US Healthcare Fraud Detection Market

ID: MRFR/HCIT/17128-HCR
100 Pages
Satyendra Maurya
Last Updated: April 06, 2026
US Healthcare Fraud Detection Market Research Report: Size, Share, Trend Analysis By Technology (Artificial Intelligence, Machine Learning, Data Analytics, Predictive Modeling), By Component (Software, Hardware, Services), By Applications (Claim Verification, Provider Enrollment Screening, Fraud Analytics) and By Deployment Mode (On-Premise, Cloud-Based) - Growth Outlook & Industry Forecast 2025 To 2035
US Healthcare Fraud Detection Market
Market Size
Forecast Period2025 - 2035
CAGR (2025 - 2035)11.21%
2024 Market Size$ 1,274 Million
2025 Market Size$ 1,416.82 Million
2035 Market Size$ 4,099 Million
Key Players
Optum
Cognizant
IBM
Change Healthcare
Verisk Analytics
Hewlett Packard Enterprise
Trends
  • Increased Adoption of AI and Machine Learning
  • Regulatory Compliance and Scrutiny
  • Focus on Preventive Strategies
Opportunities
  • Increased Regulatory Pressure
  • Shift Towards Value-Based Care
  • Growing Demand for Cost Reduction
Summary Table of Contents Segmentation Download PDF
  1. 1 SECTION I: EXECUTIVE SUMMARY AND KEY HIGHLIGHTS
    1. 1.1 EXECUTIVE SUMMARY
      1. 1.1.1 Market Overview
      2. 1.1.2 Key Findings
      3. 1.1.3 Market Segmentation
      4. 1.1.4 Competitive Landscape
      5. 1.1.5 Challenges and Opportunities
      6. 1.1.6 Future Outlook
  2. 2 SECTION II: SCOPING, METHODOLOGY AND MARKET STRUCTURE
    1. 2.1 MARKET INTRODUCTION
      1. 2.1.1 Definition
      2. 2.1.2 Scope of the study
        1. 2.1.2.1 Research Objective
        2. 2.1.2.2 Assumption
        3. 2.1.2.3 Limitations
    2. 2.2 RESEARCH METHODOLOGY
      1. 2.2.1 Overview
      2. 2.2.2 Data Mining
      3. 2.2.3 Secondary Research
      4. 2.2.4 Primary Research
        1. 2.2.4.1 Primary Interviews and Information Gathering Process
        2. 2.2.4.2 Breakdown of Primary Respondents
      5. 2.2.5 Forecasting Model
      6. 2.2.6 Market Size Estimation
        1. 2.2.6.1 Bottom-Up Approach
        2. 2.2.6.2 Top-Down Approach
      7. 2.2.7 Data Triangulation
      8. 2.2.8 Validation
  3. 3 SECTION III: QUALITATIVE ANALYSIS
    1. 3.1 MARKET DYNAMICS
      1. 3.1.1 Overview
      2. 3.1.2 Drivers
      3. 3.1.3 Restraints
      4. 3.1.4 Opportunities
    2. 3.2 MARKET FACTOR ANALYSIS
      1. 3.2.1 Value chain Analysis
      2. 3.2.2 Porter's Five Forces Analysis
        1. 3.2.2.1 Bargaining Power of Suppliers
        2. 3.2.2.2 Bargaining Power of Buyers
        3. 3.2.2.3 Threat of New Entrants
        4. 3.2.2.4 Threat of Substitutes
        5. 3.2.2.5 Intensity of Rivalry
      3. 3.2.3 COVID-19 Impact Analysis
        1. 3.2.3.1 Market Impact Analysis
        2. 3.2.3.2 Regional Impact
        3. 3.2.3.3 Opportunity and Threat Analysis
  4. 4 SECTION IV: QUANTITATIVE ANALYSIS
