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1919677

医疗保健诈欺侦测管理市场：市场洞察、竞争格局及预测（2033 年）

Medical Fraud Detection Management Market Insights, Competitive Landscape, and Market Forecast - 2033
出版日期: | 出版商: Fairfield Market Research | 英文 200 Pages | 商品交期: 2-5个工作天内

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简介目录

随着医疗服务提供者、保险公司和政府机构日益重视诈欺侦测和预防，全球医疗保健诈欺侦测管理市场正经历快速成长。预计该市场将从 2026 年的 27 亿美元成长到 2033 年的 57 亿美元，预测期内复合年增长率 (CAGR) 为 11.40%。这一增长得益于人工智慧 (AI)、机器学习 (ML) 和云端运算等先进技术的日益普及，这些技术使机构能够分析大量医疗保健数据并有效率地侦测诈欺行为。

医疗保健欺诈，包括医疗保险索赔欺诈、医疗服务提供者欺诈、患者欺诈和药房欺诈，对医疗保健行业构成重大挑战。这些诈欺行为不仅造成巨大的经济损失，还会对病患照护和信任产生负面影响。先进的诈欺侦测管理解决方案使机构能够识别可疑索赔、主动评估风险并确保符合监管标准。

市场洞察

由于医疗保健营运日益复杂以及诈欺活动不断增多，医疗保健诈欺侦测管理市场正在迅速发展。各机构越来越多地利用数据驱动型解决方案来监控交易、分析行为模式并实施预防措施。

包括描述性分析、预测性分析和规范性分析在内的软体解决方案是诈欺侦测策略的核心。描述性分析有助于了解历史诈欺模式，预测性分析可以预测潜在的诈欺行为，而规范性分析则为风险缓解提供可操作的建议。除了软体之外，咨询、整合和託管服务等服务产品也有助于实施有效的诈欺管理策略。

由于云端解决方案具有可扩展性、成本效益以及易于与现有系统整合等优势，其应用趋势越来越倾向于云端解决方案。然而，对于那些具有严格资料安全要求和监管限制的机构而言，本地部署解决方案仍然至关重要。

市场驱动因素

推动医疗保健诈欺侦测管理市场成长的关键因素有很多。首先，全球医疗保健系统中诈欺行为的普遍存在，使得对先进的检测和预防工具的需求变得迫切。仅保险索赔诈欺每年就对该行业造成数十亿美元的损失，促使支付方和医疗服务提供者投资于自动化解决方案。

其次，人工智慧和机器学习技术的进步显着提高了诈欺侦测的准确性。预测模型可以识别索赔和医疗服务提供者行为中的异常情况，而指导性解决方案则为风险缓解和流程改进提供建议。

第三，日益严格的监管审查和合规要求迫使各机构实施全面的诈欺侦测系统。世界各地的医疗保健机构正在製定严格的指导方针，旨在最大限度地减少经济损失、确保透明度并维护患者的信任。

最后，医疗保健营运的日益数位化，包括电子健康记录 (EHR) 和自动化理赔​​处理，正在促进即时诈欺监控。数位系统能够实现无缝数据分析，从而及早发现可疑活动并及时介入。

商机

医疗保健诈欺侦测管理市场为技术提供者、保险公司和医疗机构提供了庞大的商机。提供人工智慧驱动的分析、云端平台和託管服务的公司可以抓住不断增长的市场需求。

此外，提供将诈欺侦测与合规管理、风险评估和收款结合的解决方案也具有潜力。此类综合平台可以帮助机构降低营运复杂性并提高效率。

技术提供者、保险公司和医疗机构之间的策略联盟可望扩大这些解决方案的覆盖范围和应用。此外，对成本控制、预防性护理和营运透明度的日益重视，也为满足不断变化的市场需求的创新服务产品创造了机会。

