US Healthcare Insurance Market Analysis


  • Type: Service area
  • Published : December 2021
  • Region: North America
  • Country: US
  • Report ID : 4985

  • Format: PPT, PDF

US Healthcare Insurance Market : Segmented by Insurance Type, Coverage Type, Age Type and End User Type – Growth, Market Size, Future Prospects & Competitive Analysis, 2020 – 2028

SKU: 4985 Categories: ,

Report Description of the Healthcare Insurance in US

Research Scope and Assumption

  • The report provides the market value for the base year 2020 and a yearly forecast up to 2028 in terms of revenue (USD billion)
  • The key industry dynamics, regulatory scenario, reimbursement scenario, major market trends, and drug markets are evaluated to understand their impacts on the demand for the forecast period. The growth rates were estimated using correlation, regression, and time-series analysis
  • We have used the combination of top-down and bottom-up approach for market sizing, analyzing key regional markets, dynamics, and trends for various solutions, services, and end uses
  • All market estimates and forecasts have been validated through primary interviews with the Key Industry Players (KIPs) and secondary analysis
  • Inflation has not been accounted for in order to estimate and forecast the market
  • Numbers may not add up due to rounding off

Research Objective:

  • To analyze and forecast the market size of US Healthcare Insurance market
  • To classify and forecast US Healthcare Insurance market based on application, drugs, project type, and application.
  • To identify drivers and challenges for US Healthcare Insurance market
  • To examine competitive developments such as mergers and acquisitions, agreements, collaborations and partnerships, etc., in US Healthcare Insurance market
  • To conduct pricing analysis for US Healthcare Insurance market
  • To identify and analyze the profile of leading players operating in US Healthcare Insurance market

Reason to buy the report:

  • Facilitate decision-making based on strong current and forecast data for Healthcare Insurance market
  • Develop strategies based on the latest regulatory framework
  • Strategically analyze micro-markets with respect to individual growth trends, future prospects, and their contribution to the market
  • Analyze competitive developments such as expansions, investments, mergers & acquisitions, new product developments, and research & developments in the Healthcare Insurance market
  • Analyze the opportunities in the market for stakeholders and draw a competitive landscape for market leaders
  • To strategically profile key players and comprehensively analyze their market shares and core competencies
  • We have technically sound team which do a deep dive research and also provide strategy based consulting analysis

Healthcare Insurance Market Executive Summary

Health insurance protects an insured individual against financial losses arising due to a medical emergency. It covers medical treatment expenditures, such as ambulance charges, doctor consultation fees, and hospitalization, medicines and day care procedures costs. The payout is generally either made on actual expenses incurred in the hospital using original medical bills or diagnosis of diseases without submitting bills. Health insurance also provides easy access to medical treatment with a cashless facility at network hospitals of the insurer. According to – Centre for Disease Control and Prevention, the United States spent USD 3.8 trillion in 2019 almost 17.7% of the country’s GDP making the average per person expenditure on health in the United States at USD 11,582 which crossed the USD 12,000 mark in 2020

Market Size and Key Findings

The Healthcare Insurance market size is at around USD xx billion in 2020 and is projected to reach USD xx billion by 2028, exhibiting a CAGR of 4.2% during the forecast period

The Healthcare Insurance in US, will be growing at faster pace of 4.2% during the forecasted period till 2028. The US healthcare insurance market is the largest in the world, without adhering to WHO’s Universal Health Coverage. Although 8% of the US population does not have a health insurance, the United States continues to top the growth in health premiums in North America

Market Dynamics

Market Growth Drivers Analysis

Increase in the Total Health Expenditure, which includes both Public and Private spending on the programs that promote health and prevent disease with the utilization of Medical, Paramedical, and Nursing Knowledge and Technology. Also, Growth in the overall Employment increases the Demand for Health Insurance through both Individual and Employer-Sponsored Health coverage

Market Restraints

Government Regulations and related Policy orders effecting a lot of unprecedented changes in the way healthcare coverage is being offered to the American citizens. The Expensive Healthcare Insurance and an even Expensive Treatment did not see any improvement even after repeated state intervention due to the highly privatized sector

COVID-19 impact on “Healthcare Insurance” in US

The Covid-19 crisis has simultaneously created a surge in demand for health care due to spikes in hospitalization and diagnostic testing while threatening to reduce clinical capacity as health care workers contract the virus themselves. The increased mismatch between patient needs and provider capacity highlights one of the most pervasive inadequacies of the U.S. health care system. During the pandemic, many insurance companies found themselves in a surprisingly strong position. They continued to take in premium dollars from members. At the same time, because elective health care largely disappeared, insurers didn’t have to pay much out. Looking ahead, insurance plans must confront the fact that health care spending levels are likely to increase dramatically to care for COVID-19 patients and for the many members who have deferred non-critical health care

