What is the current valuation of the US medical payment-fraud-detection market?

The market valuation was 492.49 USD Million in 2024. Read More

What is the projected market size for the US medical payment-fraud-detection market by 2035?

The projected valuation for 2035 is 1156.78 USD Million. Read More

What is the expected CAGR for the US medical payment-fraud-detection market during the forecast period 2025 - 2035?

The expected CAGR is 8.07% during the forecast period 2025 - 2035. Read More

Which companies are considered key players in the US medical payment-fraud-detection market?

Key players include Optum, Cognizant, Change Healthcare, McKesson, Anthem, Quest Diagnostics, IBM Watson Health, and Verisk Analytics. Read More

What are the main components of the US medical payment-fraud-detection market?

The main components are Services, valued at 200.0 to 450.0 USD Million, and Software, valued at 292.49 to 706.78 USD Million. Read More

How is the US medical payment-fraud-detection market segmented by delivery mode?

The market is segmented into On-premise, valued at 200.0 to 450.0 Million, and Cloud-based, valued at 292.49 to 706.78 Million. Read More

What are the different types of analytics used in the US medical payment-fraud-detection market?

The types of analytics include Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics, with valuations ranging from 100.0 to 500.0 USD Million. Read More

What is the source of service segmentation in the US medical payment-fraud-detection market?

The source of service is segmented into In-house, valued at 246.24 to 552.71 Million, and Outsourced, valued at 246.25 to 604.07 Million. Read More

Who are the end-users of the US medical payment-fraud-detection market?

End-users include Private Insurance Payers, Public/Government Agencies, and Third-Party Service Providers, with valuations from 142.49 to 460.0 USD Million. Read More

What trends are expected to shape the US medical payment-fraud-detection market in the coming years?

Trends may include increased adoption of advanced analytics and cloud-based solutions, driven by the projected growth in market valuation. Read More

US Medical Payment Fraud Detection Market

ID: MRFR/MED/15181-HCR

100 Pages

Vikita Thakur

Last Updated: April 06, 2026

US Medical Payment Fraud Detection Market Research Report By Type (Descriptive Analytics, Predictive Analytics, Prescriptive Analytics), By Component (Services, Software), By Delivery Mode (On-premise, Cloud-based), By Source of Service (In-house, Outsourced) and By End-User (Private Insurance Payers, Public/Government Agencies, Third-Party Service Providers) - Growth & Industry Forecast 2025 To 2035

US Medical Payment Fraud Detection Market Infographic

Summary Table of Contents Segmentation Download PDF

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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 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 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 SECTION IV: QUANTITATIVE ANALYSIS
1. 4.1 Construction, BY Type (USD Million)
  1. 4.1.1 Descriptive Analytics
  2. 4.1.2 Predictive Analytics
  3. 4.1.3 Prescriptive Analytics
2. 4.2 Construction, BY Component (USD Million)
  1. 4.2.1 Services
  2. 4.2.2 Software
3. 4.3 Construction, BY Delivery Mode (USD Million)
  1. 4.3.1 On-premise
  2. 4.3.2 Cloud-based
4. 4.4 Construction, BY Source of Service (USD Million)
  1. 4.4.1 In-house
  2. 4.4.2 Outsourced
5. 4.5 Construction, BY End-User (USD Million)
  1. 4.5.1 Private Insurance Payers
  2. 4.5.2 Public/Government Agencies
  3. 4.5.3 Third-Party Service Providers
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 Construction
  5. 5.1.5 Competitive Benchmarking
  6. 5.1.6 Leading Players in Terms of Number of Developments in the Construction
  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 Change Healthcare (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 McKesson (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 Anthem (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 Quest Diagnostics (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 IBM Watson Health (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 Verisk Analytics (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 LIST OF FIGURES
1. 6.1 MARKET SYNOPSIS
2. 6.2 US MARKET ANALYSIS BY TYPE
3. 6.3 US MARKET ANALYSIS BY COMPONENT
4. 6.4 US MARKET ANALYSIS BY DELIVERY MODE
5. 6.5 US MARKET ANALYSIS BY SOURCE OF SERVICE
6. 6.6 US MARKET ANALYSIS BY END-USER
7. 6.7 KEY BUYING CRITERIA OF CONSTRUCTION
8. 6.8 RESEARCH PROCESS OF MRFR
9. 6.9 DRO ANALYSIS OF CONSTRUCTION
10. 6.10 DRIVERS IMPACT ANALYSIS: CONSTRUCTION
11. 6.11 RESTRAINTS IMPACT ANALYSIS: CONSTRUCTION
12. 6.12 SUPPLY / VALUE CHAIN: CONSTRUCTION
13. 6.13 CONSTRUCTION, BY TYPE, 2024 (% SHARE)
14. 6.14 CONSTRUCTION, BY TYPE, 2024 TO 2035 (USD Million)
15. 6.15 CONSTRUCTION, BY COMPONENT, 2024 (% SHARE)
16. 6.16 CONSTRUCTION, BY COMPONENT, 2024 TO 2035 (USD Million)
17. 6.17 CONSTRUCTION, BY DELIVERY MODE, 2024 (% SHARE)
18. 6.18 CONSTRUCTION, BY DELIVERY MODE, 2024 TO 2035 (USD Million)
19. 6.19 CONSTRUCTION, BY SOURCE OF SERVICE, 2024 (% SHARE)
20. 6.20 CONSTRUCTION, BY SOURCE OF SERVICE, 2024 TO 2035 (USD Million)
21. 6.21 CONSTRUCTION, BY END-USER, 2024 (% SHARE)
22. 6.22 CONSTRUCTION, BY END-USER, 2024 TO 2035 (USD Million)
23. 6.23 BENCHMARKING OF MAJOR COMPETITORS
7 LIST OF TABLES
1. 7.1 LIST OF ASSUMPTIONS
7.1.1
1. 7.2 US MARKET SIZE ESTIMATES; FORECAST
  1. 7.2.1 BY TYPE, 2025-2035 (USD Million)
  2. 7.2.2 BY COMPONENT, 2025-2035 (USD Million)
  3. 7.2.3 BY DELIVERY MODE, 2025-2035 (USD Million)
  4. 7.2.4 BY SOURCE OF SERVICE, 2025-2035 (USD Million)
  5. 7.2.5 BY END-USER, 2025-2035 (USD Million)
2. 7.3 PRODUCT LAUNCH/PRODUCT DEVELOPMENT/APPROVAL
7.3.1
1. 7.4 ACQUISITION/PARTNERSHIP
7.4.1

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US Construction Market Segmentation

Construction By Type (USD Million, 2025-2035)

Descriptive Analytics
Predictive Analytics
Prescriptive Analytics

Construction By Component (USD Million, 2025-2035)

Services
Software

Construction By Delivery Mode (USD Million, 2025-2035)

On-premise
Cloud-based

Construction By Source of Service (USD Million, 2025-2035)

In-house
Outsourced

Construction By End-User (USD Million, 2025-2035)

Private Insurance Payers
Public/Government Agencies
Third-Party Service Providers

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