Premium plan: Despite moderate volatility, revenue is expected to continue increasing

Over the five years to 2018, the Health and Medical Insurance industry in Massachusetts has experienced moderate volatility. Revenue grew immediately following the implementation of the Patient Protection and Affordable Care Act (PPACA) because private insurance enrollment increased throughout the country. However, the impact of the PPACA on Massachusetts enrollment was mitigated compared with other states because Massachusetts already had strong health insurance regulation. Despite volatility, industry revenue is expected to rise over the five years to 2018. Over the next five years, the industry in Massachusetts is expected to continue growing, albeit at a slightly slower pace...purchase to read more.

Industry Statistics & Market Size
Revenue
$20bn
Annual Growth 13-18
1.9%
Forecast Growth 18-23
Profit
Employment
12,632
Businesses
77

Industry Threats & Opportunities

  • The industry is undergoing heavy consolidation and competition has increased
  • Additional Insights for the Health & Medical Insurance in Massachusetts Industry

    IBISWorld identifies 250 Key Success Factors for a business.The most important for the Health & Medical Insurance in Massachusetts Industry are

  • Having an extensive distribution/collection network
  • Having a good reputation
  • Ability to pass on cost increases
  • IBISWorld analysts also discuss how external factors such as Total health expenditure and Number of employees in Massachusetts in the Health & Medical Insurance in Massachusetts industry impact industry performance..

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    What's in this report

    What is the Health & Medical Insurance in Massachusetts 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 in Massachusetts 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) plans
  • High-deductible health plans (HDHPs)
  • Health maintenance organization (HMO) plans
  • Point-of-service (POS) plans
  • Medicaid (via private companies)
  • Medicare (via private companies)
  • Industry Activities
  • Underwriting health and medical insurance policies
  • Underwriting dental policies
  • Providing pharmacy benefit management services
  • Managing care between the health provider and individual recipient
  • Administering of self-funded insurance plans
  • Investing health insurance premiums
  • Similar Industries
  • Reinsurance Carriers
  • Health & Welfare Funds
  • Workers' Compensation & Other Insurance Funds
  • Emergency & Other Outpatient Care Centers
  • Life Insurance & Annuities in California
  • Health & Medical Insurance in California
  • Property, Casualty & Direct Insurance in California
  • Life Insurance & Annuities in New York
  • Health & Medical Insurance in New York
  • Property, Casualty & Direct Insurance in New York
  • Property, Casualty and Direct Insurance in Illinois
  • Life Insurance & Annuities in Illinois
  • Health & Medical Insurance in Illinois
  • Property, Casualty and Direct Insurance in Texas
  • Property, Casualty and Direct Insurance in Florida
  • Health & Medical Insurance in Florida
  • Property, Casualty and Direct Insurance in Massachusetts
  • Life Insurance & Annuities in Massachusetts
  • Property, Casualty and Direct Insurance in Ohio
  • Health & Medical Insurance in Ohio
  • Property, Casualty and Direct Insurance in Pennsylvania
  • Life Insurance & Annuities in Pennsylvania
  • Health & Medical Insurance in Pennsylvania
  • Property, Casualty and Direct Insurance in New Jersey
  • Life Insurance & Annuities in New Jersey
  • Health & Medical Insurance in New Jersey
  • Property, Casualty and Direct Insurance in Georgia
  • Life Insurance & Annuities in Georgia
  • Health & Medical Insurance in Georgia
  • Property, Casualty and Direct Insurance in Michigan
  • Life Insurance & Annuities in Michigan
  • Health & Medical Insurance in Michigan
  • Property, Casualty and Direct Insurance in Wisconsin
  • Life Insurance & Annuities in Wisconsin
  • Health & Medical Insurance in Wisconsin
  • Property, Casualty and Direct Insurance in Washington
  • Life Insurance & Annuities in Washington
  • Health & Medical Insurance in Washington
  • Property, Casualty and Direct Insurance in Virginia
  • Life Insurance & Annuities in Virginia
  • Health & Medical Insurance in Virginia
  • Property, Casualty and Direct Insurance in Tennessee
  • Life Insurance & Annuities in Tennessee
  • Health & Medical Insurance in Tennessee
  • Property, Casualty and Direct Insurance in Missouri
  • Life Insurance & Annuities in Missouri
  • Property, Casualty and Direct Insurance in North Carolina
  • Life Insurance & Annuities in North Carolina
  • Health & Medical Insurance in North Carolina
  • Property, Casualty and Direct Insurance in Minnesota
  • Life Insurance & Annuities in Minnesota
  • Health & Medical Insurance in Minnesota
  • Property, Casualty and Direct Insurance in Maryland
  • Life Insurance & Annuities in Maryland
  • Health & Medical Insurance in Maryland
  • Property, Casualty and Direct Insurance in Colorado
  • Life Insurance & Annuities in Colorado
  • Health & Medical Insurance in Colorado
  • Table of Contents

    Industry Definition
    Main Activities
    Similar Industries
    Additional Resources
    Industry Statistics Snapshot
    Industry Structure
    Executive Summary
    Executive Summary
    Key External Drivers
  • Total health expenditure
  • Number of employees in Massachusetts
  • Median age of population
  • Number of physician visits
  • Per capita disposable income in Massachusetts

