In terms of revenue, the fraud detection and prevention market stood at US$ 20.70 Bn in 2018, and is expected to grow at a CAGR of 25.6% during the forecast period (2019 – 2027). The study analyzes the market in terms of revenue across all the major regions, which is further bifurcated into countries.
Pune, India -- (SBWIRE) -- 03/15/2019 -- Healthcare fraud is an industry-wide problem that directly impacts the cost and quality of patient care. As per National Health Care Anti-Fraud Association (NHCCA) financial losses due to health care fraud are in tens of billions of dollars each year. In 2015, the NHCCA estimated that at least 3 percent of all health care spending, or $68 billion, is lost to health care fraud. This need to curb the detrimental impacts on the healthcare sector is driving the fraud detection and prevention market. Few common examples of fraud and abuse in healthcare include illegal medical billing practices in which claims are falsified, multiple claims filed by different providers for the same patient, patient identities are stolen and used to gain reimbursement for medical services never provided, and collusion between unprincipled providers and their patients in which money from claims is shared.
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The traditional efforts to detect healthcare fraud and abuse involved laborious investigative work after occurrence of the fraud. Investigation authorities took years to gather evidence for prosecution of the guilty and recovery of the money. Modern technological advancements has made it possible to detect anomalies and prevent the event of fraud which is propelling the global fraud detection and prevention market. Predictive analytics identifies patterns that are potentially fraudulent and then develops rules to mark certain claims. For instance, a provider making a claim for a procedure that is outside of his/her area of expertise would be marked for further scrutiny, as per the pre-set rules. AI-based solutions can continually mine data, identify emerging fraudulent patterns and create new rules. Using these new rules, solutions enhance their capabilities by identifying more advanced fraud potentials. For instance, the WhiteHatAI Centaur is true AI driven software that acts as a forensic tool for examining every line of every claim quickly and accurately while learning from all interactions with a skilled professional. The solution offered by this software lists suspect issues and it provides a flexible summary framework, which is used by organizations to confirm, dispute, eliminate or re-negotiate presented charges. On similar lines, machine learning is being leveraged for combating the problem of prescription billing abuse.
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"Factors such as increasing cases of healthcare fraud, rising pressure to reduce healthcare costs, increase in the number of people seeking health insurance, favorable government initiatives to combat healthcare fraud, and technological advancements, are the major driving factors of fraud detection and prevention market. In order to flag criminal activity, providers and payers that want to improve their ability to detect and react to healthcare fraud must invest in health IT and technologically advanced solutions. They can benefit by collaborating with law enforcement agencies and regulatory groups to establish industry-standard fraud prevention protocols. Payers that successfully support their fraud prevention activities maintain positive revenues, protect consumers from overbilling and increased premiums, and ensure that financial assets are secure."
The detailed research study provides qualitative and quantitative analysis of fraud detection and prevention market. The market has been analyzed from demand as well as supply side. The demand side analysis covers market revenue across regions and further across all the major countries. The supply side analysis covers the major market players and their regional and global presence and strategies. The geographical analysis done emphasizes on each of the major countries across North America, Europe, Asia Pacific, Middle East, Africa and Latin America.
Some of the players operating in the fraud detection and prevention market are ACI Worldwide, Inc., BAE Systems, Cyxtera Technologies, Inc., Dell Inc., Distil, Inc., DXC Technology, Experian Information Solutions, Inc., Fair Isaac Corporation (FICO), First Data Corporation, FIS, Fiserv, Inc., FRISS , Guardian Analytics, IBM Corporation, iovation Inc., Kount Inc., LexisNexis, MaxMind, Inc., NICE, Oracle, SAP SE, SAS Institute Inc., Securonix, Inc., SIMILITY , Software AG, ThreatMetrix and Wirecard AG amongst others.
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Fraud Detection and Prevention Market:
By Deployment Mode
- On Cloud
- On Premise
By Organization Size
- SMEs
- Large Enterprise
By Component
- Solutions
- Fraud Analytics
- Authentication
- Single-Factor Authentication
- Multifactor Authentication
- Others
- Services
- Professional Service
- Managed Service
By Application
- Identity Theft
- Payment Frauds
- Electronic Payment Fraud
- Mobile Payment Fraud
- Credit and Debit Card Fraud
- Money Laundering
- Others (Banking Transactions, Fund Transfers etc.)
By Industry Vertical:
- Banking, Financial Services and Insurance (BFSI)
- Energy and Power
- Government/Public Sector
- Healthcare
- Manufacturing
- Real Estate
- Retail
- Telecommunication
- Others (Travel and Transportation, Media and Entertainment, etc.)
By Geography
- North America
- U.S.
- Canada
- Mexico
- Rest of North America
- Europe
- France
- The UK
- Spain
- Germany
- Italy
- Nordic Countries
- Denmark
- Finland
- Iceland
- Sweden
- Norway
- Benelux Union
- Belgium
- The Netherlands
- Luxembourg
- Rest of Europe
- Asia Pacific
- China
- Japan
- India
- New Zealand
- Australia
- South Korea
- Southeast Asia
- Indonesia
- Thailand
- Malaysia
- Singapore
- Rest of Southeast Asia
- Rest of Asia Pacific
- Middle East and Africa
- Saudi Arabia
- UAE
- Egypt
- Kuwait
- South Africa
- Rest of Middle East & Africa
- Latin America
- Brazil
- Argentina
- Rest of Latin America
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