区域分析

北美预计将引领市场，这主要得益于其医疗保健诈欺的高发生率、健全的监管框架以及对先进技术的早期应用。该地区主要技术供应商和保险公司的存在将进一步推动市场成长。

在政府措施和数位化医疗普及的推动下，欧洲预计将保持稳定成长，从而带动对诈欺侦测解决方案的需求。亚太地区由于医疗保健成本上升、保险覆盖范围扩大以及人工智慧驱动解决方案的日益普及，被定位为高成长地区。

拉丁美洲和中东及非洲是新兴市场，这些地区的机构正在采用诈欺侦测管理系统来提高支付完整性并减少财务损失。人们对医疗保健诈欺的认识不断提高以及数位化程度的提高是推动这些地区市场扩张的关键因素。

主要公司

全球医疗保健诈欺侦测管理市场竞争激烈，多家成熟公司提供先进的解决方案和服务。主要参与公司包括：

  • IBM 公司（IBM Watson Health/IBM Analytics）
  • SAS Institute Inc.
  • Oracle 公司
  • Microsoft 公司
  • Optum, Inc.（联合健康集团）
  • McKesson 公司
  • Change Healthcare（联合健康集团旗下公司）
  • Verisk Health（Verisk Analytics）
  • Cognizant Technology Solutions
  • HCL Technologies
  • 埃森哲公司
  • DXC Technology
  • FICO（Fair Isaac 公司）
  • Experian Health
  • Cerner 公司

这些公司致力于人工智慧、机器学习、预测分析和云端平台领域的创新，以巩固其市场地位，并满足日益增长的高效诈欺侦测需求。

市场区隔

全球医疗保健诈欺侦测管理市场细分如下：

按组件：

  • 软体
  • 服务

依解决方案类型：

  • 描述性分析
  • 预测性分析
  • 规范分析

依部署模式：

  • 云端部署
  • 本地部署

按诈欺类型：

  • 保险索赔欺诈
  • 医疗服务提供者欺诈
  • 病患诈欺
  • 药局诈欺

按最终用户用户：

  • 公私保险支付方
  • 医疗服务提供者
  • 第三方管理机构 (TPA)
  • 政府机构

依应用领域：

  • 理赔审核与预付款审计
  • 付款充足性和收款
  • 风险评估与合规性

依地区：

  • 北美
  • 欧洲
  • 亚太地区
  • 拉丁美洲
  • 中东和非洲

目录

第一章 执行摘要

第二章：市场概览

  • 市场定义与市场区隔
  • 市场动态
  • 价值链分析
  • 新冠疫情影响分析
  • 波特五力分析
  • 俄乌衝突的影响
  • PESTLE 分析
  • 监理分析
  • 价格趋势分析

第三章 全球医疗保健诈欺侦测管理市场预测，2020-2033 年

  • 全球医疗保健诈欺侦测管理市场按组件划分的收入预测（十亿美元），2020-2033 年
    • 软体
    • 服务
  • 全球医疗保健诈欺侦测管理市场按解决方案类型划分的收入预测（十亿美元），2020-2033 年
    • 描述性分析
    • 预测性分析
    • 规范分析
  • 全球医疗保健诈欺侦测管理市场按部署模式划分的预测（收入，单位：十亿美元），2020-2033 年
    • 云端部署
    • 本地部署
  • 全球医疗保健诈欺侦测管理市场按诈欺类型划分的预测（收入，单位：十亿美元），2020-2033 年
    • 保险诈欺
    • 医疗服务提供者欺诈
    • 病患诈欺
    • 药局诈欺
  • 全球医疗保健诈欺侦测管理市场按最终用户划分的预测（收入，单位：十亿美元），2020-2033 年
    • 公共和私人支付方
    • 医疗服务提供者
    • 第三方管理机构 (TPA)
    • 政府机构
  • 全球医疗保健诈欺侦测管理市场按地区划分的预测（收入，单位：十亿美元）， 2020-2033
    • 北美
    • 欧洲
    • 亚太地区
    • 拉丁美洲
    • 中东和非洲

