Health insurance exchange is a federally operated marketplace for insurance where small business and individuals compare and shop for health coverage. Healthcare consumers and governments are demanding that providers and payers offer more services that leads to changes in healthcare landscape. There is increased demand for cost reductions, increased patient satisfaction and improved health outcomes with changing public policies. Healthcare insurance exchange providers are either private exchange or public exchange.
Private exchanges include health insurance carriers and benefit companies while public exchange includes the part of healthcare policies such as Affordable Care Act (ACA) and the Children’s Health Insurance Program (CHIP). Private exchanges are a process for offering employer-sponsored health insurance that combine increased plan choice, online shopping, cost containment strategies and benefit administration. In private exchange, companies buy health insurance and then their employees can choose a health plan from those provided by participating payers.
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Increase in adoption of IT services by third party administrators (TPAs) and changes in healthcare reforms such as Obama care are the major drivers for the growth of the global health insurance exchange market. In addition, the increasing demand for reduction of healthcare insurance cost and growing number of private health exchange companies are anticipated to fuel the growth of the global health insurance exchange market during the forecast period. However, low awareness about health exchange among the people and complex technologies and procedures involved in healthcare are expected to limit the growth of the global health insurance exchange market.
The health insurance exchange market has been segmented by type, by end user and by geography. In terms of type, the health insurance exchange market has been categorized into public and private exchange. Public health insurance exchange is the major contributor to the global health insurance exchange market. Furthermore, public exchange is segmented into state-based exchange, state partnership model, and federally facilitated exchange. Private exchange is categorized into single-carrier exchange and multi-carrier exchange. In terms of end users, market has been segmented into payers and providers.
Geographically, the health insurance exchange market has been segmented into North America, Europe, Asia Pacific, Latin America and Middle East & Africa. North America accounts for a significant share in the global market for health insurance exchange with a major contribution from U.S. owing to very well established healthcare system and increased adoption of IT in the country.
Presence of private healthcare organization, positive initiatives by government in implementing the healthcare policies and constantly improving reimbursement scenario would further propel the health insurance exchange market growth. Europe is anticipated to be the second largest market in health insurance exchange due to implementation of healthcare policies in developed countries such as U.K. and Germany. Moreover, the presence of well-established reimbursement policies in this region and the healthcare regulatory framework are expected to enhance the health insurance exchange market growth.
The major factor that is expected to drive the market in Asia Pacific include the improving healthcare infrastructure in emerging countries such as India and China with the increasing patient awareness for different healthcare policies. This market growth can be attributed to the investments done by governments to improve the present healthcare infrastructure, which will enhance the growth of the health insurance exchange in the developing countries, such as China and India. Latin American countries such as Brazil and Mexico are expected to contribute considerably in driving the health insurance exchange market growth in upcoming 5 years.
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The major players operating in this market include Allscripts, Accenture PLC, CGI Group Inc., Oracle Corporation, IBM Corporation, Inovalon Holdings, Inc., Wipro Limited, Xerox Corporation Ltd., Tata Consultancy Services Limited, Microsoft Corporation, Noridian Healthcare Solutions, LLC, Hewlett-Packard Company among other significant players worldwide.