GVR Report cover U.S. Healthcare Discount Plan Market Size, Share & Trends Report

U.S. Healthcare Discount Plan Market Size, Share & Trends Analysis Report By Service (Dental Care, Health Advocate, Virtual Visits, Alternative Medicines, Prescription Drugs, Vision Care), And Segment Forecasts, 2022 - 2030

  • Report ID: GVR-4-68038-881-7
  • