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Managed Healthcare, HMOs & PPOs – Industry Analysis, Statistics, Trends, and Forecasts

SIC 6324  |  NAICS 524114

The following guide to industry research and analysis provides sources for industry statistics, trends, and forecasts, financial ratios, salary surveys, and more.

See the following sections listed below to view available resources by category:

For guides to other industries, see our index of over 400 industries.

Industry Analysis, Statistics, Trends, and Forecasts

Health Maintenance Organization (HMO) Providers  (view report)
Health & Medical Insurance Providers  (view report)
Comprehensive industry research reports provide in-depth industry analysis and five-year forecasts, with special focus on the underlying structure and external forces and relationships that affect industries and their performance. Topics addressed in the reports include:
Sample industry research report and selected industry statistics including market size, five-year average growth rate, number of businesses, and total employment are available free online.

UBM Medica, LLC
Managed Healthcare Executive Magazine

Monthly publication features news and information for managed healthcare executives, with special features including the annual "State of the Industry" report (December) which identifies some of the top challenges faced by healthcare executives and provides advice from industry experts on how to deal with and overcome these challenges. Digital editions of the magazine are available free online.

Sanofi-Aventis U.S. LLC
Payer Digest

Annual report provides detailed data and analysis for commercial, Medicare, and Medicaid managed healthcare plan models including HMO, PPO, Medicare Advantage, and Medicaid MCO plan models, with topics covered in the commercial, Medicare, and Medicaid sections including demographic data, utilization measures, financial metrics, and retail prescription spending and out-of-pocket drug costs.

MCOL | HealthQuest Publishers
Resources available from this organization include:

Managed Care Fact Sheets
Fact sheets section provides a statistical overview of key aspects of this industry, with topics covered in this section including enrollment and penetration by provider type, top national plans by enrollment, key performance measures, healthcare cost components, premium increase trends, tax-advantaged health savings and spending accounts, and Medicare Advantage and Part D prescription drug plans.

Managed Care Training Manual
E-learning application provides an introductory overview of various aspects of the business including structure, financing, delivery systems, care management, and legal and regulatory environment, and also features an advanced topics section which addresses premiums and benefits, financial metrics, data and analytics, care management, and provider and consumer issues on a more detailed basis.

National Leadership Directory
Annual publication provides information on over 1,000 managed care organizations, including health plans, provider networks, pharmacy benefits managers, administrative organizations, and specialty organizations, with information provided for each organization including contact information, parent company, company type, and executive and management personnel by name, job function, and title.

Market Analysis

Market analysis report provides industry statistics for a user-defined area on a national, state, county, metro area, or zip code level, with data provided including number of companies, market volume and sales trends, average company sales, sales per employee, staffing and employment trends, average employee wage, and business start up activity and failure rates. Sample report can be viewed online.

More Resources
For more industry research reports and other resources, see the following resource guide.

Financial Statements and Financial Ratios

Industry Financial Ratios
Health & Medical Insurance / Health Maintenance Organizations (HMOs)  Search for "524114"
Five-year financial statement analysis reports provide income statements, balance sheets, and key industry financial ratios for companies of all sizes, with financial data available by sales size range on a national, state, and metropolitan area level including:
Sample reports on a national and metropolitan area level are available free online.

HMO / Health & Medical Insurance Providers
(see links for individual reports)

Financial benchmarking section of this report provides an analysis of industry income and expenses as a percentage of revenue for managed healthcare organizations that provide coverage through a network of physicians, hospitals, and other healthcare providers, with HMO models used to provide coverage including staff, group, open-panel, and network models. Sample report is available online.

Compensation and Salary Surveys

Culpepper and Associates, Inc.
Healthcare Compensation Survey

Online subscription service provides compensation data for executive, operations, and administrative personnel employed by hospitals, insurance companies, and other organizations provided healthcare services, with job classifications covered for health insurance plan providers including top executives, plan operations and underwriting, service operations and claims, and quality and utilization personnel.

PayScale, Inc.
HMO / PPO / Managed Care Providers

Free online service provides median salary, bonus, and hourly wage rate data for job positions in this sector such as managed care manager, case manager, care coordinator, registered nurse, licensed practical nurse, and social worker, with employers for which compensation data is provided including Molina Healthcare, Inc., UnitedHealth Group, Inc., Centene Corporation, and Kaiser Permanente, Inc.

U.S. Bureau of Labor Statistics
Health & Medical Insurance Carriers

Annual employment and wage survey provides hourly and annual wage data for personnel employed by health insurance companies on a national, state, and metropolitan area basis, with managed care providers such as health maintenance organizations (HMOs) that provide health insurance coverage without providing medical care services included in the survey. All information is available free online.

Business Valuation Resources

Private company sales transaction data for over 800 industries.

Related Industries:
Hospitals and Medical Centers
Insurance Companies and Carriers
Insurance Agencies and Brokers
Physicians and Medical Practices


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