第四章：北美医疗保健诈欺侦测管理市场展望，2020-2033

第五章：欧洲医疗保健诈欺侦测管理市场展望，2020-2033

第六章：亚太地区医疗保健诈欺侦测管理市场展望，2020-2033

第七章：拉丁美洲医疗保健诈欺侦测管理市场展望，2020-2033

第八章：中东与非洲医疗保健诈欺侦测管理市场展望，2020-2033

章节9：竞争格局

  • 公司与细分市场热力图
  • 公司市占率分析（2025 年）
  • 竞争格局概览
  • 公司简介
    • IBM 公司（IBM Watson Health/IBM Analytics）
    • SAS Institute Inc.
    • Oracle 公司
    • Microsoft 公司
    • Optum, Inc.（联合健康集团）
    • McKesson 公司
    • Change Healthcare（联合健康集团旗下公司）
    • Verisk Health（Verisk Analytics）
    • Cognizant Technology Solutions
    • HCL Technologies

第十章附录

简介目录

The global Medical Fraud Detection Management Market is experiencing rapid growth as healthcare providers, insurers, and government agencies increasingly focus on detecting and preventing fraudulent activities. The market is expected to expand from USD 2.7 billion in 2026 to USD 5.7 billion by 2033, growing at a CAGR of 11.40% during the forecast period. This growth is fueled by the increasing adoption of advanced technologies, such as artificial intelligence (AI), machine learning (ML), and cloud computing, which enable organizations to analyze vast amounts of healthcare data and detect fraud efficiently.

Medical fraud, including insurance claims fraud, provider fraud, patient fraud, and pharmacy fraud, represents a significant challenge for the healthcare industry. Such fraudulent activities not only result in substantial financial losses but also impact patient care and trust. The adoption of sophisticated fraud detection management solutions allows organizations to identify irregularities in claims, assess risks proactively, and ensure compliance with regulatory standards.

Market Insights

The market for medical fraud detection management is evolving rapidly due to the growing complexity of healthcare operations and the surge in fraudulent activities. Organizations are increasingly leveraging data-driven solutions to monitor transactions, analyze behavioral patterns, and implement preventive measures.

Software solutions, including descriptive, predictive, and prescriptive analytics, are central to fraud detection strategies. Descriptive analytics helps organizations understand historical patterns of fraudulent activities, predictive analytics forecasts potential fraud, and prescriptive analytics provides actionable recommendations to mitigate risks. Alongside software, service offerings-including consulting, integration, and managed services-support organizations in implementing effective fraud management strategies.

Deployment trends indicate a growing preference for cloud-based solutions, which offer scalability, cost-efficiency, and ease of integration with existing systems. However, on-premise solutions remain relevant for organizations with strict data security requirements or regulatory constraints.

Market Drivers

Several key factors are driving the growth of the medical fraud detection management market. First, the prevalence of fraudulent activities in healthcare systems worldwide has created a pressing need for advanced detection and prevention tools. Insurance claims fraud alone costs the industry billions of dollars annually, motivating payers and providers to invest in automated solutions.

Second, advancements in AI and ML technologies have significantly enhanced fraud detection accuracy. Predictive models can identify anomalies in claims and provider behavior, while prescriptive solutions offer recommendations for risk mitigation and process improvement.

Third, increasing regulatory scrutiny and compliance mandates are compelling organizations to adopt comprehensive fraud detection systems. Healthcare authorities across the globe are establishing stringent guidelines to minimize financial losses, ensure transparency, and safeguard patient trust.

Finally, the ongoing digitization of healthcare operations-including electronic health records (EHRs) and automated claims processing-is facilitating real-time fraud monitoring. Digital systems allow for seamless data analysis, enabling early detection of suspicious activities and timely intervention.

