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CGI Inc.
Change Healthcare Inc.
Conduent Inc.
Cotiviti Inc.
ExlService Holdings Inc.
Fair Isaac Corp.
H2O.ai Inc.
HCL Technologies Ltd.
Healthcare Fraud Shield
International Business Machines Corp.
Optum Inc.
Qlarant Quality Solutions Inc.
SAS Institute Inc.
Thomson Reuters Corp.
Wipro Ltd.
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LSH
The healthcare fraud detection market is forecasted to grow by USD 1,092.1 mn during 2024-2029, accelerating at a CAGR of 11.8% during the forecast period. The report on the healthcare fraud detection market provides a holistic analysis, market size and forecast, trends, growth drivers, and challenges, as well as vendor analysis covering around 25 vendors.
The report offers an up-to-date analysis regarding the current market scenario, the latest trends and drivers, and the overall market environment. The market is driven by increased number of patients seeking health insurance, increasing cases of healthcare fraud, and rise in number of health care bpo and fraud identity management software.
Market Scope
Base Year 2025
End Year 2029
Series Year 2025-2029
Growth Momentum Accelerate
YOY 2025 10.3%
CAGR 11.8%
Incremental Value $1,092.1 mn
The study was conducted using an objective combination of primary and secondary information including inputs from key participants in the industry. The report contains a comprehensive market size data, segment with regional analysis and vendor landscape in addition to an analysis of the key companies. Reports have historic and forecast data.
Technavio's healthcare fraud detection market is segmented as below:
By Type
Descriptive analytics
Predictive analytics
Prescriptive analytics
By End-user
Private insurance payers
Third-party administrators (TPAs)
Government agencies
Hospitals and healthcare providers
By Delivery Mode
By Geographical Landscape
North America
Asia
Europe
Rest of World (ROW)
This study identifies the emergence of social media and its impact on healthcare industry as one of the prime reasons driving the healthcare fraud detection market growth during the next few years. Also, increasing favorable government initiatives and increase in cloud-based solutions for fraud detection will lead to sizable demand in the market.
The report on the healthcare fraud detection market covers the following areas:
Healthcare Fraud Detection Market sizing
Healthcare Fraud Detection Market forecast
Healthcare Fraud Detection Market industry analysis
The robust vendor analysis is designed to help clients improve their market position, and in line with this, this report provides a detailed analysis of several leading healthcare fraud detection market vendors that include CGI Inc., Change Healthcare Inc., Codoxo, Conduent Inc., Cotiviti Inc., ExlService Holdings Inc., Fair Isaac Corp., FraudLens, H2O.ai Inc., HCL Technologies Ltd., Healthcare Fraud Shield, International Business Machines Corp., Optum Inc., OSP, Qlarant Quality Solutions Inc., SAS Institute Inc., Thomson Reuters Corp., and Wipro Ltd.. Also, the healthcare fraud detection market analysis report includes information on upcoming trends and challenges that will influence market growth. This is to help companies strategize and leverage all forthcoming growth opportunities.
The publisher presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters such as profit, pricing, competition, and promotions. It presents various market facets by identifying the key industry influencers. The data presented is comprehensive, reliable, and a result of extensive primary and secondary research. The market research reports provide a complete competitive landscape and an in-depth vendor selection methodology and analysis using qualitative and quantitative research to forecast accurate market growth.
