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

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As the unemployment rate declines, more Americans will be covered by private employer-sponsored health insurance. For these reasons, industry research firm IBISWorld has updated a report on the Medical Claims Processing Services industry in its growing industry report collection.

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

After a double-digit drop in 2009, revenue for the Medical Claims Processing Services industry is projected to grow at an average annual 3.8% to $2.1 billion over the five years to 2014 (forecast period ends December 31, 2014). Improving economic conditions have brought down the unemployment rate, increasing Americans' access to private employer-sponsored health insurance. In addition, the aging population has increased the number of patients who are eligible for Medicare, a government-sponsored health insurance program. “Older individuals are more likely to suffer from chronic illnesses and other health problems and are therefore more apt to use medical care that requires industry services,” according to IBISWorld Industry Analyst Leah Goddard. Furthermore, healthcare reform that was passed under the Patient Protection and Affordable Care Act (PPACA) in 2010 has extended coverage to previously uninsured patients, driving growth in doctors' visits. IBISWorld expects the healthcare reform law, which created health insurance exchanges that came online in 2014, to help propel revenue 3.2% over the year.

Rising demand for medical claims processing services has attracted new entrants to the industry. “Despite consolidation in the early part of the period, companies have expanded operations in recent years to meet rising demand,” says Goddard. Over the five years to 2014, the number of industry enterprises is projected to grow at an average annual rate of 1.1% to 5,084 operators (forecast period ends December 31, 2014). However, this trend has heightened competition between industry participants, putting downward pressure on industry profitability.

The Medical Claims Processing Services industry will continue to benefit from higher health expenditure in coming years. As the unemployment rate declines, more Americans will be covered by private employer-sponsored health insurance. Meanwhile, the expanding senior population will create demand via Medicare. In addition, the PPACA will continue to extend health insurance coverage to more Americans, including patients with preexisting conditions.

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

This 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 or call 1-800-330-3772.

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Gavin Smith
IBISWorld Inc.
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