Consistent increases in healthcare expenditure and medical cost inflation, as well as a sharp decline in the uninsured rate, have driven industry growth in recent years. Industry revenue is correlated with total health expenditure, as operators increase premiums to maintain profitability. Despite this revenue growth, medical cost increases and new legislation mandating minimum medical loss ratios have put pressure on industry profit. As a result, revenue is anticipated to increase over the five years to 2016, while profit margins are expected to decline slightly. Over the five years to 2021, revenue is forecast to rise. Other key sources of growth include medical cost inflation and increased demand from the aging US population.
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.
This report covers the scope, size, disposition and growth of the industry including the key sensitivities and success factors. Also included are five year industry forecasts, growth rates and an analysis of the industry key players and their market shares.