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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 | Oct 2014

Pre-existing condition: New regulations will increase demand but challenge profit margins

IBISWorld’s Health & Medical Insurance market research report offers insightful industry analysis and research into the market at the national level. IBISWorld’s in-depth industry market research is presented in a logical and consistent format. The industry report contains key industry statistics, market size, industry trends, and growth and profit forecasts for a 5-year outlook period.

Report Snapshot
Industry Statistics & Market Size
Revenue
$677bn
Annual Growth 09-14
1.1%
Annual Growth 14-19
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Profit
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Employment
456,240
Businesses
961
Industry Analysis & Industry Trends

The Health and Medical Insurance industry has been characterized by slow growth over the five years to 2014 as a result of reduced employer coverage and continued consumer deleveraging. However, consistent increases in healthcare expenditure and medical cost inflation have continued to drive industry growth. In the next five years, the industry will continue to benefit from rising health expenditure and an aging US population that demands increased insurance coverage. Health insurance reforms expected to take effect in 2014 and 2015 will further increase demand for health insurance through government subsidies and an individual mandate, but will also present challenges to industry profitability... purchase to read more

Industry Report - Industry Analysis Chapter

Consistent growth in healthcare expenditure has driven industry revenue growth over the five years to 2014. Insurers have struggled to increase premiums in line with medical cost inflation; however, this is due to the price-sensitive nature of their services and a cash-strapped customer base. Consequently, revenue growth has lagged behind total health spending, and operators' profit margins, measured as interest before earnings and taxes, have remained restrained... 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 workers 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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