Business Opportunities

The medical fraud detection management market offers significant business opportunities for technology providers, insurance companies, and healthcare organizations. Companies delivering AI-powered analytics, cloud-based platforms, and managed services can capitalize on growing demand.

There is also potential in offering integrated solutions that combine fraud detection with compliance management, risk assessment, and payment recovery. Such comprehensive platforms help organizations reduce operational complexity and improve efficiency.

Strategic partnerships between technology providers, insurers, and healthcare providers are expected to expand solution reach and drive adoption. Furthermore, the increasing focus on cost containment, preventive care, and operational transparency creates opportunities for innovative offerings that address evolving market needs.

Regional Analysis

North America is projected to dominate the market due to the high incidence of healthcare fraud, robust regulatory frameworks, and early adoption of advanced technologies. The region is home to leading technology vendors and insurance providers, which further supports market growth.

Europe is expected to register steady growth as government initiatives and digital healthcare adoption drive the demand for fraud detection solutions. Asia Pacific represents a high-growth region, fueled by rising healthcare expenditures, expanding insurance coverage, and increasing deployment of AI-driven solutions.

Latin America and the Middle East & Africa are emerging markets where organizations are adopting fraud detection management systems to enhance payment integrity and reduce financial losses. Growing awareness of healthcare fraud and increased digitization are major factors supporting market expansion in these regions.

Key Players

The global medical fraud detection management market is competitive, with several established players offering advanced solutions and services. Major participants include:

  • IBM Corporation (IBM Watson Health / IBM Analytics)
  • SAS Institute Inc.
  • Oracle Corporation
  • Microsoft Corporation
  • Optum, Inc. (UnitedHealth Group)
  • McKesson Corporation
  • Change Healthcare (part of UnitedHealth Group)
  • Verisk Health (Verisk Analytics)
  • Cognizant Technology Solutions
  • HCL Technologies
  • Accenture plc
  • DXC Technology
  • FICO (Fair Isaac Corporation)
  • Experian Health
  • Cerner Corporation

These companies are focusing on innovation in AI, machine learning, predictive analytics, and cloud-based platforms to strengthen their market position and meet the growing demand for efficient fraud detection.

Market Segmentation

The global medical fraud detection management market can be segmented as follows:

By Component:

  • Software
  • Services

By Solution Type:

  • Descriptive Analytics
  • Predictive Analytics
  • Prescriptive Analytics

By Deployment Mode:

  • Cloud-based
  • On-premise

By Fraud Type:

  • Insurance Claims Fraud
  • Provider Fraud
  • Patient Fraud
  • Pharmacy Fraud

By End User:

  • Public & Private Insurance Payers
  • Healthcare Providers
  • Third-party Administrators (TPAs)
  • Government Agencies

By Application:

  • Claims Review & Prepayment Audits
  • Payment Integrity & Recovery
  • Risk Assessment & Compliance

By Region:

  • North America
  • Europe
  • Asia Pacific
  • Latin America
  • Middle East & Africa

Table of Contents

1. Executive Summary

  • 1.1. Global Medical Fraud Detection Management Market Snapshot
  • 1.2. Future Projections
  • 1.3. Key Market Trends
  • 1.4. Regional Snapshot, by Value, 2026
  • 1.5. Analyst Recommendations

2. Market Overview

  • 2.1. Market Definitions and Segmentations
  • 2.2. Market Dynamics
    • 2.2.1. Drivers
    • 2.2.2. Restraints
    • 2.2.3. Market Opportunities
  • 2.3. Value Chain Analysis
  • 2.4. COVID-19 Impact Analysis
  • 2.5. Porter's Fiver Forces Analysis
  • 2.6. Impact of Russia-Ukraine Conflict
  • 2.7. PESTLE Analysis
  • 2.8. Regulatory Analysis
  • 2.9. Price Trend Analysis
    • 2.9.1. Current Prices and Future Projections, 2025-2033
    • 2.9.2. Price Impact Factors

