The Asia Pacific Healthcare Fraud Analytics Market would witness market growth of 23.7% CAGR during the forecast period (2022-2028).
Before alerts are sent to analysts, clinicians, or investigators, the system uses risk- and value-based scoring models to appropriately evaluate and prioritize them. Because of the time saved, valuable personnel can work on more cases with higher efficiency and concentrate on higher-value networks that generate a higher return on investment. More precise scoring also implies fewer false positives, which means less customer annoyance and more customer satisfaction.
With a powerful fraud analytics engine that examines all data in real-time or batch, organization can also detect more payment integrity violations than ever before. The solution, which runs on SAS Viya, combines advanced analytics with embedded artificial intelligence (AI) and machine learning algorithms, as well as other techniques such as outlier analysis, business rules, database searches, text mining, network link analysis, exception reporting, and so on, to uncover more suspicious activity with greater precision.
In Asia Pacific region, substantial number of population do have a health insurance, hence numerous people out of that population are found committing healthcare fraud with an objective of getting the lump sum insurance amount. Similarly, many skilled and qualified surgeons and other healthcare professionals are found making high level healthcare fraud with carefully designed schemes to conceal the fraud. The medical association of the region as well as the respective government of the region are bringing relevant policies and regulations to get rid of such healthcare frauds, but it is not enough as whole medical infrastructure of the region is demanding the incorporation of Healthcare Fraud Analytics System to systematically get rid of all kind of healthcare frauds by both patients and healthcare professionals.
The China market dominated the Asia Pacific Prescriptive Analytics Market by Country in 2021, and would continue to be a dominant market till 2028; thereby, achieving a market value of $116.5 million by 2028. The Japan market is Poised to grow at a CAGR of 23.6% during (2022 - 2028). Additionally, The India market would showcase a CAGR of 25.1% during (2022 - 2028).
Based on Delivery Model, the market is segmented into On-premise and Cloud. Based on Application, the market is segmented into Insurance Claim Review, Pharmacy billing Issue, Payment Integrity, and Others. Based on End User, the market is segmented into Public & Government Agencies, Private Insurance Payers, Third-party Service Providers, and Employers. Based on Solution Type, the market is segmented into Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics. Based on countries, the market is segmented into China, Japan, India, South Korea, Singapore, Malaysia, and Rest of Asia Pacific.
Free Valuable Insights: The Worldwide Healthcare Fraud Analytics Market is Projected to reach USD 6.6 Billion by 2028, at a CAGR of 23%
The market research report covers the analysis of key stake holders of the market. Key companies profiled in the report include Wipro Limited, IBM Corporation, DXC Technology Company, SAS Institute, Inc., Conduent, Incorporated, HCL Technologies Ltd., UnitedHealth Group, Inc. (Optum, Inc.), OSP Labs, Cotiviti, Inc., and ExlService Holdings, Inc.
Scope of the Study
Market Segments Covered in the Report:
By Delivery Model
By Application
- Insurance Claim Review
- Pharmacy billing Issue
- Payment Integrity
- Others
By End User
- Public & Government Agencies
- Private Insurance Payers
- Third-party Service Providers
- Employers
By Solution Type
- Descriptive Analytics
- Predictive Analytics
- Prescriptive Analytics
By Country
- China
- Japan
- India
- South Korea
- Singapore
- Malaysia
- Rest of Asia Pacific
Key Market Players
List of Companies Profiled in the Report:
- Wipro Limited
- IBM Corporation
- DXC Technology Company
- SAS Institute, Inc.
- Conduent, Incorporated
- HCL Technologies Ltd.
- UnitedHealth Group, Inc. (Optum, Inc.)
- OSP Labs
- Cotiviti, Inc.
- ExlService Holdings, Inc.
