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U.S. Payment Integrity Market Size to Worth USD 8.66 Billion by 2032

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Ottawa, June 29, 2023 (GLOBE NEWSWIRE) — The U.S. Payment Integrity Market is expanding as healthcare costs continue to rise, and healthcare providers and payers are seeking ways to reduce costs and improve efficiency. In addition, the increasing prevalence of fraudulent activities in the healthcare industry has also led to a growing demand for payment integrity solutions. The adoption of technology such as Artificial Intelligence (AI), Machine Learning (ML), and blockchain are expected to further boost the growth of the payment integrity market in the U.S. These technologies offer enhanced fraud detection and prevention capabilities, improved claims processing and analysis, and increased transparency in financial transactions.

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Component Landscape

The software segment is anticipated to grow at the highest CAGR from 2023 to 2032. Payment integrity artificial intelligence software aids in the detection and gathering of evidence against fraud schemes. It also aids in the extraction of useful insights and the processing of large quantities. Furthermore, the user is able to simply transfer information amongst teams in the detection of behavior-based patterns using artificial intelligence. Overall, the market for payment integrity will develop as a result of the usage of artificial intelligence in software.

The service sector is growing at the fastest rate during the projected period. Payment integrity services relate to a variety of solutions provided by leading organizations, including secure payment, payment recovery, credit balance services, overpayment identification, and coding mistake identification. Many of the leading payment integrity solution providers are continuously improving their payment integrity solutions to ensure smooth operation and fraud-free transactions. Furthermore, these services boost provider satisfaction because this technology-driven claim uses advanced algorithms with a significant possibility for payment fault detection, resulting in higher monetary recoveries. As a result of these services, payers, and providers are on the same page at the same time, and their incorporation enables speedy completion of claim evaluations and timely payment with minimum payment fraud.

U.S. Payment Integrity Market, By Component, 2022-2032 (USD Million)

Component 2022 2023 2032 CAGR (2023-32)
Software 486.52 618.38 5,545.27 27.6 %
Services 285.74 361.62 3,119.22 27.1 %

Function Landscape

The performance management sector is anticipated to grow at a remarkable pace from 2023 to 2032. The services provided by the vendors are a big part, and performance management is a huge deal while delivering the services. The infrastructure of the payment integrity platforms should be managed, and this is done by optimization of the value received from the third-party suppliers. Furthermore, for performance management, the single platform is used in contract management, overlapping control, and performance reporting. For example, if any new user is getting onboard, then the process should be easy and rapid. Through performance management, there is a relative increase in vendor efficiency. Therefore, performance management is a critical function in the smooth running of the payment integrity business.

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U.S. Payment Integrity Market, By Function, 2022-2032 (USD Million)

Function 2022 2023 2032 CAGR (2023-32)
Query & Reporting 270.29 342.51 2,989.25 27.2 %
OLAP & Visualization 308.90 392.98 3,552.44 27.7 %
Performance Management 193.07 244.51 2,122.80 27.1 %

Application Landscape

The post-payment sector is anticipated to expand at a remarkable rate from 2023 to 2032. Data mining is the extraction of hidden, unexpected, and novel rules from big data sets. Different data mining techniques and services for applications such as telephony, DNA analysis, and medical have been developed. In terms of payments, data mining developments include initiatives to investigate new methods and applications for dealing with algorithm scalability, new application areas, and complex data by utilizing visualization approaches and constraint-based data mining. Furthermore, data mining aids in the recovery of erroneous claims linked with adjudication errors, billing problems, and contract language, as well as the prevention of similar errors from occurring again. Furthermore, data mining in post-payment aids in the repair of leaks, which leads to minimizing errors.

U.S. Payment Integrity Market, By Application, 2022-2032 (USD Million)

Application 2022 2023 2032 CAGR (2023-32)
Pre-payment 193.07 247.94 2,426.06 28.8 %
Post-payment 386.13 488.04 4,158.95 26.9 %
FWA 154.45 195.51 1,689.58 27.1 %
Others 38.61 48.51 389.90 26.1 %

Mode of Delivery Landscape

The on-premises sector is growing at the highest CAGR from 2023 to 2032. Furthermore, healthcare service providers and hospitals that strictly follow the mandates of HIPAA (Health Insurance Portability and Accountability Act) and credit card providers that follow The Payment Card Industry Data Security Standard (PCI-DSS) easily benefit from on-premises. Also, customers and partners are more easily reassured or appeased about data governance issues by employing on-premises software, thereby increasing the growth of the market.