3. Global Medical Fraud Detection Management Market Outlook, 2020 - 2033

  • 3.1. Global Medical Fraud Detection Management Market Outlook, by Component, Value (US$ Bn), 2020-2033
    • 3.1.1. Software
    • 3.1.2. Services
  • 3.2. Global Medical Fraud Detection Management Market Outlook, by Solution Type, Value (US$ Bn), 2020-2033
    • 3.2.1. Descriptive Analytics
    • 3.2.2. Predictive Analytics
    • 3.2.3. Prescriptive Analytics
  • 3.3. Global Medical Fraud Detection Management Market Outlook, by Deployment Mode, Value (US$ Bn), 2020-2033
    • 3.3.1. Cloud-based
    • 3.3.2. On-premise
  • 3.4. Global Medical Fraud Detection Management Market Outlook, by Fraud Type, Value (US$ Bn), 2020-2033
    • 3.4.1. Insurance Claims Fraud
    • 3.4.2. Provider Fraud
    • 3.4.3. Patient Fraud
    • 3.4.4. Pharmacy Fraud
  • 3.5. Global Medical Fraud Detection Management Market Outlook, by End User, Value (US$ Bn), 2020-2033
    • 3.5.1. Public & Private Insurance Payers
    • 3.5.2. Healthcare Providers
    • 3.5.3. Third-party Administrators (TPAs)
    • 3.5.4. Government Agencies
  • 3.6. Global Medical Fraud Detection Management Market Outlook, by Region, Value (US$ Bn), 2020-2033
    • 3.6.1. North America
    • 3.6.2. Europe
    • 3.6.3. Asia Pacific
    • 3.6.4. Latin America
    • 3.6.5. Middle East & Africa

4. North America Medical Fraud Detection Management Market Outlook, 2020 - 2033

  • 4.1. North America Medical Fraud Detection Management Market Outlook, by Component, Value (US$ Bn), 2020-2033
    • 4.1.1. Software
    • 4.1.2. Services
  • 4.2. North America Medical Fraud Detection Management Market Outlook, by Solution Type, Value (US$ Bn), 2020-2033
    • 4.2.1. Descriptive Analytics
    • 4.2.2. Predictive Analytics
    • 4.2.3. Prescriptive Analytics
  • 4.3. North America Medical Fraud Detection Management Market Outlook, by Deployment Mode, Value (US$ Bn), 2020-2033
    • 4.3.1. Cloud-based
    • 4.3.2. On-premise
  • 4.4. North America Medical Fraud Detection Management Market Outlook, by Fraud Type, Value (US$ Bn), 2020-2033
    • 4.4.1. Insurance Claims Fraud
    • 4.4.2. Provider Fraud
    • 4.4.3. Patient Fraud
    • 4.4.4. Pharmacy Fraud
  • 4.5. North America Medical Fraud Detection Management Market Outlook, by End User, Value (US$ Bn), 2020-2033
    • 4.5.1. Public & Private Insurance Payers
    • 4.5.2. Healthcare Providers
    • 4.5.3. Third-party Administrators (TPAs)
    • 4.5.4. Government Agencies
  • 4.6. North America Medical Fraud Detection Management Market Outlook, by Country, Value (US$ Bn), 2020-2033
    • 4.6.1. U.S. Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 4.6.2. U.S. Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 4.6.3. U.S. Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 4.6.4. U.S. Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 4.6.5. U.S. Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 4.6.6. Canada Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 4.6.7. Canada Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 4.6.8. Canada Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 4.6.9. Canada Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 4.6.10. Canada Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
  • 4.7. BPS Analysis/Market Attractiveness Analysis