Table of Contents
1 Executive Summary
1.1 Market overview
Executive Summary - Chart on Market Overview
Executive Summary - Data Table on Market Overview
Executive Summary - Chart on Global Market Characteristics
Executive Summary - Chart on Market By Geographical Landscape
Executive Summary - Chart on Market Segmentation by Type
Executive Summary - Chart on Market Segmentation by End-user
Executive Summary - Chart on Market Segmentation by Delivery Mode
Executive Summary - Chart on Incremental Growth
Executive Summary - Data Table on Incremental Growth
Executive Summary - Chart on Company Market Positioning
2 Technavio Analysis
2.1 Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
2.2 Criticality of inputs and Factors of differentiation
Overview on criticality of inputs and factors of differentiation
2.3 Factors of disruption
Overview on factors of disruption
2.4 Impact of drivers and challenges
Impact of drivers and challenges in 2024 and 2029
3 Market Landscape
3.1 Market ecosystem
Parent Market
Data Table on - Parent Market
3.2 Market characteristics
Market characteristics analysis
3.3 Value chain analysis
4 Market Sizing
4.1 Market definition
Offerings of companies included in the market definition
4.2 Market segment analysis
4.3 Market size 2024
4.4 Market outlook: Forecast for 2024-2029
Chart on Global - Market size and forecast 2024-2029 ($ million)
Data Table on Global - Market size and forecast 2024-2029 ($ million)
Chart on Global Market: Year-over-year growth 2024-2029 (%)
Data Table on Global Market: Year-over-year growth 2024-2029 (%)
5 Historic Market Size
5.1 Global Healthcare Fraud Detection Market 2019 - 2023
Historic Market Size - Data Table on Global Healthcare Fraud Detection Market 2019 - 2023 ($ million)
5.2 Type segment analysis 2019 - 2023
Historic Market Size - Type Segment 2019 - 2023 ($ million)
5.3 End-user segment analysis 2019 - 2023
Historic Market Size - End-user Segment 2019 - 2023 ($ million)
5.4 Delivery Mode segment analysis 2019 - 2023
Historic Market Size - Delivery Mode Segment 2019 - 2023 ($ million)
5.5 Geography segment analysis 2019 - 2023
Historic Market Size - Geography Segment 2019 - 2023 ($ million)
5.6 Country segment analysis 2019 - 2023
Historic Market Size - Country Segment 2019 - 2023 ($ million)
6 Qualitative Analysis
6.1 The AI impact on Global Healthcare Fraud Detection Market
7 Five Forces Analysis
7.1 Five forces summary
Five forces analysis - Comparison between 2024 and 2029
7.2 Bargaining power of buyers
Bargaining power of buyers - Impact of key factors 2024 and 2029
7.3 Bargaining power of suppliers
Bargaining power of suppliers - Impact of key factors in 2024 and 2029
7.4 Threat of new entrants
Threat of new entrants - Impact of key factors in 2024 and 2029
7.5 Threat of substitutes
Threat of substitutes - Impact of key factors in 2024 and 2029
7.6 Threat of rivalry
Threat of rivalry - Impact of key factors in 2024 and 2029
7.7 Market condition
Chart on Market condition - Five forces 2024 and 2029
8 Market Segmentation by Type
8.1 Market segments
Chart on Type - Market share 2024-2029 (%)
Data Table on Type - Market share 2024-2029 (%)
8.2 Comparison by Type
Chart on Comparison by Type
Data Table on Comparison by Type
8.3 Descriptive analytics - Market size and forecast 2024-2029
Chart on Descriptive analytics - Market size and forecast 2024-2029 ($ million)
Data Table on Descriptive analytics - Market size and forecast 2024-2029 ($ million)
Chart on Descriptive analytics - Year-over-year growth 2024-2029 (%)
Data Table on Descriptive analytics - Year-over-year growth 2024-2029 (%)
8.4 Predictive analytics - Market size and forecast 2024-2029
Chart on Predictive analytics - Market size and forecast 2024-2029 ($ million)
Data Table on Predictive analytics - Market size and forecast 2024-2029 ($ million)
Chart on Predictive analytics - Year-over-year growth 2024-2029 (%)
Data Table on Predictive analytics - Year-over-year growth 2024-2029 (%)
8.5 Prescriptive analytics - Market size and forecast 2024-2029
Chart on Prescriptive analytics - Market size and forecast 2024-2029 ($ million)