The hybrid sector is anticipated to grow at a remarkable rate from 2023 to 2032. The necessity to react quickly and shift direction is a principle of a digital business. The corporation or enterprise seeks to merge private clouds, public clouds, as well as on-premises to obtain the flexibility needed to maintain a competitive advantage. Furthermore, the implementation of a hybrid model has strengthened collaboration across integrity payment businesses.

U.S. Payment Integrity Market, By Mode of Delivery, 2022-2032 (USD Million)

Mode of Delivery 2022 2023 2032 CAGR (2023-32)
On-Premise 432.47 548.31 4,808.79 27.3 %
Cloud-Based 108.12 139.16 1,386.32 29.1 %
Hybrid 231.68 292.53 2,469.38 26.7 %

End Use Landscape

The healthcare provider sector is anticipated to grow at the fastest CAGR from 2023 to 2032. Payment integrity is critical in healthcare because it assures proper payment and accountability for qualified members. Due to changing trends, hospitals, clinics, and healthcare providers confront issues in maintaining healthcare payment integrity. Payment integrity services ensure patient and hospital openness, create confidence and knowledge of healthcare reimbursement, and decrease revenue loss.

Market Dynamics

Drivers: Growing demand for automation

Payment integrity solutions automate many of the processes involved in detecting and preventing improper payments, reducing the need for manual intervention. This automation helps improve efficiency and accuracy, further driving the adoption of payment integrity solutions.

Restraint: Unexpected Costs of Outsourcing

The market for providers of payment integrity services is also heavily consolidated. Due to this trend, payers may only have one or two vendor options accessible to them for specific services. A reduced ability to innovate and negotiate rates could be the outcome.

However, health plans have already seen internalization tactics as a potential countermeasure to the unpredictability of outsourcing expenses. Complex audits, such as IBR, DRG, and E/M evaluations, are now being carried out internally without the need for additional specialized people or a reduction in effectiveness because of technological advancements.

Related Reports

  • B2B Payments Transaction Market – The B2B payments transaction market size was estimated at USD 868.02 million in 2020 and it is expanding to USD 70 billion by 2030 with a CAGR of 10.7% between 2021 and 2030.
  • Contactless Payment Market – The global contactless payment market accounted for USD 1.1 trillion by in 2020 and it is expanding to USD 4.60 trillion by 2027 with a CAGR of 20.01% from 2020 to 2027.

Key Market Players

  • Cotiviti
  • Optum / Change Healthcare
  • Zelis
  • Availity
  • MultiPlan
  • Ceris
  • Cognizant
  • EXL
  • Performant
  • Syrtis
  • Varis
  • ClarisHealth
  • ClaimLogiq
  • Rialtic
  • HealthEdge

Segments Covered in the Report

By Component

  • Software
  • Services

By Function

  • Query & Reporting
  • OLAP & Visualization
  • Performance Management

By Application
Pre-Payment

  • Claims Editing (1st pass)
  • Claims Editing (2nd, 3rd, etc.)
  • Coding Validation

Post-Payment

  • Complex/Clinical Provider Audit
  • Coordination of Benefits (COB)
  • Subrogation
  • Data Mining

FWA

  • Provider Fraud, Waste & Abuse
  • Special Investigations

Others

  • Reporting and Analytics
  • Others

By Mode of Delivery

  • On-Premise
  • Cloud-Based
  • Hybrid

By End Use

  • Payers
  • Healthcare Providers

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Artificial Intelligence

Elevate Your Virtual Reality Experience with KIWI design RGB Vertical Stand, Now Available on Meta’s Website

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LOS ANGELES, May 11, 2024 /PRNewswire/ — Top-tier VR accessories provider KIWI design has launched its latest product, the RGB Vertical Stand. This Meta-authorized accessory, designed to deepen users’ immersion in the metaverse, is now available on the official Meta website.

“KIWI design’s commitment to pushing the boundaries of virtual reality accessories takes another leap forward with the introduction of our new products,” said Ray,the CEO of KIWI design. “We are always dedicated to bringing innovative upgrades to VR device accessories, with the goal of enriching users’ virtual reality experiences.”
The newly launched RGB Vertical Stand features a user-friendly modular design with push-in assembly, making it easy to set up and use. It is compatible with Meta Quest 3, Quest 2, and Quest Pro, ensuring widespread usability. With a magnetic USB Type-C connector, it provides an effortless way to charge and display your headset. Users can also customize their display with 16 pre-set ambient multicolor RGB light options.
With VR technology constantly evolving, users are seeking more immersive experiences. As a leading manufacturer of VR accessories, KIWI design is committed to enhancing the user experience, through unique product designs. Since its establishment in 2015, KIWI design has acquired over 100 patents and has a diverse product lineup, including head straps, facial interfaces, VR stands, charging accessories, and controller grip covers.
KIWI design has also actively participated in the Made for Meta program, which is provided by Meta to strengthen its partnerships with leading brands to deliver accessories that enhance Meta products with more choice and a richer experience for everyone. KIWI design’s participation in this program validates its high-quality design standards.
The RGB Vertical Stand for Meta Quest 3, Quest 2, and Quest Pro and another specially designed authorized charging dock for the Meta  Oculus Quest 2 are now available for purchase on both KIWI design’s website and Amazon. For more information about our brand and products, please visit our website and follow KIWI design on Facebook, Instagram, X, YouTube and TikTok.
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WIO Taps Gracenote to Revolutionize Television Broadcast Reporting

