Healthcare Fraud Analytics Market: Role of Artificial Intelligence in Healthcare Fraud Detection

PUNE, India, 2020-May-01 — /EPR Network/ —

The large number of fraudulent activities in healthcare; the increasing number of patients seeking health insurance; high returns on investment; and rising pharmacy claim-related frauds. However, the dearth of skilled personnel is likely to restrain the growth of this market.

The report “Healthcare Fraud Analytics Market by Solution Type (Descriptive, Predictive, Prescriptive), Application (Insurance Claim (Postpayment, Prepayment), Payment Integrity), Delivery (On-premise, Cloud), End User (Insurance, Government) – Global Forecast to 2025“, is projected to reach USD 4.6 billion by 2025 from USD 1.2 billion in 2020, at a CAGR of 29.8% during the forecast period. The growth of this market is mainly due to a rise in the number of fraudulent activities in healthcare, combined with the increasing number of patients seeking medical insurance and rising pharmacy claim-related frauds. Emerging markets like APAC and Latin America provide significant growth opportunities in this market.

How are the fraud analytics solutions defined for the study?

For the purpose of this study, we have considered those solutions that effectively use data analytics and related business insights using statistical, predictive, and cognitive models to detecting frauds. These solutions are predominantly deployed by payer organizations for fraud detection and prevention. Solutions that use bio-metric sensors to capture frauds are not covered under the study.

What type of analytics is expected to grow in the fraud analysis market in the coming years?

The Healthcare Fraud Analytics market is segmented into descriptive, predictive and prescriptive analytics, on the basis of solution type. While the current scenario suggests higher utilization of descriptive analytics, prescriptive analytics shall provide ample opportunities to the payer organizations in the future. As the data trend is shifting from structured to semi-structured and un-structured data, the use of prescriptive analytics for accurate prediction and analysis is expected to increase.

Download PDF Brochure @

Name some of the companies that offer innovative healthcare fraud analytics solutions.

Use of Artificial Intelligence, Machine Learning, and block-chain technology enhances the capabilities of fraud detection and helps tackle common and challenging issues in fraud detection such as incorrect billing, up-coding a procedure and kickbacks and corruption that take place while committing frauds. Some of the companies offering innovative solutions in this space include Fair Issac, SAS Institute, IBM Watson Health, SecureKey Technologies, Nuco, Friss, and

Who are the top players of this market and what growth strategies are they adopting to sustain their presence in their market?

The healthcare fraud analytics market is moving towards consolidation, with only a handful of players garnering more than 50% of the market. Along with technological advancements, majority of players are adopting inorganic growth strategies such as mergers and acquisitions, and creating joint ventures. This major players of this market are IBM, Optum, and Cotiviti Holdings.

Which geographical region is expected to grow at the highest rate in the Healthcare Fraud Analytics Market?

While North America dominates the Healthcare Fraud Analytics market, regions like Europe and Asia Pacific show suitable growth opportunities in this field in the coming years.

Get More Information @


Matched content

Editor’s pick

Express Press Release Distribution