Data Table on Prescriptive analytics - Market size and forecast 2024-2029 ($ million)
Chart on Prescriptive analytics - Year-over-year growth 2024-2029 (%)
Data Table on Prescriptive analytics - Year-over-year growth 2024-2029 (%)
8.6 Market opportunity by Type
Market opportunity by Type ($ million)
Data Table on Market opportunity by Type ($ million)
9 Market Segmentation by End-user
9.1 Market segments
Chart on End-user - Market share 2024-2029 (%)
Data Table on End-user - Market share 2024-2029 (%)
9.2 Comparison by End-user
Chart on Comparison by End-user
Data Table on Comparison by End-user
9.3 Private insurance payers - Market size and forecast 2024-2029
Chart on Private insurance payers - Market size and forecast 2024-2029 ($ million)
Data Table on Private insurance payers - Market size and forecast 2024-2029 ($ million)
Chart on Private insurance payers - Year-over-year growth 2024-2029 (%)
Data Table on Private insurance payers - Year-over-year growth 2024-2029 (%)
9.4 Third-party administrators (TPAs) - Market size and forecast 2024-2029
Chart on Third-party administrators (TPAs) - Market size and forecast 2024-2029 ($ million)
Data Table on Third-party administrators (TPAs) - Market size and forecast 2024-2029 ($ million)
Chart on Third-party administrators (TPAs) - Year-over-year growth 2024-2029 (%)
Data Table on Third-party administrators (TPAs) - Year-over-year growth 2024-2029 (%)
9.5 Government agencies - Market size and forecast 2024-2029
Chart on Government agencies - Market size and forecast 2024-2029 ($ million)
Data Table on Government agencies - Market size and forecast 2024-2029 ($ million)
Chart on Government agencies - Year-over-year growth 2024-2029 (%)
Data Table on Government agencies - Year-over-year growth 2024-2029 (%)
9.6 Hospitals and healthcare providers - Market size and forecast 2024-2029
Chart on Hospitals and healthcare providers - Market size and forecast 2024-2029 ($ million)
Data Table on Hospitals and healthcare providers - Market size and forecast 2024-2029 ($ million)
Chart on Hospitals and healthcare providers - Year-over-year growth 2024-2029 (%)
Data Table on Hospitals and healthcare providers - Year-over-year growth 2024-2029 (%)
9.7 Market opportunity by End-user
Market opportunity by End-user ($ million)
Data Table on Market opportunity by End-user ($ million)
10 Market Segmentation by Delivery Mode
10.1 Market segments
Chart on Delivery Mode - Market share 2024-2029 (%)
Data Table on Delivery Mode - Market share 2024-2029 (%)
10.2 Comparison by Delivery Mode
Chart on Comparison by Delivery Mode
Data Table on Comparison by Delivery Mode
10.3 Cloud-based - Market size and forecast 2024-2029
Chart on Cloud-based - Market size and forecast 2024-2029 ($ million)
Data Table on Cloud-based - Market size and forecast 2024-2029 ($ million)
Chart on Cloud-based - Year-over-year growth 2024-2029 (%)
Data Table on Cloud-based - Year-over-year growth 2024-2029 (%)
10.4 On-premises - Market size and forecast 2024-2029
Chart on On-premises - Market size and forecast 2024-2029 ($ million)
Data Table on On-premises - Market size and forecast 2024-2029 ($ million)
Chart on On-premises - Year-over-year growth 2024-2029 (%)
Data Table on On-premises - Year-over-year growth 2024-2029 (%)
10.5 Market opportunity by Delivery Mode
Market opportunity by Delivery Mode ($ million)
Data Table on Market opportunity by Delivery Mode ($ million)
11 Customer Landscape
11.1 Customer landscape overview
Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
12 Geographic Landscape
12.1 Geographic segmentation
Chart on Market share By Geographical Landscape 2024-2029 (%)
Data Table on Market share By Geographical Landscape 2024-2029 (%)
12.2 Geographic comparison
Chart on Geographic comparison
Data Table on Geographic comparison
12.3 North America - Market size and forecast 2024-2029
Chart on North America - Market size and forecast 2024-2029 ($ million)
Data Table on North America - Market size and forecast 2024-2029 ($ million)
Chart on North America - Year-over-year growth 2024-2029 (%)
