Overview

In remission: Rising aggregate health expenditure will foster demand for HMO-provided coverage

IBISWorld’s Industry Market Report on HMO Providers is a comprehensive guide to market size and growth prospects. Ensure due diligence in your research with our strategic analysis of the factors influencing companies, including new product developments; economic, lifestyle and demographic influences; distribution and supply chain factors; and pricing issues.

REPORT SNAPSHOT

Industry Threats & Opportunities

  • Rising aggregate health expenditure will outweigh the decline of HMO penetration
  • The share of Medicare Advantage’s enrollees covered by HMOs has remained steady
  • As the median age of the population continues its ascent, revenue is anticipated to rise

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    Industry Analysis & Industry Trends

    Despite decreasing penetration of the employer and Medicare markets, the HMO Providers industry has benefited over the five years to 2017 from significant growth in healthcare expenditures. Over the five years to 2022, the industry will benefit from rising aggregate health expenditure, which is anticipated to outweigh the continued decline of HMO penetration in the employer-sponsored insurance market. In addition, the industry will benefit from a range of other macroeconomic and demographic trends as well as a continued increase in the median age of the population. As a result of these trends and the impact of regulatory changes on healthcare demand, industry revenue is anticipated to rise over the next five years...

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    Industry Report - Industry Investment Chapter

    The HMO Providers industry operates with a moderate level of capital intensity. IBISWorld estimates that for every $1.00 spent on wages, the industry will allocate $0.15 to capital investment. To run daily operations, a significant amount of capital is needed, including properties, plants and equipment. In addition, companies in the industry invest a considerable amount in the development of internal-use software. However, multiple large health insurers, such as Humana, rely on independent third parties for large portions of their equipment, facilities, systems-related support and data center operations. Through these third parties, they enter long-term leases for facilities, computer hardware and equipment. The..

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    Additional Insights for the HMO Providers Industry

    IBISWorld identifies 250 Key Success Factors for a business.The most important for the HMO Providers Industry are

  • Ability to pass on cost increases
  • Must comply with government regulations
  • Effective cost controls
  • IBISWorld analysts also discuss how external factors such as Total health expenditure and Median age of population in the HMO Providers industry impact industry performance..

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    Look under the hood?

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    Industry Products

    What is the HMO Providers Industry?

    This industry provides Health Maintenance Organization (HMO) insurance coverage that supplies clients with access to physicians and other medical staff primarily engaged in providing a range of outpatient medical services with a focus generally on primary healthcare.

    Industry Products
    Private Group HMO plans
    Private Individual HMO plans
    Medicare, Medicaid and other government HMO plans
    Industry Activities
    Providing managed care for group markets
    Providing managed care for individual markets
    Providing managed care for government-sponsored plans

    Table of Contents

    About this Industry
    Industry Definition
    Main Activities
    Similar Industries
    Additional Resources
    Industry at a Glance
    Industry Statistics Snapshot
    Industry Structure
    Executive Summary
    Industry Performance
    Executive Summary
    Key External Drivers
  • Total health expenditure
  • Median age of population
  • Number of employees
  • Number of people with private health insurance

  • Current Performance
  • HMO types and trends
  • Medicare Advantage dominance
  • Faltering employer-based premiums
  • Chart: Revenue Growth

  • Industry Outlook
  • Rising healthcare costs aid revenue
  • Impact of health reform
  • Table: HMO Providers Industry Revenue Outlook

  • Industry Life Cycle
  • Life cycle reasons
  • Chart: Benchmarking - HMO Providers Industry Lifecycle vs The Economy

  • Products & Markets
    Supply Chains
    Key Buying Industries
  • Consumers

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

  • Products & Services
  • Private Individual HMO plans
  • Medicare, Medicaid and other government HMO plans
  • Private Group HMO plans
  • Chart: HMO Providers Industry Products and Services Segmentation

  • Demand Determinants
    Major Markets
  • Consumers in metropolitan areas
  • Consumers in nonmetropolitan areas
  • Chart: Major Market Segmentation for the HMO Providers Industry

  • International Trade
    Business Locations
    Chart: Business Locations by State
    Competitive Landscape
    Market Share Concentration
    Key Success Factors
    Cost Structure Benchmarks
    ProfitHealthcare benefit expensesWagesOther
  • Chart: Cost Structure Benchmarking – Sector vs HMO Providers

  • Basis of Competition
  • Internal competition
  • External competition

  • Barriers to Entry
  • Table: Barrier to Entry Checklist for the HMO Providers Industry

  • Industry Globalization
    Major Companies
    UnitedHealth Group Inc.Anthem Inc.Humana Inc.
  • Table: UnitedHealth Group Inc. - financial performance
  • Table: Anthem Inc. - financial performance
  • Table: Humana Inc. - financial performance

  • Operating Conditions
    Capital Intensity
  • Chart: Level of Capital Intensity for the HMO Providers Industry
  • Chart: Tools of the Trade: Growth Strategies for Success

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

  • Regulation & Policy
    Industry Assistance
    Key Statistics
    Table: Industry Data for the HMO Providers Industry
    Includes:
  • Industry Revenue (2008-2022)
  • Industry Gross Product (2008-2022)
  • Establishments (2008-2022)
  • Businesses (2008-2022)
  • Employment (2008-2022)
  • Wages (2008-2022)
  • Total Health Expenditure (2008-2022)

  • Table: Annual Percentage Change for Key Industry Data
    Table: Key Ratios for Industry Key Data
    Jargon & Glossary
    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.ÿ
  • 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.
  • Medicare Advantage Plan
  • A type of Medicare health plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits.
  • Why buy this report?

    IBISWorld industry market research reports enable you to:
    • Find out about key industry trends
    • Identify threats and opportunities
    • Inform your decisions for marketing, strategy and planning
    • Quickly build competitive intelligence
    This report on HMO Providers:
    • 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 HMO Providers 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 HMO Providers, you can expect thoroughly researched, reliable and current information that will help you to make faster, better business decisions.

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