5. Europe Medical Fraud Detection Management Market Outlook, 2020 - 2033

  • 5.1. Europe Medical Fraud Detection Management Market Outlook, by Component, Value (US$ Bn), 2020-2033
    • 5.1.1. Software
    • 5.1.2. Services
  • 5.2. Europe Medical Fraud Detection Management Market Outlook, by Solution Type, Value (US$ Bn), 2020-2033
    • 5.2.1. Descriptive Analytics
    • 5.2.2. Predictive Analytics
    • 5.2.3. Prescriptive Analytics
  • 5.3. Europe Medical Fraud Detection Management Market Outlook, by Deployment Mode, Value (US$ Bn), 2020-2033
    • 5.3.1. Cloud-based
    • 5.3.2. On-premise
  • 5.4. Europe Medical Fraud Detection Management Market Outlook, by Fraud Type, Value (US$ Bn), 2020-2033
    • 5.4.1. Insurance Claims Fraud
    • 5.4.2. Provider Fraud
    • 5.4.3. Patient Fraud
    • 5.4.4. Pharmacy Fraud
  • 5.5. Europe Medical Fraud Detection Management Market Outlook, by End User, Value (US$ Bn), 2020-2033
    • 5.5.1. Public & Private Insurance Payers
    • 5.5.2. Healthcare Providers
    • 5.5.3. Third-party Administrators (TPAs)
    • 5.5.4. Government Agencies
  • 5.6. Europe Medical Fraud Detection Management Market Outlook, by Country, Value (US$ Bn), 2020-2033
    • 5.6.1. Germany Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 5.6.2. Germany Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 5.6.3. Germany Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 5.6.4. Germany Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 5.6.5. Germany Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 5.6.6. Italy Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 5.6.7. Italy Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 5.6.8. Italy Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 5.6.9. Italy Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 5.6.10. Italy Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 5.6.11. France Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 5.6.12. France Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 5.6.13. France Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 5.6.14. France Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 5.6.15. France Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 5.6.16. U.K. Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 5.6.17. U.K. Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 5.6.18. U.K. Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 5.6.19. U.K. Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 5.6.20. U.K. Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 5.6.21. Spain Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 5.6.22. Spain Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 5.6.23. Spain Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 5.6.24. Spain Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 5.6.25. Spain Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 5.6.26. Russia Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 5.6.27. Russia Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 5.6.28. Russia Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 5.6.29. Russia Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 5.6.30. Russia Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 5.6.31. Rest of Europe Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 5.6.32. Rest of Europe Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 5.6.33. Rest of Europe Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 5.6.34. Rest of Europe Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 5.6.35. Rest of Europe Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
  • 5.7. BPS Analysis/Market Attractiveness Analysis

