Health Insurance Exchange Market by Type (Public, & Private Exchanges), Phase (Implementation, QA, Operations), Component (Services, Software, Hardware), End User (Government Agencies, TPAs, Health Plans) - Trends & Global Forecasts to 2018
The global health insurance exchange (HIX) IT market is segmented based on type, phase, component, enduser, and geography. On the basis of type, the market is broadly classified into public and private exchanges. Based on phase, the market is divided into pre-implementation services, implementation/ exchange infrastructure delivery, program management and independent verification and validation (IV&V)/quality assurance (QA), and operations and maintenance. The market, by component, is divided into services,software, and hardware. Based on enduser, the HIX IT market is segmented into government agencies, third party administrators (TPAs)/brokerage firms/consultancies, and health plans/payers. Based on geography, the market is classified into the U.S., Europe, Asia, and the Rest of the World (RoW).
The health insurance exchange market shows a double-digit growth rate due to the PPACA reforms, federal funding, trend toward defined contribution model, and drive to reduce healthcare costs and make healthcare affordable. Apart from these parameters, other factors such as growing healthcare IT adoption, boosting healthcare information exchanges, and integration environments are indirectly supporting this market growth. However, factors such as dataprivacy and security issues, high capital investments, lack of awarenessespecially for private exchanges, complex set of technologies, changing regulations, and lack of manpower with healthcare and technical skills may hinder the growth of this market.
The U.S. health insurance exchange market carries a lions share in the global market and is yet poised to grow at the fastest CAGR during the forecast period owing to growing adoption of private exchanges. The European market currently has a miniscule market share, growing at a lower rate mainly due to economic crisis, cultural barriers to IT adoption, and lack of initiatives for implementing HIX. Currently, Asia and the Rest of the Worlddo not have a measurable stake in this market. However, increasing HCIT and HIE adoption, decent IT skills, and the increasingoutsourcing trend is expected to generaterevenues in terms of private exchanges in this market in the near future.
Some leading players in the health insurance exchange market are Accenture (Ireland), CGI Group, Inc. (Canada), Deloitte (U.S.), IBM Corporation (U.S.), Infosys (India), MAXIMUS (U.S.), Oracle Corporation (U.S.),Xerox Corporation Ltd. (U.S.), and other emerging players such as Connecture (U.S.), Cognosante (U.S.), hCentive (U.S.), Hewlett-Packard (U.S.), Hexaware Technologies (India), Inovalon, Inc. (U.S.), KPMG (Netherlands), Microsoft Corporation (U.S.), Noridian Healthcare Solutions, LLC (U.S.), Tata Consultancy Services (TCS) (India), and WiproLimited (India), among others.
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This research report covers the global health insurance exchange market by type, phase, component, enduser, and geography.
By Type
- Public Exchange
- State-based Exchange
- Federally Facilitated Exchange (FFE)
- State Partnership Model
- Private Exchange
- Multi-carrier Exchange
- Single-carrier Exchange
By Phase
- Pre-implementation Services
- Implementation/Exchange Infrastructure Delivery
- System Development and Deployment
- System Integration and Interfacing
- System Software Components
- Program Management and Independent Verification and Validation (IV&V) /Quality Assurance (QA)
- Operations and Maintenance
By Component
- Services
- Software
- Hardware
By End User
- Government Agencies
- Third Party Administrators (TPAs), Brokerage Firms, and Consultancies
- Health Plans/Payers
By Geography
- U.S.
- Europe
- Asia
- Rest of the World (RoW)
The Health Insurance Exchange (HIX) IT market includesthe revenue generated by the IT vendors mainly in terms of planning, designing, and implementing exchanges, system integrations, program management, operations, and maintenance. This report studies the health insurance exchange market by exchange type, phase, component, end user, and geography.
The marketis driven by several factors such as federal health insurance mandates, federal funding, trend toward defined contribution model, and drive to reduce healthcare costs and make healthcare affordable, growing healthcare IT adoption, and the shift towardintegrated environments. The global market is valued at an estimated $1,609 million in 2013 and is expected to grow at a CAGR of 10.5%during the forecast period (2013-2018). Growth is mainly driven by private exchanges and operational and maintenance activities for public exchanges.Cloud-based computing shows a great opportunity in the HIX market.