    1. 4.1 Security, Access Control and Robotics, BY Technology (USD Million)
      1. 4.1.1 Artificial Intelligence
      2. 4.1.2 Machine Learning
      3. 4.1.3 Data Analytics
      4. 4.1.4 Predictive Modeling
    2. 4.2 Security, Access Control and Robotics, BY Component (USD Million)
      1. 4.2.1 Software
      2. 4.2.2 Hardware
      3. 4.2.3 Services
    3. 4.3 Security, Access Control and Robotics, BY Application (USD Million)
      1. 4.3.1 Claim Verification
      2. 4.3.2 Provider Enrollment Screening
      3. 4.3.3 Fraud Analytics
    4. 4.4 Security, Access Control and Robotics, BY Deployment Mode (USD Million)
      1. 4.4.1 On-Premise
      2. 4.4.2 Cloud-Based
  5. 5 SECTION V: COMPETITIVE ANALYSIS
    1. 5.1 Competitive Landscape
      1. 5.1.1 Overview
      2. 5.1.2 Competitive Analysis
      3. 5.1.3 Market share Analysis
      4. 5.1.4 Major Growth Strategy in the Security, Access Control and Robotics
      5. 5.1.5 Competitive Benchmarking
      6. 5.1.6 Leading Players in Terms of Number of Developments in the Security, Access Control and Robotics
      7. 5.1.7 Key developments and growth strategies
        1. 5.1.7.1 New Product Launch/Service Deployment
        2. 5.1.7.2 Merger & Acquisitions
        3. 5.1.7.3 Joint Ventures
      8. 5.1.8 Major Players Financial Matrix
        1. 5.1.8.1 Sales and Operating Income
        2. 5.1.8.2 Major Players R&D Expenditure. 2023
    2. 5.2 Company Profiles
      1. 5.2.1 Optum (US)
        1. 5.2.1.1 Financial Overview
        2. 5.2.1.2 Products Offered
        3. 5.2.1.3 Key Developments
        4. 5.2.1.4 SWOT Analysis
        5. 5.2.1.5 Key Strategies
      2. 5.2.2 Cognizant (US)
        1. 5.2.2.1 Financial Overview
        2. 5.2.2.2 Products Offered
        3. 5.2.2.3 Key Developments
        4. 5.2.2.4 SWOT Analysis
        5. 5.2.2.5 Key Strategies
      3. 5.2.3 IBM (US)
        1. 5.2.3.1 Financial Overview
        2. 5.2.3.2 Products Offered
        3. 5.2.3.3 Key Developments
        4. 5.2.3.4 SWOT Analysis
        5. 5.2.3.5 Key Strategies
      4. 5.2.4 Change Healthcare (US)
        1. 5.2.4.1 Financial Overview
        2. 5.2.4.2 Products Offered
        3. 5.2.4.3 Key Developments
        4. 5.2.4.4 SWOT Analysis
        5. 5.2.4.5 Key Strategies
      5. 5.2.5 Verisk Analytics (US)
        1. 5.2.5.1 Financial Overview
        2. 5.2.5.2 Products Offered
        3. 5.2.5.3 Key Developments
        4. 5.2.5.4 SWOT Analysis
        5. 5.2.5.5 Key Strategies
      6. 5.2.6 Hewlett Packard Enterprise (US)
        1. 5.2.6.1 Financial Overview
        2. 5.2.6.2 Products Offered
        3. 5.2.6.3 Key Developments
        4. 5.2.6.4 SWOT Analysis
        5. 5.2.6.5 Key Strategies
      7. 5.2.7 McKesson (US)
        1. 5.2.7.1 Financial Overview
        2. 5.2.7.2 Products Offered
        3. 5.2.7.3 Key Developments