Competitive Landscape

Key Players

The “Healthcare Insurance” in US study report will provide valuable insights with an emphasis on the Healthcare Insurance in US including some of the key market players such as UnitedHealth Group, Anthem, Humana Group, HCSC Group, Centene Corporation

Our market analysis also entails a section solely dedicated to such major players wherein our analysts provide an insight to the financial statements of all the major players, along with its product benchmarking and revenue analysis. The competitive landscape section also includes key development strategies, market share, and market ranking analysis of the above-mentioned players

Notable Recent Deals

  1. Telehealth giant Teladoc’s acquire Livongo. The deal created a digital health behemoth that combines one of the largest telehealth companies with a platform for managing chronic conditions

Healthcare Policies and Regulatory Landscape

Policy changes and Reimbursement scenario

HIPAA imposes compliance obligations on the benefit plan directly – but not on the employer. Also, Benefit plan is primarily a contract with employees that is defined by the ERISA statute and employers need to comply with a set of obligations imposed on this piece of paper because the Non-compliance with HIPAA may affect transparency and privacy with employees.

Also, HIPAA rules for employers:

  • Privacy and Personal Health Information Rule
  • Electronic Security Rule
  • Breach Notification Rule
  • Administrative Simplification Regulation
  • Omnibus Rule

1. Report Description of the Healthcare Insurance Market……………
1.1 Research Scope and Assumption
1.2 Objective of the Study
1.3 Research Methodology
1.4 Reason to Buy the Report
2. Healthcare Insurance Market Executive Summary………………………
2.1 Healthcare Insurance Market – Industry Snapshot & Key Buying Criteria, 2020-2028
2.2 Market Size, Growth Prospects and Key Findings
3. Market Dynamics of Healthcare Insurance market……………………
3.1 Market Growth Drivers Analysis
3.1.1 Increase in the Total Health Expenditure
3.1.2 Growth in the Overall Employment
3.2 Market Restraints Analysis
3.2.1 Government Regulations and Related Policy
3.2.2 Expensive Healthcare Insurance
3.3 Covid-19 Market Impact Analysis
4. Healthcare Insurance in US Market Segmentation………………………………………
4.1 By Insurance Type Analysis:
4.1.1 Disease Insurance
4.1.2 Medical Insurance
4.2 By Coverage Type Analysis
4.2.1 Preferred Provider Organizations (PPOS)
4.2.2 Point of Service
4.2.3 Health Maintenance Organizations (HMOS)
4.2.4 Exclusive Provider Organizations (EPOS)
4.3 By Age Type:
4.3.1 Senior Citizens
4.3.2 Adults
4.3.3 Minors
4.4 By End-Users Type:
4.4.1 Group
4.4.2 Individuals
5. Healthcare Insurance Products Market Share………………………………………
5.1 Market Analysis, Insights and Forecast – By Revenue
6. Competitive Landscape…………………………………………………………………
6.1 Major Top Market Players
6.2 R&D Initiatives in Healthcare Insurance Market
6.3 Notable recent deals in Healthcare Insurance Market
6.3.1 Joint Ventures
6.3.2 Partnerships
6.3.3 Mergers & Acquisitions
6.3.4 Strategic Divestments
7. Key Company Profiles………………………………………………………………….
7.1 UnitedHealth Group Company Overview
Product & Services, Strategies & Financials
7.2 Anthem Company overview
Product & Services, Strategies & Financials
7.3 Humana Group Technology Solutions Company overview
Product & Services, Strategies & Financials
7.4 HCSC Group Company overview
Product & Services, Strategies & Financials
7.5 Centene Corporation Company overview
Product & Services, Strategies & Financials
8. Healthcare Policies and Regulatory Landscape……………………………………
8.1 Policy changes and Reimbursement scenario
8.2 Government Initiatives / Intervention programs
9. Factors Driving Future Growth…………………………………………………………
9.1 New Trends and Development of Healthcare Insurance market
9.2 Future Opportunities
10. Strategic Recommendations

Healthcare Insurance Market Segmentation

By Insurance Type:

  • Disease Insurance
  • Medical Insurance

By Coverage Type:

  • Preferred Provider Organizations (PPOS)
  • Point of Service (POS)
  • Health Maintenance Organizations (HMOS)
  • Exclusive Provider Organizations (EPOS)

By Age Type:

  • Senior Citizens
  • Adults
  • Minors

By End User Type:

  • Group
  • Individuals

Research Methodology

Insights10 will provide you reports within 10 key parameters which are:

  1. Market overview
  2. Market growth drivers & restraints
  3. Epidemiology or disease type
  4. Market segmentation
  5. Market share
  6. Competitive landscape
  7. Key company profiles
  8. Healthcare policies & regulatory framework
  9. Reimbursement scenario
  10. Factors driving future growth

Based on our many years of experience, we believe that these are the parameters that are critical to decision making for business stakeholders. Our focused approach to develop reports focused on 10 key parameters, enabled us to arrive at the name “Insights10”.