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LOS ANGELES, May 11, 2024 /PRNewswire/ — WIO LLC, parent company of the global TV broadcast airings platform, WIOpro™, has announced a new strategic agreement with Gracenote, the global content data business unit of Nielsen, to address the longstanding challenge of accurately tracking and collecting music royalties generated by broadcast television and digital programming, With this agreement, WIO will integrate Gracenote TV program metadata and show airings into its WIOpro™ (“When’s It On – Professional”) platform enabling performance rights organizations, copyright management organizations and other entities to better monitor broadcast schedules and identify when royalties have been earned.

By integrating Gracenote historical program data into WIOpro’s new LookBack™ feature, WIO is enhancing its reporting capabilities and empowering Collection Societies, Rights Management Companies and the royalty-earning community to more easily monitor and export broadcast airings and better understand collections opportunities.
“At WIO, we are committed to empowering collection societies and copyright holders around the world with our platform tools and unprecedented access to the best and most accurate television broadcast and streaming data available,” said Shawn Pierce, Co-Founder and CEO of WIO LLC. “We have enjoyed an incredible relationship with Gracenote for 10 years. With the solidification of this agreement, we are able to deliver an unrivaled dataset to the royalty and residual community in a way that has not been offered before.” said Adam Shafron, Co-Founder and CTO of WIO LLC.
“WIO’s platform developed to solve the difficult matter of royalty tracking only becomes more powerful based on the integration of accurate, timely and comprehensive Gracenote metadata,” said Scott Monahan, Director, Strategic Partnerships, Gracenote. “We look forward to the combination of WIOpro’s technology and Gracenote’s program metadata delivering on the promise of transforming music royalty collection so that rights holders can be fairly compensated for use of their work.”
WIO and Gracenote will be at the MusicBiz 2024 conference in Nashville, TN May 13 – 16. Contact Dave Pelman, COO of WIO LLC at [email protected] for media queries or to book an appointment for a product demonstration.
About WIO:WIO is a technology company dedicated to providing broadcast television and digital programming data tailored specifically for the royalty and residual collection industry. Through its platform WIOpro (wiopro.com), users obtain access to real-time broadcast insights, reporting and curated data delivery.
About Gracenote:Gracenote is the content data business unit of Nielsen providing entertainment metadata, connected IDs and related offerings to the world’s leading creators, distributors and platforms. Gracenote enables advanced content navigation and discovery capabilities helping individuals easily connect to the TV shows, movies, music, podcasts and sports they love while delivering powerful content analytics making complex business decisions simpler.
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IDTechEx Explores Printed Electronics in Electrified and Autonomous Mobility

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BOSTON, May 10, 2024 /PRNewswire/ — Electrification, autonomy, and vehicle ownership saturation are causing a technological revolution in the automotive sector. These automotive meta-trends are driving drastic changes in electronic component requirements and present a high-volume opportunity for printed electronics to capitalize on.

