Cover Image
市場調查報告書

醫療保險IT:美國家概要及預測 (2014年∼2020年)

Health Insurance Information Technology: US Overview and Outlook, 2014-2020

出版商 Frost & Sullivan 商品編碼 344899
出版日期 內容資訊 英文 134 Pages
商品交期: 最快1-2個工作天內
價格
Back to Top
醫療保險IT:美國家概要及預測 (2014年∼2020年) Health Insurance Information Technology: US Overview and Outlook, 2014-2020
出版日期: 2015年11月06日 內容資訊: 英文 134 Pages
簡介

本報告提供美國的醫療保險IT市場調查分析,提供您整體市場/市場部門別之推動市場要素,主要課題,未來預測,收益成長的預測等系統性資訊。

第1章 摘要整理

第2章 市場背景

第3章 醫療保險產業概要

  • 概要
  • 何謂醫療保險
  • 主要的功能與核心流程
  • 醫療保險和醫療保險服務的資金提供
  • 公共 vs. 民間健康保險
  • 定義
  • 市場類別
  • 宏觀情勢等

第4章 ACA和醫療保險產業

  • 患者保護以及醫療費負擔合理化法 (PPACA)
  • ACA (Affordable Care Act) 的主要活動時間軸
  • ACA資金
  • ACA資金來源的分佈
  • 主要的醫療保險市場改革
  • ACA醫療賠付率的影響
  • ACA-MLR規則
  • ACA的優點
  • ACA線上保險
  • 主要的ACA保險計劃

第5章 醫療保險支出趨勢

  • 醫療保險的涵蓋範圍
  • 政府的定義
  • 國民醫療費趨勢
  • 每人的醫療費的年度年複合成長率 (實際成果·預測)
  • 國民醫療費對公共/民間健康保險的比例
  • 國民醫療費對公共/民間健康保險
  • 與GDP比較下主要的國民醫療費類別的年度年複合成長率 (預測)
  • 主要不同分類的醫療保險支出之年度年複合成長率 (預測)

第6章 醫療保險和IT

  • 市場區隔:醫療保險IT
  • 核心IT架構
  • 軟體應用程式的市場滲透
  • 醫療保險產業上主要IT供應商
  • IT基礎設施/硬體設備
  • 核心管理系統
  • BI/分析
  • 消費者參與
  • 醫療保險公司
  • 醫療制度的IT投資的主要領域
  • 下一代的醫療制度的IT的優先順序

第7章 醫療保險IT的綜合市場:推動因素,阻礙因素,趨勢

  • 概要
  • IT/商務課題
  • 推動市場要素
  • 阻礙市場要素
  • 美國的醫療保險IT市場的推動因素與阻礙因素的影響製圖

第8章 醫療保險IT的綜合市場:收益預測與趨勢

  • 評估
  • 預測的前提條件與定義
  • 預測手法
  • 綜合醫療保險IT:收益預測
  • 綜合市場收益預測的考察
  • 綜合醫療保險IT:各市場區隔的收益佔有率預測
  • 各市場區隔的收益預測

第9章 收益預測:市場區隔

  • 評估:IT基礎設施/硬體設備
  • 收益預測:IT基礎設施/硬體設備
  • 預測的前提條件的考察:IT基礎設施/硬體設備
  • 評估:核心管理系統
  • 收益預測:核心管理系統
  • 預測的前提條件的考察:核心管理系統
  • 評估:BI/分析
  • 收益預測:BI/分析
  • 預測的前提條件的考察:BI/分析
  • 評估:消費者參與
  • 收益預測:醫療保險IT,消費者參與
  • 預測的前提條件的考察:醫療保險IT,消費者參與

第10章 競爭環境

  • 競爭市場力影響付款人IT供應商
  • 競爭市場結構
  • 最近值得注意的交易
  • 主要供應商與產品

第11章 彙整

第12章 附錄

目錄
Product Code: NF1E-01-00-00-00

Changing IT Priorities for Next Generation Health Plans

Healthcare payers are grappling with a number of significant challenges that are upending their traditional business models and operational processes. To tackle these many challenges, health insurance organizations are actively looking at information technology as a lever of operational efficiency and transformational change, with spending priorities focusing on new tools for analytics, consumer engagement, and population health/care management. This study sizes and forecast the health insurance IT market at a broad market level, looking at revenue for the total market and four main IT market segments as defined by Frost & Sullivan -infrastructure/hardware; core administrative systems; business intelligence(BI)/analytics; and consumer engagement. The study covers factors driving the need to deploy IT in response to dynamic industry shifts; discusses key challenges impacting the health insurance industry and the IT market that serves the industry; provides an overall outlook for future business and IT trends for health insurance companies; and forecasts revenue growth for the total payer IT market and key market segments for the 6-year period from 2015 to 2020.

Table of Contents

1. EXECUTIVE SUMMARY

Executive Summary

  • 1. Key Findings-Study Highlights
  • 2. Key Findings-Study Highlights (continued)
  • 3. Key Findings (continued)
  • 4. Scope and Segmentation
  • 5. Scope and Segmentation (continued)
  • 6. Key Questions This Study Will Answer
  • 7. Measurements
  • 8. CEO's Perspective
  • 9. Executive Summary-3 Big Predictions

2. MARKET BACKGROUND

Market Background

  • 1. Snapshot of the Health Insurance Industry in 2014
  • 2. Health Insurance Industry Fundamentals
  • 3. IT Solutions Used by Health Insurance Organizations
  • 4. Market Scope and Definition for Health Insurance IT
  • 5. Market Distribution Structure for IT Solutions Used by Health Insurance Organizations

3. INTRODUCTION TO THE HEALTH INSURANCE INDUSTRY

Introduction to the Health Insurance Industry

  • 1. Introduction to Insurance
  • 2. What is Health Insurance?
  • 3. Key Functions and Core Processes of Health Insurance Organizations
  • 4. How Health Insurance Fits in With Funding for Healthcare Services
  • 5. Public Versus Private Health Insurance
  • 6. Definitions of Common Types of Health Insurance Plans
  • 7. Definitions of Types of Managed Care Organizations
  • 8. Key Market Categories for Health Insurance Plans
  • 9. Macro Conditions Impacting Health Insurance Organizations
  • 10. Macro Conditions Impacting Health Insurance Organizations (continued)
  • 11. Summary of Enveloping Elements Impacting Health Insurers
  • 12. Winning Strategies to Drive Business Value

4. THE AFFORDABLE CARE ACT AND THE HEALTH INSURANCE INDUSTRY

The Affordable Care Act and the Health Insurance Industry

  • 1. The Patient Protection and Affordable Care Act
  • 2. Timeline of Key Events for the Affordable Care Act
  • 3. How is ACA Funded?
  • 4. Estimated Distribution of ACA Funding Sources Over Time
  • 5. Key Health Insurance Market Reforms Due to ACA
  • 6. The Impact of ACA Medical Loss Ratio
  • 7. Premium Distribution Based on ACA-MLR Rule
  • 8. Ten Essential Health Benefits of ACA
  • 9. ACA Online Insurance Exchanges
  • 10. The Key ACA Insurance Plans

5. TRENDS IN HEALTH INSURANCE EXPENDITURES

Trends in Health Insurance Expenditures

  • 1. Health Insurance Coverage-Snapshot of US Population
  • 2. Government Definitions for Health Insurance and Payment Categories of National Health Insurance Expenditures
  • 3. Trends in National Health Expenditures
  • 4. Historical and Projected Average Annual Growth Rates for Per Capita Health Spend
  • 5. National Health Expenditures by Type of Service
  • 6. Percentage Distribution of National Health Expenditures for Public and Private Health Insurance
  • 7. National Health Expenditures for Public and Private Health Insurance
  • 8. Projected Average Annual Growth for Select NHE Categories Compared to National Gross Domestic Product (GDP)
  • 9. Projected Average Annual Growth in Health Insurance Spend by Select Categories

6. HEALTH INSURANCE AND INFORMATION TECHNOLOGY

Health Insurance and Information Technology

  • 1. Market Segmentation-Health Insurance IT
  • 2. Core IT Architecture
  • 3. Market Penetration for Software Applications
  • 4. Select IT Vendors Serving the Health Insurance Industry
  • 5. IT Infrastructure/Hardware
  • 6. Core Administrative Systems
  • 7. BI/Analytics
  • 8. Consumer Engagement
  • 9. Health Insurers View IT Investments as Key to Transformation, Growth, and Innovation
  • 10. Top Areas of IT Investments for Health Plans
  • 11. IT Priorities for Next Generation Health Plans: Where Vendors Need to Focus

7. TOTAL HEALTH INSURANCE IT MARKET-DRIVERS, RESTRAINTS, AND TRENDS

Total Health Insurance IT Market-Drivers, Restraints, and Trends

  • 1. The Big Picture: Macro Forces Impacting the Health Insurance Industry
  • 2. Key IT and Business Challenges Facing Health Insurance
  • 3. Market Drivers
  • 4. Market Restraints
  • 5. Impact Mapping of Drivers and Restraints for the US Health Insurance IT Market

8. TOTAL HEALTH INSURANCE IT MARKET-REVENUE FORECAST AND TRENDS

Total Health Insurance IT Market-Revenue Forecast and Trends

  • 1. Measurements
  • 2. Forecast Assumptions and Definitions
  • 3. Forecast Methodology
  • 4. Total Health Insurance IT-Revenue Forecast
  • 5. Total Market Revenue Forecast Discussion
  • 6. Total Health Insurance IT-Percent Revenue Forecast by Segment
  • 7. Revenue Forecast by Market Segment

9. REVENUE FORECAST AND TRENDS-MARKET SEGMENTS

Revenue Forecast and Trends-Market Segments

  • 1. Measurements-IT Infrastructure/Hardware Segment
  • 2. Revenue Forecast-IT Infrastructure/Hardware Segment
  • 3. Discussion of Forecast Assumptions-IT Infrastructure/Hardware Segment
  • 4. Measurements-Core Administrative Systems Segment
  • 5. Revenue Forecast-Core Administrative Systems Segment
  • 6. Discussion of Forecast Assumptions-Core Administrative Systems Segment
  • 7. Measurements-BI/Analytics Segment
  • 8. Revenue Forecast-Health Insurance IT, BI/Analytics Segment
  • 9. Discussion of Forecast Assumptions-BI/Analytics Segment
  • 10. Measurements-Consumer Engagement Segment
  • 11. Revenue Forecast-Health Insurance IT, Consumer Engagement Segment
  • 12. Discussion of Forecast Assumptions-Health Insurance IT, Consumer Engagement Segment

10. COMPETITIVE ENVIRONMENT

Competitive Environment

  • 1. Competitive Market Forces Impacting Payer IT Vendors
  • 2. Competitive Market Structure
  • 3. Competitive Market Structure (continued)
  • 4. Competitive Market Structure (continued)
  • 5. Competitive Market Structure (continued)
  • 6. Recent Notable Deals
  • 7. Recent Notable Deals (continued)
  • 8. Recent Notable Deals (continued)
  • 9. Recent Notable Deals (continued)
  • 10. Select Vendors and Products
  • 11. Select Vendors and Products
  • 12. Select Vendors and Products
  • 13. Select Vendors and Products
  • 14. Select Vendors and Products
  • 15. Select Vendors and Products

11. THE LAST WORD

The Last Word

  • 1. 3 Big Predictions
  • 2. Legal Disclaimer

12. APPENDIX

Appendix

  • 1. Definition of Select Terms Related to Health Insurance
  • 2. Definition of Select Terms Related to Health Insurance
  • 3. Definition of Select Terms Related to Health Insurance
  • 4. Definition of Select Terms Related to Health Insurance
  • 5. Definition of Select Terms Related to Health Insurance
  • 6. Summary of Select Provisions of the ACA Impacting the Health Insurance Industry
  • 7. Summary of Select Provisions of the ACA Impacting the Health Insurance Industry
  • 8. Summary of Select Provisions of the ACA Impacting the Health Insurance Industry
  • 9. US Health and Medical Insurance Carriers-Historical Statistics
  • 10. Top Health Insurance Companies by Net Premium Written
  • 11. Top Health Insurance Companies by Net Premium Written (continued)
  • 12. Top Health Insurance Companies by Total Enrollment
  • 13. Top Health Insurance Companies by Total Enrollment (continued)
  • 14. Methodology
  • 15. Sources
  • 16. Sources
  • 17. Learn More-Next Steps
Back to Top