What’s the Buzz About the Just Released March 23rd Report on the Global Healthcare Fraud Detection Market?

Online publications such as The Courier, The Bisouv Network, and even the KSU Sentinel, the student newspaper of Kennesaw State University are covering the latest research issued by Glob Market Reports, or “GMR,” entitled “Global Healthcare Fraud Analysis 2016-2020 and Forecast 2021-2026.”¹

The trend is not good

The compound annual growth rate (CAGR) of healthcare fraud looking back is not an indication of the future. The investment in global healthcare fraud analytics was $1.02 Billion in 2019 and is expected to reach USD 6.65 Billion by 2027, a CAGR of 27.8%. This is a clear indication that as we have reported here previously, healthcare fraud of all forms, principally healthcare insurance fraud as well as cybercrime are alarmingly increasing.

Consider these factors when deciding your organization’s healthcare fraud detection and protection systems and procedures:

The USA is the epicenter of global healthcare fraud. Nearly half the world’s investment in healthcare fraud analytics, 49.5% to be precise, is projected to occur in North America, and the bulk of this will be in the USA, over the next 6 years. This is an astonishing number when considering that the USA has 4.2% of the world’s population.
Health insurance claims are estimated to run up to $3.7 Billion by 2027. Healthcare fraud is expected to expand rapidly in step with this increase due to the growing number of people with medical insurance and the fraud incidents associated with health insurance claims.
The expanding healthcare insurance industry will be another factor expected to accelerate fraud and the market for healthcare fraud analytics in the coming years.
Half the need for fraud analytics will be focused on premise where service delivery takes place. This impacts IT capabilities and related internal data systems.
The GMR study also reported that the high price of fraud prevention tools and the inability of end-users to implement fraud analytics for healthcare will hinder growth of analytics during the forecast period.

You can take action now

This dire outlook need not be the case with ToolCASE at work. Taking proactive steps now, before the demand for healthcare fraud analytics to prevent fraud increased is crucial with the financial stakes involved.

The advent of Artificial Intelligence enables real time monitoring and predictive analysis of fraud possible. The leader in providing healthcare and medical fraud protection is ToolCASE and its proprietary software, RembrandtAI.

Your fraud or accounting department can use the RembrandtAI suite of software to potentially save you millions of dollars based on the size of your business and work force. Besides detecting and protecting your company against fraud, it can resolve customer inquiries, process authorized expenses, and assures regulatory compliance.

Informant, one of the key products provided by ToolCASE, is a full risk management solution that monitors all transactions across all types and channels of transaction in real-time and with interactive capability. Monitoring takes place on a dashboard that provides you alerts and visualization of transactions. The ToolCASE RembrandtAI suite of software detects and protects your organization against healthcare fraud, and help you manage your organization’s healthcare costs.

Source: 1- https://www.globmarketreports.com/industry-reports/87427/Healthcare-Fraud-Detection-market