Health Care Fraud Analytics Market Trends

Global Health Care Fraud Analytics Market size was valued at USD 2.5 billion in 2023 and is poised to grow from USD 3.11 billion in 2024 to USD 17.71 billion by 2032, growing at a CAGR of 24.3% during the forecast period (2025-2032). 

The global healthcare fraud analytics market features intense competition among key players striving to enhance healthcare systems' integrity. Established companies like IBM, SAS, and Optum dominate with their advanced analytics solutions, leveraging AI and machine learning to detect and prevent fraudulent activities across medical claims, billing, and patient data. Meanwhile, innovative entrants such as Cotiviti and Pondera offer specialized tools that target evolving fraud schemes. The market's landscape is characterized by continuous technological advancements and collaborations with healthcare providers, as stakeholders increasingly prioritize robust fraud detection to ensure financial security and quality care delivery. 'IBM Corporation (USA) ', 'Optum Inc. (USA) ', 'SAS Institute Inc. (USA) ', 'DXC Technology Company (USA) ', 'Conduent Incorporated (USA) ', 'HCL Technologies Ltd. (India) ', 'Wipro Limited (India) ', 'Cotiviti Inc. (USA) ', 'EXL Service Holdings Inc. (USA) ', 'OSP Labs (USA) ', 'McKesson Corporation (USA) ', 'Northrop Grumman Corporation (USA) ', 'RELX Group PLC (LexisNexis) (UK) ', 'Healthcare Fraud Shield (USA) ', 'Sharecare Inc. (USA) ', 'FraudLens Inc. (USA) ', 'HMS Holding Corp. (USA) ', 'Codoxo (USA) ', 'FRISS International B.V. (Netherlands) ', 'MultiPlan Inc. (USA)'

The increasing prevalence of healthcare fraud and the growing adoption of advanced analytics solutions by healthcare providers and payers to detect and prevent fraudulent activities are propelling the global healthcare fraud analytics market.

In the global healthcare fraud analytics market, key developments include advanced AI and machine learning integration for real-time anomaly detection, predictive modeling, and claims analysis, enhancing fraud identification accuracy. Collaborations between technology providers and healthcare organizations are fostering innovative solutions. Regulatory compliance and data security remain focal points, driving the adoption of robust fraud prevention systems. Additionally, the market sees continuous refinement of algorithms, leveraging big data analytics to improve fraud detection and prevention while minimizing false positives, ultimately safeguarding healthcare resources, and ensuring quality patient care.

The largest market for healthcare fraud analytics has traditionally been North America, particularly the United States. The region's extensive healthcare system, high healthcare spending, and strict regulatory environment have driven the adoption of advanced fraud detection technologies.