6. Asia Pacific Medical Fraud Detection Management Market Outlook, 2020 - 2033

  • 6.1. Asia Pacific Medical Fraud Detection Management Market Outlook, by Component, Value (US$ Bn), 2020-2033
    • 6.1.1. Software
    • 6.1.2. Services
  • 6.2. Asia Pacific Medical Fraud Detection Management Market Outlook, by Solution Type, Value (US$ Bn), 2020-2033
    • 6.2.1. Descriptive Analytics
    • 6.2.2. Predictive Analytics
    • 6.2.3. Prescriptive Analytics
  • 6.3. Asia Pacific Medical Fraud Detection Management Market Outlook, by Deployment Mode, Value (US$ Bn), 2020-2033
    • 6.3.1. Cloud-based
    • 6.3.2. On-premise
  • 6.4. Asia Pacific Medical Fraud Detection Management Market Outlook, by Fraud Type, Value (US$ Bn), 2020-2033
    • 6.4.1. Insurance Claims Fraud
    • 6.4.2. Provider Fraud
    • 6.4.3. Patient Fraud
    • 6.4.4. Pharmacy Fraud
  • 6.5. Asia Pacific Medical Fraud Detection Management Market Outlook, by End User, Value (US$ Bn), 2020-2033
    • 6.5.1. Public & Private Insurance Payers
    • 6.5.2. Healthcare Providers
    • 6.5.3. Third-party Administrators (TPAs)
    • 6.5.4. Government Agencies
  • 6.6. Asia Pacific Medical Fraud Detection Management Market Outlook, by Country, Value (US$ Bn), 2020-2033
    • 6.6.1. China Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 6.6.2. China Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 6.6.3. China Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 6.6.4. China Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 6.6.5. China Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 6.6.6. Japan Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 6.6.7. Japan Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 6.6.8. Japan Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 6.6.9. Japan Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 6.6.10. Japan Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 6.6.11. South Korea Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 6.6.12. South Korea Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 6.6.13. South Korea Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 6.6.14. South Korea Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 6.6.15. South Korea Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 6.6.16. India Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 6.6.17. India Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 6.6.18. India Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 6.6.19. India Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 6.6.20. India Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 6.6.21. Southeast Asia Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 6.6.22. Southeast Asia Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 6.6.23. Southeast Asia Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 6.6.24. Southeast Asia Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 6.6.25. Southeast Asia Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 6.6.26. Rest of SAO Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 6.6.27. Rest of SAO Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 6.6.28. Rest of SAO Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 6.6.29. Rest of SAO Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 6.6.30. Rest of SAO Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
  • 6.7. BPS Analysis/Market Attractiveness Analysis

7. Latin America Medical Fraud Detection Management Market Outlook, 2020 - 2033

  • 7.1. Latin America Medical Fraud Detection Management Market Outlook, by Component, Value (US$ Bn), 2020-2033
    • 7.1.1. Software
    • 7.1.2. Services
  • 7.2. Latin America Medical Fraud Detection Management Market Outlook, by Solution Type, Value (US$ Bn), 2020-2033
    • 7.2.1. Descriptive Analytics
    • 7.2.2. Predictive Analytics
    • 7.2.3. Prescriptive Analytics
  • 7.3. Latin America Medical Fraud Detection Management Market Outlook, by Deployment Mode, Value (US$ Bn), 2020-2033
    • 7.3.1. Cloud-based
    • 7.3.2. On-premise
  • 7.4. Latin America Medical Fraud Detection Management Market Outlook, by Fraud Type, Value (US$ Bn), 2020-2033
    • 7.4.1. Insurance Claims Fraud
    • 7.4.2. Provider Fraud
    • 7.4.3. Patient Fraud
    • 7.4.4. Pharmacy Fraud
  • 7.5. Latin America Medical Fraud Detection Management Market Outlook, by End User, Value (US$ Bn), 2020-2033
    • 7.5.1. Public & Private Insurance Payers
    • 7.5.2. Healthcare Providers
    • 7.5.3. Third-party Administrators (TPAs)
    • 7.5.4. Government Agencies
  • 7.6. Latin America Medical Fraud Detection Management Market Outlook, by Country, Value (US$ Bn), 2020-2033
    • 7.6.1. Brazil Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 7.6.2. Brazil Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 7.6.3. Brazil Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 7.6.4. Brazil Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 7.6.5. Brazil Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 7.6.6. Mexico Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 7.6.7. Mexico Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 7.6.8. Mexico Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 7.6.9. Mexico Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 7.6.10. Mexico Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 7.6.11. Argentina Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 7.6.12. Argentina Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 7.6.13. Argentina Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 7.6.14. Argentina Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 7.6.15. Argentina Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 7.6.16. Rest of LATAM Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 7.6.17. Rest of LATAM Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 7.6.18. Rest of LATAM Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 7.6.19. Rest of LATAM Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 7.6.20. Rest of LATAM Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
  • 7.7. BPS Analysis/Market Attractiveness Analysis

