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表紙:ヘルスケア向け不正検出市場:現状分析と予測(2021年~2027年)
市場調査レポート
商品コード
1002619

ヘルスケア向け不正検出市場:現状分析と予測(2021年~2027年)

Healthcare Fraud Detection Market: Current Analysis and Forecast (2021-2027)

出版日: | 発行: UnivDatos Market Insights Pvt Ltd | ページ情報: 英文 208 Pages | 納期: 即日から翌営業日

価格
価格表記: USDを日本円(税抜)に換算
本日の銀行送金レート: 1USD=111.25円
ヘルスケア向け不正検出市場:現状分析と予測(2021年~2027年)
出版日: 2021年04月27日
発行: UnivDatos Market Insights Pvt Ltd
ページ情報: 英文 208 Pages
納期: 即日から翌営業日
  • 全表示
  • 概要
  • 目次
概要

医療の不正行為は、医療制度における費用の大幅な増加につながっています。GAO(米国会計検査院)によると、主要な医療プログラムに対する連邦政府の支出は、2020年度のGDPの5.9%から2050年度にはGDPの8.0%にまで拡大するとされています。

医療保険を申請する患者数の増加や、薬局での不正請求の増加などを理由に、ヘルスケア向け不正検出の需要が高まっています。ソーシャルメディアがヘルスケア業界に与える影響、クラウドベースの分析ソリューションの迅速な浸透、ヘルスケアサービスにおけるAIの効果、不正ID管理ソフトウェア数の増加などが市場の成長を後押ししています。

当レポートでは、世界のヘルスケア向け不正検出市場を調査し、市場の概要、コンポーネント・配信形態・ソリューションタイプ・用途・エンドユーザー・地域別の市場規模の推移と予測、成長率、収益額、競合情勢、市場シェア、主要企業のプロファイルなどをまとめています。

目次

第1章 イントロダクション

第2章 調査手法・前提条件

  • 調査手法

第3章 市場概要

第4章 エグゼクティブサマリー

第5章 世界のヘルスケア向け不正検出市場の分析

第6章 市場洞察:コンポーネント別

  • サービス
  • ソフトウェア

第7章 市場洞察:配信形態別

  • オンプレミス配信
  • オンデマンド配信

第8章 市場洞察:ソリューションタイプ別

  • 記述的分析
  • 予測的分析
  • 処方的分析

第9章 市場洞察:用途別

  • 保険金請求
  • ペイメントインテグリティ
  • 薬局の請求書
  • その他

第10章 市場洞察:エンドユーザー別

  • 保険会社
  • 政府機関
  • サードパーティのサービスプロバイダー
  • その他

第11章 市場洞察:地域別

  • 北米
    • 米国
    • カナダ
    • その他
  • 欧州
    • ドイツ
    • フランス
    • 英国
    • イタリア
    • スペイン
    • その他
  • アジア太平洋地域
    • 中国
    • 日本
    • インド
    • オーストラリア
    • その他
  • その他の地域

第12章 需要と供給サイドの分析

  • デマンドサイド分析
  • サプライサイド分析

第13章 バリューチェーン分析

第14章 市場動向と洞察

第15章 市場力学

  • 促進要因
  • 課題
  • 影響分析
  • 市場機会

第16章 競合シナリオ

  • 市場シェア:企業別(2019年)

第17章 企業プロファイル

  • IBM Corporation
  • Optum, Inc.
  • COTIVITI, INC
  • McKesson Corporation
  • Fair Isaac Corporation
  • SAS Institute Inc.
  • SCIO Inspire, Corp
  • Conduent, Inc.
  • HCL Technologies Limited
  • CGI Inc.
  • DXC Technology Company
  • Northrop Grumman

第18章 免責事項

目次
Product Code: UMHE21216

Healthcare fraud has led to a significant addition of expenses in the healthcare system. As per GAO (General Accounting Office), 'federal spending on major health care programs to grow from 5.9% of GDP in the fiscal year 2020 to 8.0% of GDP in the fiscal year 2050'. The enormous volume of money involved in the healthcare sector and its size make it an attractive fraud target.

