Top 20 healthcare payors
Hospital revenue sources breakdown into a payor mix of private insurance companies and government insurance programs like Medicare and Medicaid. The percentage of the total payor mix from private/self-pay revenue reached 67.4% in 2020, reflecting market dynamics like private insurance companies compensating hospitals at a higher rate than government programs and increasing Medicare Advantage enrollment.
What are the largest healthcare payor organizations?
The Definitive Healthcare ConnectedCareView product tracks key metrics on over 1,200 payor and payor subsidiary organizations. The following list highlights the largest 20 payors (excluding payor subsidiaries) based on total incurred claims.
Largest healthcare insurance companies by total incurred claims
| Rank | Definitive ID | Payor Name | State | Total Incurred Claims | Covered Lives |
| 1 | 583130 | Kaiser Permanente Health Plans | CA | $48,190,589,886 | 9,257,115 |
| 2 | 575957 | Anthem Blue Cross & Blue Shield | IN | $30,985,209,365 | 5,837,538 |
| 3 | 583151 | UnitedHealthcare | MN | $30,958,353,507 | 7,210,507 |
| 4 | 853221 | Health Care Service Corporation Group | IL | $27,089,269,607 | 5,012,197 |
| 5 | 552479 | Florida Blue | FL | $13,889,381,085 | 2,375,334 |
| 6 | 575895 | Centene Corporation | MO | $13,418,778,596 | 2,644,427 |
| 7 | 552477 | Blue Shield of California | CA | $12,195,926,108 | 2,397,370 |
| 8 | 552393 | Aetna | CT | $11,754,508,700 | 2,395,899 |
| 9 | 552436 | Cigna | CT | $11,628,634,678 | 2,203,802 |
| 10 | 575917 | CareFirst BlueCross BlueShield | MD | $7,195,025,341 | 1,356,715 |
| 11 | 552472 | BlueCross BlueShield of Michigan Group | MI | $6,395,661,082 | 1,446,414 |
| 12 | 552480 | Highmark | PA | $6,063,926,192 | 1,201,149 |
| 13 | 1041823 | BlueCross BlueShield of NC Group | NC | $6,031,728,568 | 1,011,974 |
| 14 | 575753 | BlueCross BlueShield of Massachusetts Group | MA | $5,218,911,620 | 880,201 |
| 15 | 553215 | Horizon Blue Cross Blue Shield of New Jersey | NJ | $5,096,699,541 | 800,870 |
| 16 | 575911 | BlueCross BlueShield of Alabama | AL | $4,640,722,164 | 907,023 |
| 17 | 552481 | Humana Group | KY | $4,239,355,565 | 777,097 |
| 18 | 575058 | Independence Blue Cross Group | PA | $3,767,306,513 | 811,687 |
| 19 | 583128 | EmblemHealth | NY | $3,379,255,409 | 500,117 |
| 20 | 583141 | Regence | OR | $3,330,774,479 | 747,541 |
Fig 1 Data is from the Definitive Healthcare ConnectedCareView product. Data is sourced from proprietary research and the CMS Consumer Information and Oversight (CCIIO) Medical Loss Ratio reports. The most recent data is from calendar year CY 2020. Accessed February 2022.
In 2020, the 20 largest healthcare payor organizations accounted for over $255.5 billion in incurred claims and covered nearly 50 million patient lives.
Kaiser Permanente Health Plans had the highest incurred claims at over $48.2 billion — approximately 19% of the claims represented on this list. Along with ranking first in incurred claims, Kaiser Permanente Health Plans also had the highest total covered lives at just over 9 million people. Anthem Blue Cross & Blue Shield (formally known as WellPoint) and UnitedHealthcare each had about $31 billion in total incurred claims in 2020. For total covered lives, Anthem Blue Cross & Blue Shield had 5.8 million compared to UnitedHealthcare’s 7.2 million covered lives.
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