The global market is facing a plethora of challenges. Travel bans and quarantines, halt of indoor/outdoor activities, temporary shutdown of business operations, supply demand fluctuations, stock market volatility, falling business assurance, and many uncertainties are somehow exerting a partial negative impact on the business dynamics.  

The healthcare industry has been witnessing a number of cases of frauds, done by patients, doctors, physicians, and other medical specialists. Many healthcare providers and specialists have been observed to be engaged in fraudulent activities, for the sake of profit. In the healthcare sector, fraudulent activities done by patients include the fraudulent procurement of sickness certificates, prescription fraud, and evasion of medical charges. 

Emerging markets such as Asia promise significant growth in health insurance coverage, mainly due to increasing government initiatives, rising government and private investments for promoting medical insurance, and growing income levels. This growth is aided by the increasing affordability of health insurance for the middle class in this region and the rising awareness regarding the benefits of health insurance. 

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As per the US Department of Health and Human Services findings of 2018, national Medicaid data has shortcomings that could hinder the process of fraud detection in the public sector. The OIG claims that Medicaid data is often incomplete and inaccurate; this affects the process of detecting fraudulent claims and results in the wastage of billions of dollars due to FWA. 

The healthcare industry is changing at an incredible rate, and one of the major contributors to this change is the increasing popularity of healthcare communication through social media. Not only has social media become a place where people seek health information, but social media channels also allow for two-way public communication between patients, providers, and other third parties. This helps create a large forum for health discussions globally.

This vast network of healthcare influencers, leaders, patients, providers, organizations, and governmental entities creates a massive amount of healthcare data on a regular basis. This data, if segregated, segmented, and analyzed in a meaningful way, can offer incredible value for improving treatment efficiencies and health outcomes. 

Key Market Players

The prominent players in Healthcare Fraud Analytics Market are IBM Corporation (US), Optum, Inc. (US), Cotiviti, Inc. (US), Change Healthcare (US), Fair Isaac Corporation (US), SAS Institute Inc. (US), EXLService Holdings, Inc. (US), Wipro Limited (India), Conduent, Incorporated (US), CGI Inc. (Canada), HCL Technologies Limited (India), Qlarant, Inc. (US), DXC Technology (US), Northrop Grumman Corporation (US), LexisNexis (US), Healthcare Fraud Shield (US), Sharecare, Inc. (US), FraudLens, Inc. (US), HMS Holding Corp. (US), Codoxo (US), H20.ai (US), Pondera Solutions, Inc. (US), FRISS (The Netherlands), Multiplan (US), FraudScope (US), and OSP Labs (US).