The demand for healthcare fraud detection is increasing on account of rising patients number applying for health insurance, an increase in the number of frauds in pharmacy bills etc. Social media influence on the healthcare industry, speedy acceptance of cloud-based analytical solutions, AI effects in the healthcare services, and increase in the number of fraud identity management software propel the market growth. However, some of the restraints in the market include lack of skilled personnel, reluctance to adopt healthcare fraud analytics paired with high upfront cost of deployment.

Based on components, the market is fragmented into Services and Software. The healthcare fraud detection market is expected to record the high growth owing to advancements in software technology, a high adoption rate of fraud detection software by insurance companies, rise in software availability in the developed regions, among others. For instance, healthcare cloud has launched patient analytics software for the tracking of patient outcomes and utilizes extensive database and proprietary analytics to recommend procedures based on patient comorbidities. The software segment generated revenue of USD XX million in 2020 and is expected to grow at a CAGR of XX% during the forecast period to reach a market valuation of USD XX million by 2027F.

Based on delivery models, the market is bifurcated into on-premises and on-demand delivery model. On-premises delivery model is expected to record highest growth owing to high flexibility, pay-as-you-go pricing, and the lack of upfront capital investments for hardware. The On-premises delivery model generated revenue of USD XX million in 2020 and is expected to grow at a CAGR of XX% during the forecast period to reach a market valuation of USD XX million by 2027F.

Based on solutions type, the market is divided into descriptive analytics, predictive analytics, and prescriptive analytics. Descriptive analytics holds the major share owing to its high assistance in predictive and prescriptive analytics. For instance, Vidence and NTT DATA announced a partnership to deliver predictive analytics in oncology. This collaboration will make use of a combination of medical imaging scans, clinical and outcomes data to build a predictive model that will improve treatment regimens.

Based on applications, the market is segmented into insurance claims, payment integrity, pharmacy bill and others. The review of insurance claims holds the largest share owing to a high number of people seeking health insurance, an increase in the uptake of the prepayment review model amongst the patients, an increase in fraud activities, and the rising need to control these frauds. For instance, Care Shield insurance announced the launch of Care Shield, which will cover numerous medical expenses and the protection of No Claim Bonus (NCB) benefit from lapsing.

Based on end-user, the market is fragmented into private insurance payers, government agencies, third-party service providers, and others. Government agencies dominates the market on account of rising fraudulent activities coupled with emerging need for data security. For instance, Criminal Division, Fraud Section's Health Care Fraud (HCF) Unit is comprised of more than 70 prosecutors whose core mission is to prosecute health care fraud-related cases involving patient harm and huge financial loss.

For a better understanding of the adoption of Healthcare Fraud Analytics, the market is analyzed based region/ countries including North America (US, Canada, and the Rest of North America), Europe (Germany, France, Italy, Spain, UK, and Rest of Europe), Asia-Pacific (China, Japan, India, Australia, and Rest of APAC), and Rest of World. North America dominates the healthcare fraud analytics market in 2020, on account of the rising number of people seeking health insurance, rising fraudulent activities, and rise in government anti-fraud initiatives and advancements in technology. As per the National Healthcare Anti-Fraud Association (NHCAA), health care fraud costs the U.S. nearly US$68 billion every year.

Some of the major players operating in the market include: IBM Corporation, Optum, Inc., COTIVITI, INC., McKesson Corporation, Fair Isaac Corporation, SAS Institute Inc., SCIO Inspire, Corp., Conduent, Inc., HCL Technologies Limited, CGI Inc., DXC Technology Company, and Northrop Grumman, etc. Several M&As along with partnerships have been undertaken by these players to boost their presence in different regions.

Global Healthcare Fraud Detection Market was valued at USD XX million in 2020 and is projected to expand significantly with a CAGR of XX% from 2021F to 2027F. The Global Healthcare Fraud Detection Market is expected to witness a boost on account of rising patients number applying for health insurance, an increase in the number of frauds in pharmacy, healthcare, and high returns on investment.

