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.
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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.
Key External Drivers
Industry Life Cycle
Products & Markets
Products & Services
Globalization & Trade
Market Share Concentration
Key Success Factors
Cost Structure Benchmarks
Barriers to Entry
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