The Global Healthcare Fraud Analytics Market is projected to reach $7.30 billion by 2028, from a value of $1.94 billion in 2022, by registering a CAGR of 24.7% during the forecast period. Increasing pharmacy claims-related fraud, rising health-related expenditure, and increased number of patients seeking health insurance are the major factors propelling the growth of the market. However, a lack in the data capturing process in Medicaid services is hampering the market growth. Moreover, the integration of Artificial Intelligence for better performance is creating ample opportunities across the globe.
Recent Developments
In Nov 2020, Centene Corporation acquired Apixio, Inc to bolster Centenes predictive analytics capabilities, and unstructured data analysis and help in developing algorithms that provide appropriate insights and solutions. It will also help Centene to improve its value-based healthcare payment mechanism.
In Sep 2020, ClarisHealth launched its comprehensive payment integrity technology platform Pareo®. Pareo Fraud Detection works seamlessly with Pareo Fraud Case Management for an integrated, 360-degree approach to mitigating fraud, waste and abuse (FWA). Pareo® Fraud Detection leverages artificial intelligence with healthcare FWA expertise to help the SIU identify fraudulent behavior of providers.
In July 2020, SAS Institute partnered with National Health Authority (NHA), NHA is responsible for implementing Indias flagship public health insurance/assurance scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. This partnership aimed to aid check abuse and fraud in the execution structure of the Ayushman Bharat Pradhan Mantri Jan Arogya Yojna (AB PM-JAY) scheme.
In Jan 2019, LexisNexis collaborated with QuadraMed to improve patient matching for QuadraMeds Enterprise Master Patient Index (EMPI) software and clean-up customers at over 1,200 healthcare facilities.
Competitive Landscape
Cotiviti Holdings, Inc., Wipro Limited, SAS Institute, Conduent Inc., Northrop Grumman Corporation, LexisNexis, International Business Machines Corporation (IBM), CGI Inc., HCL Technologies Limited, FraudScope, Inc., ClarisHealth, DXC Technology Co, Pondera Solutions, LLC, Centene Corporation, and ExlService Holdings, Inc. are some of the major players in the global Healthcare Fraud Analytics market.
