U.S. Commercial Health Insurance Industry

This note describes the role of commercial payers in the U.S. healthcare industry. We begin with a review of the historical evolution of commercial payers and their role in the market, from the beginning to the Affordable Care Act and beyond. Every wave of reforms in the healthcare industry has impacted commercial payers and forced them to adapt and evolve. The note then provides a quick overview of the main service lines where commercial payers have traditionally operated. An overview of the main players in 2017–2018 follows and describes the main strategic frameworks applied by these organizations. The note concludes with a detailed section on the new trends and challenges that threat the very existence of commercial payers in the future and provides insights into potential future strategic choices that will likely affect once again how commercial payers adapt and operate in the future.