ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET 2019-2028

Lifesciences | Healthcare IT

ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET 2019-2028

Market By Type, Application, End-user And Geography | Forecast 2019-2028

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Triton Market Research, in its report on the healthcare fraud analytics and detection market in the Asia-Pacific region, states that it will grow at a CAGR of 24.12% in the forecasted period 2019-2028.



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The countries studied in the Asia-Pacific healthcare fraud analytics and detection market are:

           South Korea

           China

           ASEAN countries

           Japan

           India

           Australia & New Zealand

           Rest of APAC countries

There is a tremendous increase in fraudulent activities in the Asia-Pacific region owing to growing penetration of the internet, increasing mobile data usage and the growing trend of adopting BYOD (bring your own device) in organizations. It is reported that China has adopted disciplinary systems for clinics, hospitals and pharmacists found overcharging their services. The disciplinary actions may include fines, approval and others. The welfare law implemented recently in the country is likely to scale back the rate of frauds significantly. This law brings different medical insurance benefits under one roof and implements anti-fraud measures. Since the medical insurance fraud is widely spread in China, there is a high potential for growth in the healthcare fraud analytics and detection market in the country.

The healthcare system in Japan is characterized by a universal insurance scheme, in which participants can choose better healthcare facilities at a comparably low price. This healthcare system is available to all Japanese citizens, and also the non-Japanese citizens who have been residing in the country for more than a year. The growing healthcare industry indicates an increased adoption of the healthcare fraud analytics and detection market in the country over the coming years.

CGI Group Inc is an information technology services provider. The company offers services such as systems integration, business consulting and IT outsourcing. It has its business operations in different regions, including the Asia-Pacific. CGI Proper Pay is a product provided by the company that aids in detecting enterprise-wide fraud, waste and abuse (FWA) and thus helps companies predict fraud medical and pharmacy claims.

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Table of Content

1.    ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET - SUMMARY

2.    INDUSTRY OUTLOOK

2.1. MARKET DEFINITION

2.2. KEY INSIGHTS

2.2.1.   ASIA-PACIFIC IS THE LEADING REGIONAL MARKET

2.2.2.   PRESCRIPTIVE ANALYSIS IS ANTICIPATED TO GROW AT HIGHEST CAGR

2.2.3.   GROWING PRESSURE TO INCREASE OPERATIONAL EFFICIENCY AND REDUCE HEALTHCARE SPENDING

2.3. PORTER’S FIVE FORCE ANALYSIS

2.3.1.   THREAT OF NEW ENTRANTS

2.3.2.   THREAT OF SUBSTITUTE

2.3.3.   BARGAINING POWER OF SUPPLIERS

2.3.4.   BARGAINING POWER OF BUYERS

2.3.5.   THREAT OF COMPETITIVE RIVALRY

2.4. MARKET ATTRACTIVENESS INDEX

2.5. VENDOR SCORECARD

2.6. IMPACT OF COVID-19 ON HEALTHCARE FRAUD ANALYTICS AND DETECTION

2.7. MARKET DRIVERS

2.7.1.   SURGE IN HEALTHCARE EXPENDITURE

2.7.2.   SWELL IN THE NUMBER OF PATIENTS OPTING FOR HEALTH INSURANCE

2.8. MARKET RESTRAINTS

2.8.1.   UNWILLINGNESS TO ADOPT HEALTHCARE FRAUD ANALYTICS

2.9. MARKET OPPORTUNITIES

2.9.1.   INCREASE IN FALSE ACTIVITIES IN HEALTHCARE

2.10. MARKET CHALLENGES

2.10.1. HIGH COST OF FRAUD DETECTION AND PREVENTION SOLUTIONS

3.    ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET OUTLOOK - BY TYPE

3.1. DESCRIPTIVE ANALYSIS

3.2. PREDICTIVE ANALYSIS

3.3. PRESCRIPTIVE ANALYSIS

4.    ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET OUTLOOK - BY APPLICATION

4.1. REVIEW OF INSURANCE CLAIMS

4.2. PAYMENT INTEGRITY

5.    ASIA-PACIFIC  HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET OUTLOOK - BY END-USER

5.1. PRIVATE INSURANCE PAYERS

5.2. GOVERNMENT AGENCIES

5.3. OTHER END-USERS

6.    ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET – REGIONAL OUTLOOK

6.1. CHINA

6.2. JAPAN

6.3. INDIA

6.4. SOUTH KOREA

6.5. ASEAN COUNTRIES

6.6. AUSTRALIA & NEW ZEALAND

6.7. REST OF ASIA-PACIFIC

7.    COMPETITIVE LANDSCAPE

7.1. CGI INC

7.2. DXC TECHNOLOGY COMPANY

7.3. EXL

7.4. INTELLIGENT BUSINESS MACHINES CORPORATION

7.5. MCKESSON CORPORATION

7.6. NORTHROP GRUMMAN CORPORATION

7.7. OSP LABS

7.8. SAS INSTITUTE INC

7.9. RELX GROUP PLC

7.10. UNITEDHEALTH GROUP (OPTUM INC)

7.11. COTIVITI INC

7.12. CHANGE HEALTHCARE

7.13. FAIR ISSAC CORPORATION

7.14. PONDERA SOLUTIONS

8.    METHODOLOGY & SCOPE

8.1. RESEARCH SCOPE

8.2. SOURCES OF DATA

8.3. RESEARCH METHODOLOGY

List of table

TABLE 1: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY COUNTRY, 2019-2028 (IN $ MILLION)

TABLE 2: MARKET ATTRACTIVENESS INDEX

TABLE 3: VENDOR SCORECARD

TABLE 4: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY COUNTRY, 2019-2028 (IN $ MILLION)

TABLE 5: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY TYPE, 2019-2028 (IN $ MILLION)

TABLE 6: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY APPLICATION, 2019-2028 (IN $ MILLION)

TABLE 7: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY END-USER, 2019-2028 (IN $ MILLION)

List of Figures

FIGURE 1: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY TYPE, 2018 & 2028 (IN %)

FIGURE 2: PORTER’S FIVE FORCE ANALYSIS

FIGURE 3: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY DESCRIPTIVE ANALYSIS, 2019-2028 (IN $ MILLION)

FIGURE 4: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PREDICTIVE ANALYSIS, 2019-2028 (IN $ MILLION)

FIGURE 5: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PRESCRIPTIVE ANALYSIS, 2019-2028 (IN $ MILLION)

FIGURE 6: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY REVIEW OF INSURANCE CLAIMS, 2019-2028 (IN $ MILLION)

FIGURE 7: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PAYMENT INTEGRITY, 2019-2028 (IN $ MILLION)

FIGURE 8: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PRIVATE INSURANCE PAYERS, 2019-2028 (IN $ MILLION)

FIGURE 9: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY GOVERNMENT AGENCIES, 2019-2028 (IN $ MILLION)

FIGURE 10: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY OTHER END-USERS, 2019-2028 (IN $ MILLION)

FIGURE 11: ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, REGIONAL OUTLOOK, 2018 & 2028 (IN %)

FIGURE 12: CHINA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

FIGURE 13: JAPAN HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

FIGURE 14: INDIA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

FIGURE 15: SOUTH KOREA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

FIGURE 16: ASEAN COUNTRIES HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

FIGURE 17: AUSTRALIA & NEW ZEALAND HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

FIGURE 18: REST OF ASIA-PACIFIC HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

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