The market is segmented based on exchanges types, phases, components, endusers, and geography. On the basis of exchange type, the market is divided intopublic and private exchanges. Based on phase, the market is divided into pre-implementation services, implementation/exchange infrastructure delivery, program management and independent verification and validation (IV&V)/qualityassurance (QA), and operations and maintenance. The market, by component, is divided into services, software, and hardware. Based on end user, the market is segmented into government agencies, third party administrators (TPAs)/brokerage firms/consultancies, and health plans/ payers. Based on geography, the market is classified into the U.S., Europe, Asia, and the Rest of the world (RoW).
Global Health Insurance Exchange (HIX) IT Market, By Type, 20122018 ($Million)
Source: Annual Reports/SEC Filings; Conferences; Press Releases; White Papers; Journals/Magazines; News Articles; Government Publications; AMA, CMA, IRS, HIPPA, NAIC, CHIP, NESCIES, NCSL, HITSP, HIMSS; and MarketsandMarkets Analysis
Public exchanges account for the largest share of the Health Insurance Exchange market in 2013. Despite the largest share carried by public exchanges, private exchanges overtake significantly in terms of market growth. Currently, the private health insurance exchange market is in its nascent stage. However, the concept of private exchanges gained a much higher attention in 2013 with the introduction of the ACA due to which exchange discussion started to take off in the real sense. Skyrocketing healthcare costs are making increasing number of employers to shift from traditional defined benefit plans to defined contribution plans helping them to manage costs as well as benefit their employees.
The global market is significantly dominated by the U.S. carrying a share of over95%.The U.S. is expected to continue to lead this market during the forecast period.The European market currently has a miniscule market share, growing at a lower rate mainly due to economic crisis, cultural barriers to IT adoption, and lack of initiatives for implementing HIXs. Currently, Asia and the Rest of the World donot have a measurable stake in this market. However, increasing HCIT and HIE adoption, decent IT skills, and the increasingoutsourcing trend will generate revenue in terms of private exchanges in this market in the near future.
Some leading players in the Health Insurance Exchange market are Accenture (Ireland), CGI Group, Inc. (Canada), Deloitte (U.S.), IBM Corporation (U.S.), Infosys (India), MAXIMUS (U.S.), Oracle Corporation (U.S.), and Xerox Corporation Ltd. (U.S.) and other emerging players such as Connecture (U.S.), Cognosante (U.S.), hCentive (U.S.), Hewlett-Packard (U.S.), Hexaware Technologies (India), Inovalon, Inc. (U.S.), KPMG (Netherlands), Microsoft Corporation (U.S.), Noridian Healthcare Solutions, LLC (U.S.), Tata Consultancy Services (TCS) (India), and Wipro Limited (India), among others.
