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Medical Claims Processing Services in the US Industry Market Research Report from IBISWorld Has Been Updated
  • USA - English


News provided by

IBISWorld Inc.

Jan 02, 2014, 13:00 ET

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The number of privately insured people will rise, supporting demand for industry services.

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New York, NY (PRWEB) January 02, 2014 -- Despite the recession, the Medical Claims Processing Services industry has recorded average annual growth over the five years to 2013. Tough economic conditions caused nationwide layoffs, severing Americans' access to employer-sponsored private insurance in 2008 and 2009. As a result, the number of physicians' visits dropped, weakening demand for medical claims processing. The industry suffered revenue drops in both 2008 and 2009. However, the aging population created demand from another downstream market, helping mitigate revenue declines during the period. As patients reach retirement age, they become eligible for Medicare, a government-provided social insurance program. The insurance coverage provided through this program helps create demand from retiring baby boomers, which has benefited the industry. Additionally, the healthcare reform that was enacted in 2010 has helped provide insurance to previously uninsured patients, allowing for an increase in doctors' visits during 2013. IBISWorld expects this reform to help drive revenue up in 2013.

Market share concentration in the Medical Claims Processing Services industries is low. The largest player, HMS Holdings, accounts for more than 10.0% of industry revenue, while the rest of the largest players hold less than 5.0% of revenue each (see IBISWorld report OD4792). Major players are typically large-scale insurance service providers that operate in a variety of service segments, including risk, consulting and claims adjustments. Over the five years to 2013, market share concentration has increased slowly, primarily because of HMS Holdings' aggressive acquisition streak during much of the period. The company's revenue has grown every year, far outpacing industry growth.

According to IBISWorld Industry Analyst Anna Son, “Profit has remained steady during the five years to 2013.” As demand and revenue fell in the midst of the recession, industry operators took cost-cutting measures, including a cut in the workforce, reflecting an average annual decline, which helped reduce wage costs. Moreover, a slew of factors will likely be favorable for the industry over the five years to 2018. As national unemployment abates, more Americans will be covered by private health insurance. Meanwhile, the growing senior population will create demand via Medicare, and the 2010 Patient Protection and Affordable Care Act (PPACA) will allow more patients with preexisting conditions to be covered by insurance. Together, “these factors will help drive industry revenue up by 2018,” says Son.

For more information, visit IBISWorld’s Medical Claims Processing Services in the US industry report page.

Follow IBISWorld on Twitter: https://twitter.com/#!/IBISWorld
Friend IBISWorld on Facebook: http://www.facebook.com/pages/IBISWorld/121347533189

IBISWorld industry Report Key Topics
The Medical Claims Processing Services industry processes and administers medical insurance policies and claims. Businesses help doctors and other healthcare providers collect payments from insurance companies and Medicare.

Industry Performance
Executive Summary
Key External Drivers
Current Performance
Industry Outlook
Industry Life Cycle
Products & Markets
Supply Chain
Products & Services
Major Markets
Globalization & Trade
Business Locations
Competitive Landscape
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Barriers to Entry
Major Companies
Operating Conditions
Capital Intensity
Key Statistics
Industry Data
Annual Change
Key Ratios

About IBISWorld Inc.
Recognized as the nation’s most trusted independent source of industry and market research, IBISWorld offers a comprehensive database of unique information and analysis on every US industry. With an extensive online portfolio, valued for its depth and scope, the company equips clients with the insight necessary to make better business decisions. Headquartered in Los Angeles, IBISWorld serves a range of business, professional service and government organizations through more than 10 locations worldwide. For more information, visit http://www.ibisworld.com or call 1-800-330-3772.

Gavin Smith, IBISWorld Inc., http://www.ibisworld.com, +1 (310) 866-5042, [email protected]

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