Data Table on North America - Year-over-year growth 2024-2029 (%)
12.4 Asia - Market size and forecast 2024-2029
Chart on Asia - Market size and forecast 2024-2029 ($ million)
Data Table on Asia - Market size and forecast 2024-2029 ($ million)
Chart on Asia - Year-over-year growth 2024-2029 (%)
Data Table on Asia - Year-over-year growth 2024-2029 (%)
12.5 Europe - Market size and forecast 2024-2029
Chart on Europe - Market size and forecast 2024-2029 ($ million)
Data Table on Europe - Market size and forecast 2024-2029 ($ million)
Chart on Europe - Year-over-year growth 2024-2029 (%)
Data Table on Europe - Year-over-year growth 2024-2029 (%)
12.6 Rest of World (ROW) - Market size and forecast 2024-2029
Chart on Rest of World (ROW) - Market size and forecast 2024-2029 ($ million)
Data Table on Rest of World (ROW) - Market size and forecast 2024-2029 ($ million)
Chart on Rest of World (ROW) - Year-over-year growth 2024-2029 (%)
Data Table on Rest of World (ROW) - Year-over-year growth 2024-2029 (%)
12.7 US - Market size and forecast 2024-2029
Chart on US - Market size and forecast 2024-2029 ($ million)
Data Table on US - Market size and forecast 2024-2029 ($ million)
Chart on US - Year-over-year growth 2024-2029 (%)
Data Table on US - Year-over-year growth 2024-2029 (%)
12.8 Canada - Market size and forecast 2024-2029
Chart on Canada - Market size and forecast 2024-2029 ($ million)
Data Table on Canada - Market size and forecast 2024-2029 ($ million)
Chart on Canada - Year-over-year growth 2024-2029 (%)
Data Table on Canada - Year-over-year growth 2024-2029 (%)
12.9 China - Market size and forecast 2024-2029
Chart on China - Market size and forecast 2024-2029 ($ million)
Data Table on China - Market size and forecast 2024-2029 ($ million)
Chart on China - Year-over-year growth 2024-2029 (%)
Data Table on China - Year-over-year growth 2024-2029 (%)
12.10 Mexico - Market size and forecast 2024-2029
Chart on Mexico - Market size and forecast 2024-2029 ($ million)
Data Table on Mexico - Market size and forecast 2024-2029 ($ million)
Chart on Mexico - Year-over-year growth 2024-2029 (%)
Data Table on Mexico - Year-over-year growth 2024-2029 (%)
12.11 Germany - Market size and forecast 2024-2029
Chart on Germany - Market size and forecast 2024-2029 ($ million)
Data Table on Germany - Market size and forecast 2024-2029 ($ million)
Chart on Germany - Year-over-year growth 2024-2029 (%)
Data Table on Germany - Year-over-year growth 2024-2029 (%)
12.12 India - Market size and forecast 2024-2029
Chart on India - Market size and forecast 2024-2029 ($ million)
Data Table on India - Market size and forecast 2024-2029 ($ million)
Chart on India - Year-over-year growth 2024-2029 (%)
Data Table on India - Year-over-year growth 2024-2029 (%)
12.13 UK - Market size and forecast 2024-2029
Chart on UK - Market size and forecast 2024-2029 ($ million)
Data Table on UK - Market size and forecast 2024-2029 ($ million)
Chart on UK - Year-over-year growth 2024-2029 (%)
Data Table on UK - Year-over-year growth 2024-2029 (%)
12.14 Brazil - Market size and forecast 2024-2029
Chart on Brazil - Market size and forecast 2024-2029 ($ million)
Data Table on Brazil - Market size and forecast 2024-2029 ($ million)
Chart on Brazil - Year-over-year growth 2024-2029 (%)
Data Table on Brazil - Year-over-year growth 2024-2029 (%)
12.15 Japan - Market size and forecast 2024-2029
Chart on Japan - Market size and forecast 2024-2029 ($ million)
Data Table on Japan - Market size and forecast 2024-2029 ($ million)
Chart on Japan - Year-over-year growth 2024-2029 (%)
Data Table on Japan - Year-over-year growth 2024-2029 (%)
12.16 France - Market size and forecast 2024-2029
Chart on France - Market size and forecast 2024-2029 ($ million)
Data Table on France - Market size and forecast 2024-2029 ($ million)
Chart on France - Year-over-year growth 2024-2029 (%)
Data Table on France - Year-over-year growth 2024-2029 (%)
12.17 Market opportunity By Geographical Landscape
Market opportunity By Geographical Landscape ($ million)
Data Tables on Market opportunity By Geographical Landscape ($ million)