  • Current Performance
    Industry Outlook
    Industry Life Cycle
  • Life cycle reasons
  • Chart: Benchmarking - Health & Medical Insurance in Massachusetts Industry Lifecycle vs The Economy

  • Supply Chains
    Key Buying Industries
  • Consumers

  • Key Selling Industries
  • Custody, Asset & Securities Services
  • Portfolio Management

  • Products & Services
  • Pharmacy benefit management (PBM)
  • Preferred provider organization (PPO) plans
  • Medicare (via private companies)
  • High-deductible health plans (HDHPs)
  • Medicaid (via private companies)
  • Health maintenance organization (HMO) plans
  • Point-of-service (POS) plans
  • Chart: Health & Medical Insurance in Massachusetts Industry Products and Services Segmentation

  • Major Markets
  • Consumers with employer-sponsored health insurance
  • Consumers with Medicaid
  • Consumers with Medicare
  • Consumers with direct-purchased health insurance
  • Consumers with other insurance plans
  • Chart: Major Market Segmentation for the Health & Medical Insurance in Massachusetts Industry

  • Business Locations
    Chart: Business Locations by State
    Market Share Concentration
    Key Success Factors
    Cost Structure Benchmarks
  • Chart: Cost Structure Benchmarking – Sector vs Health & Medical Insurance in Massachusetts

  • Basis of Competition
    Barriers to Entry
    Anthem Inc., CVS Health Corporation, Harvard Pilgrim Health Care, UnitedHealth Group Inc., Cigna Corporation,
  • Table: Anthem Inc. - financial performance
  • Table: CVS Health Corporation - financial performance
  • Table: Harvard Pilgrim Health Care - financial performance
  • Table: UnitedHealth Group Inc. - financial performance
  • Table: Cigna Corporation - financial performance

  • Capital Intensity
  • Chart: Level of Capital Intensity for the Health & Medical Insurance in Massachusetts Industry
  • Chart: Tools of the Trade: Growth Strategies for Success

  • Technology & Systems
    Revenue Volatility
  • Chart: Volatility vs Industry Growth

  • Regulation & Policy
    Industry Assistance
    Table: Industry Data for the Health & Medical Insurance in Massachusetts Industry
    Includes:
  • Industry Revenue (2009-2023)
  • Establishments (2009-2023)
  • Businesses (2009-2023)
  • Employment (2009-2023)
  • Wages (2009-2023)
  • Number of employees in Massachusetts (2009-2023)

  • Table: Annual Percentage Change for Key Industry Data
    Table: Key Ratios for Industry Key Data
    Fully Funded Insurance
  • A type of coverage where a health insurer is financially responsible for paying all incurred benefits and administration costs of healthcare services. In return, the company receives a premium.
  • Health Maintenance Organization (Hmo)
  • A healthcare organization composed of physicians, hospitals or other providers that offer healthcare services at a reduced fee. Payment is made in advance, before services are rendered.
  • High-Deductible Health Plan
  • A health insurance plan that has a high-minimum deductible that does not cover the initial costs or all of the costs of medical expenses.
  • Indemnity Plan
  • A health plan with no preferred physician network that reimburses for medical expenses regardless of who provides the service. However, in some cases the reimbursement amount may be limited.
  • Managed Care
  • A general term that refers to the organization of doctors, hospitals and other providers into groups in order to enhance the quality and cost-effectiveness of healthcare.
  • Medical Loss Ratio
  • The ratio of premiums used to pay medical claims and improve the quality of care.
  • Point-Of-Service (Pos)
  • An HMO/PPO hybrid or "open-ended HMO" where members can choose which option (HMO or PPO) they will use each time they seek healthcare.
  • Preferred Provider Organization (Ppo)
  • A healthcare organization composed of physicians, hospitals or other providers that offer healthcare services at a reduced fee. Payment is made when services are rendered.
  • Self-Funded Insurance
  • A type of coverage where an employer or organization assumes complete responsibility for healthcare benefit payments instead of a health insurer.
  • What Our Customers Say

    Why buy this report?

    The Health & Medical Insurance in Massachusetts Industry Research Report measures market size, analyses current and future trends, and provides an indication of market share for the industry’s largest companies. IBISWorld’s collection of industry market research reports gives you insightful, up-to-date information on the supply chains, economic drivers, and key buyers and markets for hundreds of industries.

    IBISWorld industry market research reports enable you to:
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    This report on Health & Medical Insurance in Massachusetts:
    • Provides Market Size information to assist with planning and strategic decisions.
    • Includes the necessary information to perform SWOT, PEST and STEER analysis.
    • Helps you understand market dynamics to give you a deeper understanding of industry competition and the supply chain.
    • Analyses key performance and operational metrics so that you can benchmark against your own business, that of your customers’ businesses, or your competitors’ businesses.
    The Health & Medical Insurance in Massachusetts market research report includes:
    • Historical data and analysis for the key drivers of this industry
    • A five-year forecast of the market and noted trends
    • Detailed research and segmentation for the main products and markets
    • An assessment of the competitive landscape and market shares for major companies
    • And of course, much more

    IBISWorld reports on thousands of industries around the world. Our clients rely on our information and data to stay up-to-date on industry trends across all industries. With this IBISWorld Industry Research Report on Health & Medical Insurance in Massachusetts, you can expect thoroughly researched, reliable and current information that will help you to make faster, better business decisions.

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