8. Middle East & Africa Medical Fraud Detection Management Market Outlook, 2020 - 2033

  • 8.1. Middle East & Africa Medical Fraud Detection Management Market Outlook, by Component, Value (US$ Bn), 2020-2033
    • 8.1.1. Software
    • 8.1.2. Services
  • 8.2. Middle East & Africa Medical Fraud Detection Management Market Outlook, by Solution Type, Value (US$ Bn), 2020-2033
    • 8.2.1. Descriptive Analytics
    • 8.2.2. Predictive Analytics
    • 8.2.3. Prescriptive Analytics
  • 8.3. Middle East & Africa Medical Fraud Detection Management Market Outlook, by Deployment Mode, Value (US$ Bn), 2020-2033
    • 8.3.1. Cloud-based
    • 8.3.2. On-premise
  • 8.4. Middle East & Africa Medical Fraud Detection Management Market Outlook, by Fraud Type, Value (US$ Bn), 2020-2033
    • 8.4.1. Insurance Claims Fraud
    • 8.4.2. Provider Fraud
    • 8.4.3. Patient Fraud
    • 8.4.4. Pharmacy Fraud
  • 8.5. Middle East & Africa Medical Fraud Detection Management Market Outlook, by End User, Value (US$ Bn), 2020-2033
    • 8.5.1. Public & Private Insurance Payers
    • 8.5.2. Healthcare Providers
    • 8.5.3. Third-party Administrators (TPAs)
    • 8.5.4. Government Agencies
  • 8.6. Middle East & Africa Medical Fraud Detection Management Market Outlook, by Country, Value (US$ Bn), 2020-2033
    • 8.6.1. GCC Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 8.6.2. GCC Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 8.6.3. GCC Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 8.6.4. GCC Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 8.6.5. GCC Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 8.6.6. South Africa Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 8.6.7. South Africa Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 8.6.8. South Africa Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 8.6.9. South Africa Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 8.6.10. South Africa Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 8.6.11. Egypt Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 8.6.12. Egypt Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 8.6.13. Egypt Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 8.6.14. Egypt Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 8.6.15. Egypt Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 8.6.16. Nigeria Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 8.6.17. Nigeria Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 8.6.18. Nigeria Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 8.6.19. Nigeria Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 8.6.20. Nigeria Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
    • 8.6.21. Rest of Middle East Medical Fraud Detection Management Market Outlook, by Component, 2020-2033
    • 8.6.22. Rest of Middle East Medical Fraud Detection Management Market Outlook, by Solution Type, 2020-2033
    • 8.6.23. Rest of Middle East Medical Fraud Detection Management Market Outlook, by Deployment Mode, 2020-2033
    • 8.6.24. Rest of Middle East Medical Fraud Detection Management Market Outlook, by Fraud Type, 2020-2033
    • 8.6.25. Rest of Middle East Medical Fraud Detection Management Market Outlook, by End User, 2020-2033
  • 8.7. BPS Analysis/Market Attractiveness Analysis

9. Competitive Landscape

  • 9.1. Company Vs Segment Heatmap
  • 9.2. Company Market Share Analysis, 2025
  • 9.3. Competitive Dashboard
  • 9.4. Company Profiles
    • 9.4.1. IBM Corporation (IBM Watson Health / IBM Analytics)
      • 9.4.1.1. Company Overview
      • 9.4.1.2. Product Portfolio
      • 9.4.1.3. Financial Overview
      • 9.4.1.4. Business Strategies and Developments
    • 9.4.2. SAS Institute Inc.
    • 9.4.3. Oracle Corporation
    • 9.4.4. Microsoft Corporation
    • 9.4.5. Optum, Inc. (UnitedHealth Group)
    • 9.4.6. McKesson Corporation
    • 9.4.7. Change Healthcare (part of UnitedHealth Group)
    • 9.4.8. Verisk Health (Verisk Analytics)
    • 9.4.9. Cognizant Technology Solutions
    • 9.4.10. HCL Technologies

10. Appendix

  • 10.1. Research Methodology
  • 10.2. Report Assumptions
  • 10.3. Acronyms and Abbreviations