Chapter 1. Market Scope & Methodology
1.1 Market Definition
1.2 Objectives
1.3 Market Scope
1.4 Segmentation
1.4.1 Asia Pacific Healthcare Fraud Analytics Market, by Delivery Model
1.4.2 Asia Pacific Healthcare Fraud Analytics Market, by Application
1.4.3 Asia Pacific Healthcare Fraud Analytics Market, by End User
1.4.4 Asia Pacific Healthcare Fraud Analytics Market, by Solution Type
1.4.5 Asia Pacific Healthcare Fraud Analytics Market, by Country
1.5 Methodology for the research
Chapter 2. Market Overview
2.1 Introduction
2.1.1 Overview
2.1.1.1 Market Composition and Scenario
2.2 Key Factors Impacting the Market
2.2.1 Market Drivers
2.2.2 Market Restraints
Chapter 3. Competition Analysis - Global
3.1 Market Share Analysis, 2021
3.2 Strategies Deployed in Healthcare Fraud Analytics Market
Chapter 4. Asia Pacific Healthcare Fraud Analytics Market by Delivery Model
4.1 Asia Pacific On-premise Market by Country
4.2 Asia Pacific Cloud Market by Country
Chapter 5. Asia Pacific Healthcare Fraud Analytics Market by Application
5.1 Asia Pacific Insurance Claim Review Market by Country
5.2 Asia Pacific Pharmacy billing Issue Market by Country
5.3 Asia Pacific Payment Integrity Market by Country
5.4 Asia Pacific Others Market by Country
Chapter 6. Asia Pacific Healthcare Fraud Analytics Market by End User
6.1 Asia Pacific Public & Government Agencies Market by Country
6.2 Asia Pacific Private Insurance Payers Market by Country
6.3 Asia Pacific Third-party Service Providers Market by Country
6.4 Asia Pacific Employers Market by Country
Chapter 7. Asia Pacific Healthcare Fraud Analytics Market by Solution Type
7.1 Asia Pacific Descriptive Analytics Market by Country
7.2 Asia Pacific Predictive Analytics Market by Country
7.3 Asia Pacific Prescriptive Analytics Market by Country
Chapter 8. Asia Pacific Healthcare Fraud Analytics Market by Country
8.1 China Healthcare Fraud Analytics Market
8.1.1 China Healthcare Fraud Analytics Market by Delivery Model
8.1.2 China Healthcare Fraud Analytics Market by Application
8.1.3 China Healthcare Fraud Analytics Market by End User
8.1.4 China Healthcare Fraud Analytics Market by Solution Type
8.2 Japan Healthcare Fraud Analytics Market
8.2.1 Japan Healthcare Fraud Analytics Market by Delivery Model
8.2.2 Japan Healthcare Fraud Analytics Market by Application
8.2.3 Japan Healthcare Fraud Analytics Market by End User
8.2.4 Japan Healthcare Fraud Analytics Market by Solution Type
8.3 India Healthcare Fraud Analytics Market
8.3.1 India Healthcare Fraud Analytics Market by Delivery Model
8.3.2 India Healthcare Fraud Analytics Market by Application
8.3.3 India Healthcare Fraud Analytics Market by End User
8.3.4 India Healthcare Fraud Analytics Market by Solution Type
8.4 South Korea Healthcare Fraud Analytics Market
8.4.1 South Korea Healthcare Fraud Analytics Market by Delivery Model
8.4.2 South Korea Healthcare Fraud Analytics Market by Application
8.4.3 South Korea Healthcare Fraud Analytics Market by End User
8.4.4 South Korea Healthcare Fraud Analytics Market by Solution Type
8.5 Singapore Healthcare Fraud Analytics Market
8.5.1 Singapore Healthcare Fraud Analytics Market by Delivery Model
8.5.2 Singapore Healthcare Fraud Analytics Market by Application
8.5.3 Singapore Healthcare Fraud Analytics Market by End User
8.5.4 Singapore Healthcare Fraud Analytics Market by Solution Type
8.6 Malaysia Healthcare Fraud Analytics Market
8.6.1 Malaysia Healthcare Fraud Analytics Market by Delivery Model
8.6.2 Malaysia Healthcare Fraud Analytics Market by Application
8.6.3 Malaysia Healthcare Fraud Analytics Market by End User
8.6.4 Malaysia Healthcare Fraud Analytics Market by Solution Type
8.7 Rest of Asia Pacific Healthcare Fraud Analytics Market
8.7.1 Rest of Asia Pacific Healthcare Fraud Analytics Market by Delivery Model
8.7.2 Rest of Asia Pacific Healthcare Fraud Analytics Market by Application
8.7.3 Rest of Asia Pacific Healthcare Fraud Analytics Market by End User
8.7.4 Rest of Asia Pacific Healthcare Fraud Analytics Market by Solution Type
Chapter 9. Company Profiles
9.1 Wipro Limited
9.1.1 Company Overview
9.1.2 Financial Analysis
9.1.3 Segmental and Regional Analysis
9.1.4 Research & Development Expenses
9.1.5 Recent strategies and developments:
9.1.5.1 Partnerships, Collaborations, and Agreements:
9.1.5.2 Acquisition and Mergers:
9.2 IBM Corporation
9.2.1 Company Overview
9.2.2 Financial Analysis
9.2.3 Regional & Segmental Analysis
9.2.4 Research & Development Expenses
9.2.5 Recent strategies and developments:
9.2.5.1 Partnerships, Collaborations, and Agreements:
9.2.6 SWOT Analysis
9.3 DXC Technology Company
9.3.1 Company Overview
9.3.2 Financial Analysis
9.3.3 Segmental and Regional Analysis
9.4 SAS Institute, Inc.
9.4.1 Company Overview
