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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