Health & Medical Insurance in the US: Market Research Report

Market Research • Market Size • Industry Statistics • Industry Analysis • Industry Trends

Health & Medical Insurance Market Research Report | NAICS 52411b | Jul 2014

Taking care: An aging population and rising health expenditures will propel demand

IBISWorld’s Health & Medical Insurance market research report provides the latest industry statistics and industry trends, allowing you to identify the products and customers driving revenue growth and profitability. The industry report identifies the leading companies and offers strategic industry analysis of the key factors influencing the market.

Report Snapshot
Industry Statistics & Market Size
Annual Growth 09-14
Annual Growth 14-19
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Industry Analysis & Industry Trends

The Health and Medical Insurance industry is expected to grow consistently over the next five years. The reforms expected to take full effect in 2014 will lead to more individuals qualifying for financial subsidies for insurance, thereby increasing demand for industry services. Key health expenditure items (e.g. hospital services and prescription drugs) will experience strong growth over the five years to 2019. The aging population will also stimulate demand for both government-funded and private health insurance, further benefiting the industry... purchase to read more

Industry Report - Industry Products Chapter

The majority of industry revenue is generated from premiums that are related to fully funded insurance policies. Under this traditional coverage, the health insurer is financially responsible for paying all the incurred coverage benefits and administration costs of healthcare benefits. In return, the company receives a premium. Health insurers also generate income by providing network-based health and well-being services to beneficiaries in government-sponsored healthcare programs such as Medicare and Medicaid.

In addition to healthcare premiums, insurers also generate revenue from fees and product sales. For example, industry participants generate a significant amount of fee revenue for managing care for self-funded insurance plans... purchase to read more


Industry ProductsRelated ReportsTable of Contents

What is the Health & Medical Insurance Industry?

This industry underwrites (i.e. assumes the risks of and assigns premiums for) health and medical insurance policies. Insurance is the transfer of the risk of a loss in exchange for payment. Operators also provide administrative services for self-funded insurance plans (whereby an employer provides health benefits to employees with its own funds). Under this structure, the industry operator is a third-party administrator and is not responsible for health benefit payments.

Industry Products
Pharmacy benefit management (PBM)Preferred provider organization (PPO) plansHigh-deductible health plans (HDHPs)Health maintenance organization (HMO) plansPoint-of-service (POS) plansFee-for-service (FFS) plansMedicaid (via private firms)Medicare (via private firms)
Industry Activities
Underwriting health and medical insurance policiesUnderwriting dental policies Providing pharmacy benefit management servicesManaging care between the health provider and individual recipient Third-party administration of self-funded insurance plansInvestment of health insurance premiums

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