9.4.2 Recent strategies and developments:
9.4.2.1 Partnerships, Collaborations, and Agreements:
9.5 Conduent, Incorporated
9.5.1 Company Overview
9.5.2 Financial Analysis
9.5.3 Segmental and Regional Analysis
9.5.4 Research & Development Expense
9.6 HCL Technologies Ltd. (HCL Enterprises)
9.6.1 Company Overview
9.6.2 Financial Analysis
9.6.3 Segmental and Regional Analysis
9.6.4 Research & Development Expense
9.6.5 Recent strategies and developments:
9.6.5.1 Partnerships, Collaborations, and Agreements:
9.7 UnitedHealth Group, Inc. (Optum, Inc.)
9.7.1 Company Overview
9.7.2 Financial Analysis
9.7.3 Segmental Analysis
9.8 OSP Labs
9.8.1 Company Overview
9.9 Cotiviti, Inc.
9.9.1 Company Overview
9.10. ExlService Holdings, Inc.
9.10.1 Company Overview
9.10.2 Financial Analysis
9.10.3 Segmental and Regional Analysis
9.10.4 Research & Development Expenses
9.10.5 Recent strategies and developments:
9.10.5.1 Partnerships, Collaborations, and Agreements:
TABLE 1 Asia Pacific Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 2 Asia Pacific Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 3 Asia Pacific Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 4 Asia Pacific Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 5 Asia Pacific On-premise Market by Country, 2018 - 2021, USD Million
TABLE 6 Asia Pacific On-premise Market by Country, 2022 - 2028, USD Million
TABLE 7 Asia Pacific Cloud Market by Country, 2018 - 2021, USD Million
TABLE 8 Asia Pacific Cloud Market by Country, 2022 - 2028, USD Million
TABLE 9 Asia Pacific Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 10 Asia Pacific Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 11 Asia Pacific Insurance Claim Review Market by Country, 2018 - 2021, USD Million
TABLE 12 Asia Pacific Insurance Claim Review Market by Country, 2022 - 2028, USD Million
TABLE 13 Asia Pacific Pharmacy billing Issue Market by Country, 2018 - 2021, USD Million
TABLE 14 Asia Pacific Pharmacy billing Issue Market by Country, 2022 - 2028, USD Million
TABLE 15 Asia Pacific Payment Integrity Market by Country, 2018 - 2021, USD Million
TABLE 16 Asia Pacific Payment Integrity Market by Country, 2022 - 2028, USD Million
TABLE 17 Asia Pacific Others Market by Country, 2018 - 2021, USD Million
TABLE 18 Asia Pacific Others Market by Country, 2022 - 2028, USD Million
TABLE 19 Asia Pacific Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 20 Asia Pacific Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 21 Asia Pacific Public & Government Agencies Market by Country, 2018 - 2021, USD Million
TABLE 22 Asia Pacific Public & Government Agencies Market by Country, 2022 - 2028, USD Million
TABLE 23 Asia Pacific Private Insurance Payers Market by Country, 2018 - 2021, USD Million
TABLE 24 Asia Pacific Private Insurance Payers Market by Country, 2022 - 2028, USD Million
TABLE 25 Asia Pacific Third-party Service Providers Market by Country, 2018 - 2021, USD Million
TABLE 26 Asia Pacific Third-party Service Providers Market by Country, 2022 - 2028, USD Million
TABLE 27 Asia Pacific Employers Market by Country, 2018 - 2021, USD Million
TABLE 28 Asia Pacific Employers Market by Country, 2022 - 2028, USD Million
TABLE 29 Asia Pacific Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 30 Asia Pacific Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 31 Asia Pacific Descriptive Analytics Market by Country, 2018 - 2021, USD Million
TABLE 32 Asia Pacific Descriptive Analytics Market by Country, 2022 - 2028, USD Million
TABLE 33 Asia Pacific Predictive Analytics Market by Country, 2018 - 2021, USD Million
TABLE 34 Asia Pacific Predictive Analytics Market by Country, 2022 - 2028, USD Million
TABLE 35 Asia Pacific Prescriptive Analytics Market by Country, 2018 - 2021, USD Million
TABLE 36 Asia Pacific Prescriptive Analytics Market by Country, 2022 - 2028, USD Million
TABLE 37 Asia Pacific Healthcare Fraud Analytics Market by Country, 2018 - 2021, USD Million
TABLE 38 Asia Pacific Healthcare Fraud Analytics Market by Country, 2022 - 2028, USD Million
TABLE 39 China Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 40 China Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 41 China Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 42 China Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 43 China Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 44 China Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 45 China Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 46 China Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 47 China Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 48 China Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 49 Japan Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 50 