LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET 2019-2028

Lifesciences | Healthcare IT

LATIN AMERICA 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’s report on the Latin American healthcare fraud analytics and detection market illustrates that the industry is anticipated to proliferate at a CAGR of 22.99% in terms of revenue, during the forecasted period 2019-2028.



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The countries reviewed in the Latin American healthcare fraud analytics and detection market are:

           Mexico

           Brazil

           Rest of Latin America

The health ministry in Brazil is one of the primary government sources, which actively participates in the automation process of data mining majorly for knowledge extraction. This aided the decision-makers in the public healthcare sector to make decisions based on the data, as they may not have much experience in the field directly. An analytical software provider collaborated with Conductor, a company engaged in electronic payments, in 2019, to enhance the payments card protection from fraud in the country. FICO is involved in developing technologies in various domains, including healthcare. These factors are estimated to proliferate the growth of the healthcare fraud analytics and detection market in Brazil in the coming years.

In order to study the fraudulent activities in hospitals, a partnership between the Ministry of Health of Brazil and UFMG (the Federal University of Minas Gerais), named InfoSAS project, was conducted. This study succeeded in enhancing records quality, cost reduction and planning support investments. Since Brazil is a major hub for the pharmaceutical industry, various activities against healthcare fraud are likely to be on the rise. These innovative projects and collaborations are likely to aid the growth of the studied market over the forthcoming years.

International Business Machines Corporation (IBM) is an information technology company involved in providing services like enterprise software, consulting, cloud, systems and financing solutions. The company offers its services to the public, industrial, communications & distribution business and financial services. IBM has its operations across different regions, including Latin America. IBM Counter Fraud Management is a product provided by the company that aids in detecting fraudulent activities.

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Table of Content

1.    LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET - SUMMARY

2.    INDUSTRY OUTLOOK

2.1. MARKET DEFINITION

2.2. KEY INSIGHTS

2.2.1.   PRESCRIPTIVE ANALYSIS IS ANTICIPATED TO GROW AT A HIGHEST CAGR

2.2.2.   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.    LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET OUTLOOK - BY TYPE

3.1. DESCRIPTIVE ANALYSIS

3.2. PREDICTIVE ANALYSIS

3.3. PRESCRIPTIVE ANALYSIS

4.    LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET OUTLOOK - BY APPLICATION

4.1. REVIEW OF INSURANCE CLAIMS

4.2. PAYMENT INTEGRITY

5.    LATIN AMERICA  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.    LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET – REGIONAL OUTLOOK

6.1. BRAZIL

6.2. MEXICO

6.3. REST OF LATIN AMERICA

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: LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY COUNTRY, 2019-2028 (IN $ MILLION)

TABLE 2: MARKET ATTRACTIVENESS INDEX

TABLE 3: VENDOR SCORECARD

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

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

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

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

List of Figures

FIGURE 1: LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY TYPE, 2018 & 2028 (IN %)

FIGURE 2: PORTER’S FIVE FORCE ANALYSIS

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

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

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

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

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

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

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

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

FIGURE 11: LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, REGIONAL OUTLOOK, 2018 & 2028 (IN %)

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

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

FIGURE 14: REST OF LATIN AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2019-2028 (IN $ MILLION)

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