Historically, printed electronics technologies have nurtured a close relationship with the automotive sector, with printed force sensors pioneering passenger safety through seat occupancy and seatbelt detection. As such, the automotive sector continues to represent the lion’s share of the global printed and flexible sensor market, which IDTechEx’s report on the topic evaluates as worth US$421M in 2024. However, if the automotive sector is to continue to be a reliable revenue stream, printed electronics technology providers must adapt to address the emerging technical challenges facing future mobility.
Augmenting autonomous vehicles with printed electronics
As vehicle autonomy levels advance, the increasing number and distribution of spatial mapping sensors required will need continuous performance improvements to ensure passenger safety. Emerging printed electronics technologies can augment these sensors, extending detection bandwidth and maximizing reliability during operation.
Transparent conductive films (TCFs) are being developed to heat and defog LiDAR sensor panels, ensuring the function is unperturbed by external environmental conditions. Properties such as high transparency and low haze are important for defogging. These properties can be easily tuned using the wide variety of material options available for TCFs, including carbon nanotubes and silver nanowires.
IDTechEx identifies printed heating as a leading application of transparent conductive films. This is attributed to diminishing growth prospects in capacitive touch sensing applications. Innovations in thin film coating techniques have enabled indium tin oxide (ITO) to dominate touch sensing applications, all but displacing TCFs completely.
Looking towards the future, printed electronics technologies could play a more active role in advanced autonomous driving. Emerging semiconductive materials, such as quantum dots, printed directly onto conventional silicon image sensor arrays can extend detection range and sensitivity deeper into the infrared region. Augmenting existing image sensor technology with enhanced spectral range could facilitate the competition of hybrid silicon sensors with established InGaAs detectors.
Printed sensors promise granularized battery health monitoring
Vehicle electrification is driving the sustained development and evolution of electronic management systems, particularly in the battery and electric drivetrain. A strong market pull exists for technologies that increase vehicle efficiency, range, and lifetime while reducing recharge times.
Printed pressure and temperature sensors measure battery cell swelling and thermal profiles, providing granularized physical data that can be used to optimize battery deployment and recharging. Moreover, hybrid printed sensors that combine integrated printed heating elements promise a solution to actively address battery temperature. IDTechEx estimates that printed sensor-enabled battery deployment and charging optimizations could be worth up to US$3000 in savings per vehicle.
There remains uncertainty about whether electrification trends will correspond to increased demand for physical sensors in electric vehicle batteries, owing to the utility of existing electronic readouts for managing deployment. Virtual sensors also pose a threat, where AI-enabled software models interpret data to predict and emulate physical sensor functions without the need for discreet components. However, emerging regulations regarding safety and sensor redundancy will likely favor measurable metrics and see automotive makers continue to adopt physical sensors. IDTechEx predicts that virtual sensors are unlikely to displace their physical counterparts – so long as low-cost sensors remain widely available.
Embedding printed electronics in the car of the future
IDTechEx predicts that global car sales will saturate over the next decade, with automakers increasingly looking for premium features and technical innovations to differentiate themselves from the competition. In-cabin technologies will be highly desirable – as the location where passengers reside and interact with the vehicle the most.
Lighting elements are emerging as a prominent differentiator, described as “the new chrome” by Volkswagen’s chief designer. The use of in-mold structural electronics (IMSE) enables the integration of embedded lighting elements using existing manufacturing processes. 3D electronics technologies are intrinsically attractive for automotive integration, as functional layers are conformable and lightweight while easily embedded within existing aesthetic elements.
Despite strong tailwinds, the adoption of in-mold electronics within automotive interiors has been sluggish. This is attributed to the challenges of meeting automotive qualification requirements, as well as stiff competition with less sophisticated alternatives such as applying functional films to thermoformed parts. Nevertheless, momentum is building, with technology providers like Tactotek partnering with Mercedes-Benz and Stallantis to progress the automotive validation of IMSE to TRL5.
Outlook for printed electronics in automotive applications
Just as printed force sensors heralded early passenger safety systems, printed electronics technology is poised to underpin next-generation innovations for the car of the future. But this time, the competition will be stiff. Critical cost requirements must be met, while desirable new functionality must address existing challenges faced by manufacturers. Printed electronics can play a role in supporting emerging electrified and autonomous mobility, such as augmenting LiDAR sensors or optimizing electric battery deployment. Demand for technologies that enhance passenger experience and vehicle aesthetics will continue to grow, and printed electronics can supply low-power, lightweight lighting solutions for these.
Sustained engagement from tier suppliers and manufacturers continues to make the automotive sector key to printed sensor market growth opportunities – a total market IDTechEx predicts will reach US$960M by 2034. Strong partnerships between material providers and printed electronics technology providers are complementary to those of the highly vertically integrated automotive value chains between tier suppliers and OEMs. Leveraging printing techniques to provide solutions that slot into existing manufacturing processes and designs will be crucial. In the medium term, the printed electronics technologies most likely to realize revenue potential are those that can adapt to service emerging challenges already known to the automotive industry.
For more information on IDTechEx’s research on this topic, please see their report, “Printed and Flexible Sensors 2024-2034: Technologies, Players, Markets”. Downloadable sample pages are available for this report.
For the full portfolio of printed and flexible electronics market research from IDTechEx, please visit www.IDTechEx.com/Research/PE.
About IDTechEx:
IDTechEx provides trusted independent research on emerging technologies and their markets. Since 1999, we have been helping our clients to understand new technologies, their supply chains, market requirements, opportunities and forecasts. For more information, contact [email protected] or visit www.IDTechEx.com. 
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