13 Drivers, Challenges, and Opportunity/Restraints
13.1 Market drivers
13.2 Market challenges
13.3 Impact of drivers and challenges
Impact of drivers and challenges in 2024 and 2029
13.4 Market opportunities/restraints
14 Competitive Landscape
14.1 Overview
14.2 Competitive Landscape
Overview on criticality of inputs and factors of differentiation
14.3 Landscape disruption
Overview on factors of disruption
14.4 Industry risks
Impact of key risks on business
15 Competitive Analysis
15.1 Companies profiled
15.2 Company ranking index
15.3 Market positioning of companies
Matrix on companies position and classification
15.4 CGI Inc.
CGI Inc. - Overview
CGI Inc. - Business segments
CGI Inc. - Key news
CGI Inc. - Key offerings
CGI Inc. - Segment focus
SWOT
15.5 Change Healthcare Inc.
Change Healthcare Inc. - Overview
Change Healthcare Inc. - Product / Service
Change Healthcare Inc. - Key offerings
SWOT
15.6 Conduent Inc.
Conduent Inc. - Overview
Conduent Inc. - Business segments
Conduent Inc. - Key offerings
Conduent Inc. - Segment focus
SWOT
15.7 Cotiviti Inc.
Cotiviti Inc. - Overview
Cotiviti Inc. - Product / Service
Cotiviti Inc. - Key offerings
SWOT
15.8 ExlService Holdings Inc.
ExlService Holdings Inc. - Overview
ExlService Holdings Inc. - Business segments
ExlService Holdings Inc. - Key offerings
ExlService Holdings Inc. - Segment focus
SWOT
15.9 Fair Isaac Corp.
Fair Isaac Corp. - Overview
Fair Isaac Corp. - Business segments
Fair Isaac Corp. - Key news
Fair Isaac Corp. - Key offerings
Fair Isaac Corp. - Segment focus
SWOT
15.10 H2O.ai Inc.
H2O.ai Inc. - Overview
H2O.ai Inc. - Product / Service
H2O.ai Inc. - Key offerings
SWOT
15.11 HCL Technologies Ltd.
HCL Technologies Ltd. - Overview
HCL Technologies Ltd. - Business segments
HCL Technologies Ltd. - Key news
HCL Technologies Ltd. - Key offerings
HCL Technologies Ltd. - Segment focus
SWOT
15.12 Healthcare Fraud Shield
Healthcare Fraud Shield - Overview
Healthcare Fraud Shield - Product / Service
Healthcare Fraud Shield - Key offerings
SWOT
15.13 International Business Machines Corp.
International Business Machines Corp. - Overview
International Business Machines Corp. - Business segments
International Business Machines Corp. - Key news
International Business Machines Corp. - Key offerings
International Business Machines Corp. - Segment focus
SWOT
15.14 Optum Inc.
Optum Inc. - Overview
Optum Inc. - Product / Service
Optum Inc. - Key offerings
SWOT
15.15 Qlarant Quality Solutions Inc.
Qlarant Quality Solutions Inc. - Overview
Qlarant Quality Solutions Inc. - Product / Service
Qlarant Quality Solutions Inc. - Key offerings
SWOT
15.16 SAS Institute Inc.
SAS Institute Inc. - Overview
SAS Institute Inc. - Product / Service
SAS Institute Inc. - Key news
SAS Institute Inc. - Key offerings
SWOT
15.17 Thomson Reuters Corp.
Thomson Reuters Corp. - Overview
Thomson Reuters Corp. - Business segments
Thomson Reuters Corp. - Key news
Thomson Reuters Corp. - Key offerings
Thomson Reuters Corp. - Segment focus
SWOT
15.18 Wipro Ltd.
Wipro Ltd. - Overview
Wipro Ltd. - Business segments
Wipro Ltd. - Key news
Wipro Ltd. - Key offerings
Wipro Ltd. - Segment focus
SWOT
16 Appendix
16.1 Scope of the report
16.2 Inclusions and exclusions checklist
Inclusions checklist
Exclusions checklist
16.3 Currency conversion rates for US$
Currency conversion rates for US$
16.4 Research methodology
16.5 Data procurement
16.6 Data validation
16.7 Validation techniques employed for market sizing
Validation techniques employed for market sizing
16.8 Data synthesis
16.9 360 degree market analysis
360 degree market analysis
16.10 List of abbreviations