Healthcare Fraud Analytics Market

IBM Corporation (US) and Optum (US) are Leading Players in the Healthcare Fraud Analytics Market

The healthcare fraud analytics market 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 emergence of social network analytics, adoption of technologies such as AI and blockchain, and the use of healthcare analytics for fraud detection in emerging nations like the APAC and Latin America will provide growth opportunities in this market. However, the time-consuming deployment of these solutions and the need for frequent updates are some challenges faced by end users in this market.

Some of the top players competing in this market are International Business Machines Corporation (IBM) (US), Optum (US), SAS Institute (US), Change Healthcare (US), EXLService Holdings (US), and Cotiviti (US).

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IBM Corporation (US) was the leading player in the healthcare fraud analytics market in 2018. The company provides a wide range of healthcare fraud detection products in the market. IBM has a strong presence in the commercial and government healthcare payer markets. Moreover, it has a strong sales and distribution network in more than 175 countries. In order to maintain its leading position in the market, the company focuses on inorganic strategies such as acquisitions and partnerships. IBM acquired Red Hat, the leading provider of enterprise and open source solutions, to complement its cloud platform. Since the demand for cloud services in healthcare fraud detection is on the rise, this acquisition has significantly helped the company in targeting new customers and expanding its growth as a leading provider of cloud services in the insurance sector.

Optum (US) is one of the leading players in the healthcare payment integrity services market, a market that directly impacts the volume of fraud analytics in healthcare. In order to leverage growth opportunities in the healthcare fraud detection market, the company has focused on inorganic growth strategies in the past. This includes its collaboration with other top players such as the SAS Institute and companies like Availity LLC, to improve its accuracy in fraud detection and reduce claim-processing errors. At present, Optum is focusing on emerging countries such as India, with the introduction of its solutions in the Indian market.

Related Reports:

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

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Report Code
HIT 5868
RI Published ON
1/28/2020
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