        4. 5.2.7.4 SWOT Analysis
        5. 5.2.7.5 Key Strategies
      8. 5.2.8 Quest Diagnostics (US)
        1. 5.2.8.1 Financial Overview
        2. 5.2.8.2 Products Offered
        3. 5.2.8.3 Key Developments
        4. 5.2.8.4 SWOT Analysis
        5. 5.2.8.5 Key Strategies
    3. 5.3 Appendix
      1. 5.3.1 References
      2. 5.3.2 Related Reports
  6. 6 LIST OF FIGURES
    1. 6.1 MARKET SYNOPSIS
    2. 6.2 US MARKET ANALYSIS BY TECHNOLOGY
    3. 6.3 US MARKET ANALYSIS BY COMPONENT
    4. 6.4 US MARKET ANALYSIS BY APPLICATION
    5. 6.5 US MARKET ANALYSIS BY DEPLOYMENT MODE
    6. 6.6 KEY BUYING CRITERIA OF SECURITY, ACCESS CONTROL AND ROBOTICS
    7. 6.7 RESEARCH PROCESS OF MRFR
    8. 6.8 DRO ANALYSIS OF SECURITY, ACCESS CONTROL AND ROBOTICS
    9. 6.9 DRIVERS IMPACT ANALYSIS: SECURITY, ACCESS CONTROL AND ROBOTICS
    10. 6.10 RESTRAINTS IMPACT ANALYSIS: SECURITY, ACCESS CONTROL AND ROBOTICS
    11. 6.11 SUPPLY / VALUE CHAIN: SECURITY, ACCESS CONTROL AND ROBOTICS
    12. 6.12 SECURITY, ACCESS CONTROL AND ROBOTICS, BY TECHNOLOGY, 2024 (% SHARE)
    13. 6.13 SECURITY, ACCESS CONTROL AND ROBOTICS, BY TECHNOLOGY, 2024 TO 2035 (USD Million)
    14. 6.14 SECURITY, ACCESS CONTROL AND ROBOTICS, BY COMPONENT, 2024 (% SHARE)
    15. 6.15 SECURITY, ACCESS CONTROL AND ROBOTICS, BY COMPONENT, 2024 TO 2035 (USD Million)
    16. 6.16 SECURITY, ACCESS CONTROL AND ROBOTICS, BY APPLICATION, 2024 (% SHARE)
    17. 6.17 SECURITY, ACCESS CONTROL AND ROBOTICS, BY APPLICATION, 2024 TO 2035 (USD Million)
    18. 6.18 SECURITY, ACCESS CONTROL AND ROBOTICS, BY DEPLOYMENT MODE, 2024 (% SHARE)
    19. 6.19 SECURITY, ACCESS CONTROL AND ROBOTICS, BY DEPLOYMENT MODE, 2024 TO 2035 (USD Million)
    20. 6.20 BENCHMARKING OF MAJOR COMPETITORS
  7. 7 LIST OF TABLES
    1. 7.1 LIST OF ASSUMPTIONS
  8. 7.1.1
    1. 7.2 US MARKET SIZE ESTIMATES; FORECAST
      1. 7.2.1 BY TECHNOLOGY, 2025-2035 (USD Million)
      2. 7.2.2 BY COMPONENT, 2025-2035 (USD Million)
      3. 7.2.3 BY APPLICATION, 2025-2035 (USD Million)
      4. 7.2.4 BY DEPLOYMENT MODE, 2025-2035 (USD Million)
    2. 7.3 PRODUCT LAUNCH/PRODUCT DEVELOPMENT/APPROVAL
  9. 7.3.1
    1. 7.4 ACQUISITION/PARTNERSHIP
  10. 7.4.1

US Healthcare Fraud Detection Market Segmentation

US Healthcare Fraud Detection Market By Technology (USD Million, 2025-2035)

  • Artificial Intelligence
  • Machine Learning
  • Data Analytics
  • Predictive Modeling

US Healthcare Fraud Detection Market By Component (USD Million, 2025-2035)

  • Software
  • Hardware
  • Services

US Healthcare Fraud Detection Market By Application (USD Million, 2025-2035)

  • Claim Verification
  • Provider Enrollment Screening
  • Fraud Analytics

US Healthcare Fraud Detection Market By Deployment Mode (USD Million, 2025-2035)

  • On-Premise
  • Cloud-Based

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