TABLE OF CONTENTS

1 MARKET INTRODUCTION

  • 1.1 Market Definitions
  • 1.2 Objective of the Study
  • 1.3 Limitation
  • 1.4 Stake Holders
  • 1.5 Currency Used in Report
  • 1.6 Scope of the Global Healthcare Fraud Detection Market Study

2 RESEARCH METHODOLOGY OR ASSUMPTION

  • 2.1 Research Methodology for the Global Healthcare Fraud Detection Market
    • 2.1.1 Main Objective of the Global Healthcare Fraud Detection Market

3 MARKET SYNOPSIS

4 EXECUTIVE SUMMARY

5 GLOBAL HEALTHCARE FRAUD DETECTION MARKET ANALYSIS 2019-27F

6 MARKET INSIGHTS BY COMPONENTS

  • 6.1 Services
  • 6.2 Software

7 MARKET INSIGHTS BY DELIVERY MODELS

  • 7.1 On-Premise Delivery
  • 7.2 On-Demand Delivery

8 MARKET INSIGHTS BY SOLUTIONS TYPE

  • 8.1 Descriptive Analytics
  • 8.2 Predictive Analytics
  • 8.3 Prescriptive Analytics

9 MARKET INSIGHTS BY APPLICATION

  • 9.1 Insurance Claim
  • 9.2 Payment Integrity
  • 9.3 Pharmacy Bills
  • 9.4 Others

10 MARKET INSIGHTS BY END-USERS

  • 10.1 Insurance Company
  • 10.2 Government Agencies
  • 10.3 Third-party Service Providers
  • 10.4 Others

11 MARKET INSIGHTS BY REGION

  • 11.1 NORTH AMERICA HEALTHCARE FRAUD DETECTION MARKET
    • 11.1.1 United States
    • 11.1.2 Canada
    • 11.1.3 Rest of North America
  • 11.2 EUROPE HEALTHCARE FRAUD DETECTION MARKET
    • 11.2.1 Germany
    • 11.2.2 France
    • 11.2.3 United Kingdom
    • 11.2.4 Italy
    • 11.2.5 Spain
    • 11.2.6 Rest of Europe
  • 11.3 ASIA PACIFIC HEALTHCARE FRAUD DETECTION MARKET
    • 11.3.1 China
    • 11.3.2 Japan
    • 11.3.3 India
    • 11.3.4 Australia
    • 11.3.5 Rest of Asia Pacific
  • 11.4 REST OF WORLD HEALTHCARE FRAUD DETECTION MARKET

12 DEMAND AND SUPPLY SIDE ANALYSIS

  • 12.1 Demand Side Analysis
  • 12.2 Supply Side Analysis
    • 12.2.1 Top Product Launches
    • 12.2.2 Top Business Partnerships
    • 12.2.3 Top Business Expansions, Investments and Divestitures
    • 12.2.4 Top Merger and Acquisitions

13 VALUE CHAIN ANALYSIS

14 GLOBAL HEALTHCARE FRAUD DETECTION MARKET TRENDS & INSIGHTS

15 GLOBAL HEALTHCARE FRAUD DETECTION MARKET DYNAMICS

  • 15.1 Drivers
  • 15.2 Challenges
  • 15.3 Impact Analysis
  • 15.4 Opportunity

16 COMPETITIVE SCENARIO

  • 16.1 Market Share of Global Healthcare Fraud Detection Market Share, by Company 2019

17 COMPANY PROFILED

  • 17.1 IBM Corporation
  • 17.2 Optum, Inc.
  • 17.3 COTIVITI, INC
  • 17.4 McKesson Corporation
  • 17.5 Fair Isaac Corporation
  • 17.6 SAS Institute Inc.
  • 17.7 SCIO Inspire, Corp
  • 17.8 Conduent, Inc.
  • 17.9 HCL Technologies Limited
  • 17.10 CGI Inc.
  • 17.11 DXC Technology Company
  • 17.12 Northrop Grumman

18 DISCLAIMER

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