.5.3 Financials
  - 16.3.5.4 SWOT Analysis
- 16.3.6 International Business Machines Corporation
  - 16.3.6.1 Company Overview
  - 16.3.6.2 Product Portfolio
  - 16.3.6.3 Financials
- 16.3.7 Northrop Grumman Corporation
  - 16.3.7.1 Company Overview
  - 16.3.7.2 Product Portfolio
  - 16.3.7.3 Financials
  - 16.3.7.4 SWOT Analysis
- 16.3.8 RELX Group plc
  - 16.3.8.1 Company Overview
  - 16.3.8.2 Product Portfolio
  - 16.3.8.3 Financials
  - 16.3.8.4 SWOT Analysis
- 16.3.9 SAS Institute Inc.
  - 16.3.9.1 Company Overview
  - 16.3.9.2 Product Portfolio
  - 16.3.9.3 SWOT Analysis
- 16.3.10 UnitedHealth Group
  - 16.3.10.1 Company Overview
  - 16.3.10.2 Product Portfolio
  - 16.3.10.3 Financials
  - 16.3.10.4 SWOT Analysis
- 16.3.11 Wipro Ltd.
  - 16.3.11.1 Company Overview
  - 16.3.11.2 Product Portfolio
  - 16.3.11.3 Financials

簡介目錄圖表

List of Figures

Figure 1: Global: Healthcare Fraud Detection Market: Major Drivers and Challenges
Figure 2: Global: Healthcare Fraud Detection Market: Sales Value (in Billion US$), 2018-2023
Figure 3: Global: Healthcare Fraud Detection Market Forecast: Sales Value (in Billion US$), 2024-2032
Figure 4: Global: Healthcare Fraud Detection Market: Breakup by Component (in %), 2023
Figure 5: Global: Healthcare Fraud Detection Market: Breakup by Type (in %), 2023
Figure 6: Global: Healthcare Fraud Detection Market: Breakup by Delivery Mode (in %), 2023
Figure 7: Global: Healthcare Fraud Detection Market: Breakup by Application (in %), 2023
Figure 8: Global: Healthcare Fraud Detection Market: Breakup by End User (in %), 2023
Figure 9: Global: Healthcare Fraud Detection Market: Breakup by Region (in %), 2023
Figure 10: Global: Healthcare Fraud Detection (Software) Market: Sales Value (in Million US$), 2018 & 2023
Figure 11: Global: Healthcare Fraud Detection (Software) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 12: Global: Healthcare Fraud Detection (Services) Market: Sales Value (in Million US$), 2018 & 2023
Figure 13: Global: Healthcare Fraud Detection (Services) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 14: Global: Healthcare Fraud Detection (Descriptive Analytics) Market: Sales Value (in Million US$), 2018 & 2023
Figure 15: Global: Healthcare Fraud Detection (Descriptive Analytics) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 16: Global: Healthcare Fraud Detection (Predictive Analytics) Market: Sales Value (in Million US$), 2018 & 2023
Figure 17: Global: Healthcare Fraud Detection (Predictive Analytics) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 18: Global: Healthcare Fraud Detection (Prescriptive Analytics) Market: Sales Value (in Million US$), 2018 & 2023
Figure 19: Global: Healthcare Fraud Detection (Prescriptive Analytics) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 20: Global: Healthcare Fraud Detection (On-premises) Market: Sales Value (in Million US$), 2018 & 2023
Figure 21: Global: Healthcare Fraud Detection (On-premises) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 22: Global: Healthcare Fraud Detection (On-demand) Market: Sales Value (in Million US$), 2018 & 2023
Figure 23: Global: Healthcare Fraud Detection (On-demand) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 24: Global: Healthcare Fraud Detection (Insurance Claims Review) Market: Sales Value (in Million US$), 2018 & 2023
Figure 25: Global: Healthcare Fraud Detection (Insurance Claims Review) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 26: Global: Healthcare Fraud Detection (Payment Integrity) Market: Sales Value (in Million US$), 2018 & 2023
Figure 27: Global: Healthcare Fraud Detection (Payment Integrity) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 28: Global: Healthcare Fraud Detection (Private Insurance Payers) Market: Sales Value (in Million US$), 2018 & 2023
Figure 29: Global: Healthcare Fraud Detection (Private Insurance Payers) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 30: Global: Healthcare Fraud Detection (Government Agencies) Market: Sales Value (in Million US$), 2018 & 2023
Figure 31: Global: Healthcare Fraud Detection (Government Agencies) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 32: Global: Healthcare Fraud Detection (Other End Users) Market: Sales Value (in Million US$), 2018 & 2023
Figure 33: Global: Healthcare Fraud Detection (Other End Users) Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 34: North America: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 35: North America: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 36: United States: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 37: United States: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 38: Canada: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 39: Canada: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 40: Asia-Pacific: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 41: Asia-Pacific: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 42: China: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 43: China: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 44: Japan: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 45: Japan: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 46: India: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 47: India: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 48: South Korea: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 49: South Korea: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 50: Australia: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 51: Australia: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 52: Indonesia: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 53: Indonesia: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 54: Others: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 55: Others: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 56: Europe: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 57: Europe: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 58: Germany: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 59: Germany: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 60: France: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 61: France: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 62: United Kingdom: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 63: United Kingdom: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 64: Italy: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 65: Italy: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 66: Spain: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 67: Spain: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 68: Russia: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 69: Russia: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 70: Others: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 71: Others: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 72: Latin America: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 73: Latin America: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 74: Brazil: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 75: Brazil: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 76: Mexico: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 77: Mexico: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 78: Others: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 79: Others: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 80: Middle East and Africa: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2018 & 2023
Figure 81: Middle East and Africa: Healthcare Fraud Detection Market: Breakup by Country (in %), 2023
Figure 82: Middle East and Africa: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2024-2032
Figure 83: Global: Healthcare Fraud Detection Industry: SWOT Analysis
Figure 84: Global: Healthcare Fraud Detection Industry: Value Chain Analysis
Figure 85: Global: Healthcare Fraud Detection Industry: Porter's Five Forces Analysis

List of Tables

Table 1: Global: Healthcare Fraud Detection Market: Key Industry Highlights, 2023 and 2032
Table 2: Global: Healthcare Fraud Detection Market Forecast: Breakup by Component (in Million US$), 2024-2032
Table 3: Global: Healthcare Fraud Detection Market Forecast: Breakup by Type (in Million US$), 2024-2032
Table 4: Global: Healthcare Fraud Detection Market Forecast: Breakup by Delivery Mode (in Million US$), 2024-2032
Table 5: Global: Healthcare Fraud Detection Market Forecast: Breakup by Application (in Million US$), 2024-2032
Table 6: Global: Healthcare Fraud Detection Market Forecast: Breakup by End User (in Million US$), 2024-2032
Table 7: Global: Healthcare Fraud Detection Market Forecast: Breakup by Region (in Million US$), 2024-2032
Table 8: Global: Healthcare Fraud Detection Market: Competitive Structure
Table 9: Global: Healthcare Fraud Detection Market: Key Players

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