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Table Of Contents
1 Introduction (Page No. - 15)
1.1 Objectives of the Study
1.2 Report Description
1.3 Markets Covered
1.4 Stakeholders
1.5 Research Methodology
1.5.1 Market Estimation
1.5.2 Market Crackdown & Data Triangulation
1.5.3 Key Data Points from Secondary Sources
1.5.4 Key Data Points from Primary Sources
1.5.5 Assumptions
2 Executive Summary (Page No. - 26)
3 Market Overview (Page No. - 30)
3.1 Introduction
3.1.1 HIX Ecosystem
3.1.2 Health Insurance Exchange (HIX) Functions
3.2 Market Definition
3.3 Market Segmentation
3.4 Market Dynamics
3.4.1 Drivers
3.4.1.1 Ppaca/Obamacare Reforms Driving Market Growth
3.4.1.2 Federal Grants Boosting Market Growth
3.4.1.3 Rising Demand for Reduction in Healthcare Costs to Propel Market Growth
3.4.2 Restraints
3.4.2.1 High Costs to Hinder Market Growth
3.4.2.2 Complex Set of Technologies Decelerating Market Growth
3.4.3 Opportunities
3.4.3.1 Private Exchanges Providing Great Market Potential
3.4.3.2 Demand for Private Cloud-Based Architecture and Services Will Accelerate HIX Growth
3.4.4 Challenges
3.4.4.1 Building Consumer Awareness About Exchanges
3.4.4.2 Ensuring Privacy & Security
3.4.4.3 to Get Right Blend of Personnel With Healthcare and Technical Know-How
4 Global Health Insurance Exchange (HIX) IT Market, By Type (Page No. - 43)
4.1 Introduction
4.2 Public Exchanges
4.2.1 State-Based Exchanges
4.2.2 Federally Facilitated Exchanges (Ffe)
4.2.3 State Partnership Model
4.3 Private Exchanges
4.3.1 Multi-Carrier Exchange
4.3.2 Single-Carrier Exchanges
5 Global Health Insurance Exchange (HIX) IT Market,By Phase (Page No. - 71)
5.1 Introduction
5.2 Pre-Implementation Services
5.3 Implementation/Exchange Infrastructure Delivery
5.3.1 System Development & Deployment
5.3.2 System Integration & Interfacing
5.3.3 System Software Components
5.4 Program Management and Independent Verification and Validation (Iv&V)/Quality Assurance (Qa)
5.5 Operations & Maintenance
6 Global Health Insurance Exchange (HIX) IT Market,By Component (Page No. - 84)
6.1 Introduction
6.2 Services
6.3 Software
6.4 Hardware
7 Global Health Insurance Exchange (HIX) IT Market, By End User (Page No. - 92)
7.1 Introduction
7.2 Government Agencies
7.3 Third Party Administrators, Brokerage Firms, & Consultancies
7.4 Health Plans/Payers
8 Geographic Analysis (Page No. - 103)
8.1 Introduction
8.2 U.S.
8.3 Europe
8.4 Asia
8.5 ROW
9 Competitive Landscape (Page No. - 124)
9.1 Introduction
9.2 Hcentive, Inc.: Rapidly Emerging Player
9.3 Contracts, Agreements, Partnerships & Alliances
9.4 New Product Launches & Developments
9.5 Expansions
9.6 Mergers & Acquisitions
10 Company Profiles (Overview, Financials, Products & Services, Strategy, & Developments)* (Page No. - 138)
10.1 Accenture PLC
10.2 CGI Group, Inc.
10.3 Connecture Inc.
10.4 Cognosante, LLC
10.5 Deloitte
10.6 Hcentive, Inc.
10.7 Infosys
10.8 Maximus
10.9 Oracle Corporation
10.10 Xerox Corporation
*Details on Financials, Product & Services, Strategy, & Developments Might Not Be Captured in Case of Unlisted Companies.
Appendix
List of Tables (73 Tables)
Table 1 Global Health Insurance Exchange IT Market, By End User, 20122018 ($Million)
Table 2 Global Market, By Type, 20122018 ($Million)
Table 3 Health Market, By Geography, 20122018 ($Million)
Table 4 Global Public Health Insurance Exchange Market, By Type, 20122018 ($Million)
Table 5 Global Public Health Insurance Exchange Market, By Phase, 20122018 ($Million)
Table 6 Global Public HIX IT Market, By Implementation Phase, 20122018 ($Million)
Table 7 Global Public HIX IT Market, By Component, 20122018 ($Million)
Table 8 Public Health Insurance Exchange Market, By Geography, 20122018 ($Million)
Table 9 Global State-Based Exchanges IT Market, By Phase, 20122018 ($Million)
Table 10 Global State-Based Exchanges IT Market, By Component, 20122018 ($Million)
Table 11 Global Federally Facilitated Exchange IT Market, By Phase, 20122018 ($Million)
Table 12 Global Federally Facilitated Exchange IT Market, By Component, 20122018 ($Million)
Table 13 Global State Partnership Model IT Market, By Phase, 20122018 ($Million)
Table 14 Global State Partnership Model IT Market, By Component, 20122018 ($Million)
Table 15 Global Private Health Insurance Exchange Market, By Type, 20122018 ($Million)
Table 16 Global Private HIX IT Market, By Phase, 20122018 ($Million) 20122018 ($Million)
Table 18 Global Private HIX IT Market, By Component, 20122018 ($Million)
Table 19 Private Health Insurance Exchange Market, By Geography, 20122018 ($Million)
Table 20 Global Multi-Carrier Exchanges Market, By Phase, 20122018 ($Million)
Table 21 Global Multi-Carrier Exchanges Market, By Component, 20122018 ($Million)