Japan Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 51 Japan Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 52 Japan Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 53 Japan Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 54 Japan Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 55 Japan Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 56 Japan Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 57 Japan Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 58 Japan Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 59 India Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 60 India Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 61 India Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 62 India Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 63 India Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 64 India Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 65 India Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 66 India Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 67 India Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 68 India Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 69 South Korea Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 70 South Korea Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 71 South Korea Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 72 South Korea Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 73 South Korea Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 74 South Korea Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 75 South Korea Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 76 South Korea Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 77 South Korea Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 78 South Korea Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 79 Singapore Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 80 Singapore Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 81 Singapore Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 82 Singapore Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 83 Singapore Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 84 Singapore Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 85 Singapore Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 86 Singapore Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 87 Singapore Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 88 Singapore Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 89 Malaysia Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 90 Malaysia Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 91 Malaysia Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 92 Malaysia Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 93 Malaysia Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 94 Malaysia Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 95 Malaysia Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 96 Malaysia Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 97 Malaysia Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 98 Malaysia Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 99 Rest of Asia Pacific Healthcare Fraud Analytics Market, 2018 - 2021, USD Million
TABLE 100 Rest of Asia Pacific Healthcare Fraud Analytics Market, 2022 - 2028, USD Million
TABLE 101 Rest of Asia Pacific Healthcare Fraud Analytics Market by Delivery Model, 2018 - 2021, USD Million
TABLE 102 Rest of Asia Pacific Healthcare Fraud Analytics Market by Delivery Model, 2022 - 2028, USD Million
TABLE 103 Rest of Asia Pacific Healthcare Fraud Analytics Market by Application, 2018 - 2021, USD Million
TABLE 104 Rest of Asia Pacific Healthcare Fraud Analytics Market by Application, 2022 - 2028, USD Million
TABLE 105 Rest of Asia Pacific Healthcare Fraud Analytics Market by End User, 2018 - 2021, USD Million
TABLE 106 Rest of Asia Pacific Healthcare Fraud Analytics Market by End User, 2022 - 2028, USD Million
TABLE 107 Rest of Asia Pacific Healthcare Fraud Analytics Market by Solution Type, 2018 - 2021, USD Million
TABLE 108 Rest of Asia Pacific Healthcare Fraud Analytics Market by Solution Type, 2022 - 2028, USD Million
TABLE 109 Key Information – Wipro Limited
TABLE 110 Key information – IBM Corporation
TABLE 111 key information – DXC Technology Company
TABLE 112 Key information – SAS Institute, Inc.
TABLE 113 Key Information –Conduent, Incorporated
TABLE 114 Key Information – HCL Technologies Ltd.
TABLE 115 Key Information – UnitedHealth Group, Inc.
TABLE 116 Key Information – OSP Labs
TABLE 117 Key Information – Cotiviti, Inc.
TABLE 118 Key Information – ExlService Holdings, Inc.
List of Figures
FIG 1 Methodology for the research
FIG 2 Market Share Analysis, 2021
FIG 3 Swot analysis: IBM Corporation