Our analysis methodology involves three critical stages:

Stage I: Market Data Collection

Primary Interviews: We have developed a network of experts, freelancers and researchers across countries through which we engage with local experts to gather key data points and assumptions around each market. We also engage regularly with some of the best market research agencies such as Atheneum, GuidePoint, GLG, etc. to conduct surveys and interviews, and build intelligence. We have language translators as a part of our team, who between them can cover 30+ languages allowing us to extract better local insights.

Secondary Data Collection: We have developed strong expertise and experience in secondary data collection methods for developing unique data sets and research material. We gather data from multiple reliable sources to maintain the high level of accuracy and consistency. The market data is analysed and forecasted using appropriate statistical and coherent models. The report offers an overall analysis of the market size, growth, market share as well as segment-level analysis of the specific market. Our report includes precise, to the point information related to the overall market, competition, growth drivers, challenges, regulatory updates, and competition.

Data Sources: We have access to multiple highly reliable free and subscription data sources. We have many years of experience to understand which sources are more dependable for what and which to prefer for the reliable and latest information. The key sources of information include the following, but are not limited to:

  • Statistical Databases
  • Company Websites/Annual Reports
  • Trade Publications
  • Online Databases
  • Published Research Reports
  • Whitepapers
  • Press Releases of Key Market Players

Stage II: Market Data Analysis and Statistical Model

Market Trends: We generally look at macro parameter and micro indicators. The macro parameters includes changes in government policies, demand and supply of the market, government intervention programs and major market share. The micro indicators GDP growth, market size, market volume etc. We also understand nuances specific to each country like US, Canada, India, Germany, etc. and have worked across 60+ countries and hence no only understand global trends, but how these differ by country, how payment models, market structure, cultural parameters, etc. differ in each country.

Market Sizing and Analysis: Our expert data analytics team has created various market forecast models by employing the top-down approach i.e. start with large overall market and segment different areas and bottom-up approach i.e. start with population and epidemiology and roll up based on spend, etc., estimating the size of the market, and distributing among the geographic and/or product segments.

The top-down approach mainly used for new product forecasting and bottom-up approach is used for demand estimation of any product for different countries summed up to form total market. We are able to round off insights and build stronger forecasts because we always do both these methods and triangulate the final numbers.

The study on the market covers the analysis of the leading geographies such as North America, Europe, Asia-Pacific, and Africa for the period of 2020 to 2028. The qualitative analysis covers the industry landscape and trends, market opportunities, competitive landscape and policy and regulatory scenario and the quantitative analysis covers different market estimates and forecasts.

Data Triangulation & Validation:

Data triangulation of various sources and results of the research are carried out by benchmarking with reliable sources such as industry statistics, statistical databases and the company level averages etc.

We make sure to finalize the numbers in alignment to the market research. Firstly, our internal experts ensure thorough validation and checking to ensure the accurate and precise analysis and then validation is also done using multiple data analysis model.  Two level validation is done and entails finalization of report scope and to way of representation pattern.

Stage III: Interpretation and Presentation

Analysis & Interpretation: The information gathered is then analysed and synthesized. A second series of interviews are done if necessary to check and validate. The future opportunities are analysed by understanding product commercialization and many other factors. It also comprises the analysis of data discrepancies observed across various data sources. Information procured from secondary and primary results are then, interpreted by considering following parameters: (a partial list)

  • Establishing market drivers and trends
  • Analyzing regulatory landscape to understand future growth
  • Market Segment based analysis to obtain revenue / volume
  • Analyzing current needs and determining penetration to estimate market

Insights: Our reports deliver actionable insights backed with supporting facts and figures to assist you in achieving exemplary growth. Our in-depth analyses are interspersed with relevant insights and statistics to offer an executive-level view of a given market. The description helps in correlating many minor factors affecting the market and its impact to the different segments within the market.
Data curated from the analysis and interpretation are drawn to portray all in one consolidated report.

Presentation & Reporting: The market research report is presented in different forms such as charts by using a scientific approach for easy understanding. Historic, current and future analysis is provided for each market in terms of both value and volume. The size of the market is interpreted in the US Dollar value and the respective unit, based on the product, for volume consumptions.
The foreign exchange rates are calculated on the respective dates and for the respective regions covered in the study.

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