Table 22 Multi-Carrier Exchanges Market, By Geography, 20122018 ($Million)
Table 23 Global Single-Carrier Exchanges Market, By Phase, 20122018 ($Million)
Table 24 Global Single-Carrier Exchanges Market, By Component, 20122018 ($Million)
Table 25 Single-Carrier Exchanges Market, By Geography, 20122018 ($Million)
Table 26 Global Health Insurance Exchange Market, By Phase, 20122018 ($Million)
Table 27 HIX Pre-Implementation Services Market, By Geography, 20122018 ($Million)
Table 28 Global Market, By Type, 20122018 ($Million)
Table 29 HIX Implementation Market, By Geography, 20122018 ($Million)
Table 30 HIX System Development and Deployment Market, By Geography, 20122018 ($Million)
Table 31 HIX System Integration & Interfacing Market, By Geography, 20122018 ($Million)
Table 32 HIX System Software Components Market, By Geography, 20122018 ($Million)
Table 33 HIX Program Management and Iv&V/Qa Market, By Geography, 20122018 ($Million)
Table 34 HIX Operations & Maintenance Market, By Geography, 20122018 ($Million)
Table 35 Global Market, By Component, 20122018 ($Million)
Table 36 HIX IT Services Market, By Geography, 20122018 ($Million)
Table 37 HIX IT Softwaremarket, By Geography, 20122018 ($Million)
Table 38 HIX IT Hardware Market, By Geography, 20122018 ($Million)
Table 39 Global Market, By End User, 20122018($Million)
Table 40 HIX End-User Market, By Geography, 20122018 ($Million)
Table 41 Global HIX Government Agencies Market, By Phase, 20122018 ($Million)
Table 42 Global HIX Government Agencies Market, By Implementation Phase, 20122018 ($Million)
Table 43 HIX Government Agencies Market, By Geography, 20122018 ($Million)
Table 44 Global HIX Tpas, Brokerage Firms, & Consultancies Market, By Phase, 20122018 ($Million)
Table 45 HIX Tpas, Brokerage Firms, & Consultancies Market, By Geography, 20122018 ($Million)
Table 46 Global HIX Health Plans/Payers Market, By Phase, 20122018 ($Million)
Table 47 HIX Health Plans/Payers Market, By Geography, 20122018 ($Million)
Table 48 U.S.: Market, By Type, 20122018 ($Million)
Table 49 U.S.: Private HIX IT Market, By Type, 20122018 ($Million)
Table 50 U.S.: Market, By Phase, 2012 2018 ($Million)
Table 51 U.S.: HIX Implementation Market, By Type, 20122018 ($Million)
Table 52 U.S.: Market, By Component, 20122018 ($Million)
Table 53 U.S.: Market, By End User, 20122018 ($Million)
Table 54 Europe: Market, By Type, 20122018 ($Million)
Table 55 Europe: Private HIX IT Market, By Type, 20122018 ($Million)
Table 56 Europe: Market, By Phase, 20122018 ($Million)
Table 57 Europe: HIX Implementation Market, By Type, 20122018 ($Million)
Table 58 Europe: Market, By Component, 20122018 ($Million)
Table 59 Europe: Market, By End User, 20122018 ($Million)
Table 60 Asia: Private HIX IT Market, By Type, 2018 ($Million)
Table 61 Asia: Market, By Phase, 2018 ($Million)
Table 62 Asia: HIX Implementation Market, By Type, 2018 ($Million)
Table 63 Asia: Market, By Component, 2018 ($Million)
Table 64 Asia: Market, By End User, 2018 ($Million)
Table 65 ROW: Private HIX IT Market, By Type, 2018 ($Million)
Table 66 ROW: Market, By Phase, 2018 ($Million)
Table 67 ROW: HIX Implementation Market, By Type, 2018 ($Million)
Table 68 ROW: Market, By Component, 2018 ($Million)
Table 69 ROW: Market, By End User, 2018 ($Million)
Table 70 Contracts, Agreements, Partnerships, & Alliances (2011-2014)
Table 71 New Products Launches & Developments (2011-2014)
Table 72 Expansions (2011-2014)
Table 73 Mergers & Acquisitions (2011-2014)
List of Figures (14 Figures)
Figure 1 Forecast Model
Figure 2 Market Size Estimation Methodology
Figure 3 Data Triangulation
Figure 4 Global Health Insurance Exchange Market, By Type, 20132018 ($Million)
Figure 5 Global Market, By Phase, 2013 ($Million)
Figure 6 HIX Ecosystem
Figure 7 Functions of Health Insurance Exchange
Figure 8 Market Segmentation
Figure 9 Market Dynamics
Figure 10 Global Health Insurance Exchange Market, By Component, 20132018 ($Million)
Figure 11 Global Health Insurance Exchange Market Shift, By End User, 20132018 ($Million)
Figure 12 Health Insurance Exchange Market, By Geography, 20132018 ($Million)
Figure 13 Key Growth Strategies, 20112014
Figure 14 Overall Strategy, By Company, 20112014
Customization Options:
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Profiles of Other Emerging Players in this Market such as
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- Milliman
Market Size and Analysis for each Type of Exchange, by End-user
Market Size and Analysis for End-user market, by Type of Exchange
A break down of what type of exchange each U.S. State runs
Affordable Insurance Exchange Grants for each U.S. State (2012 and 2013)
Generating Response ...
Growth opportunities and latent adjacency in Health Insurance Exchange Market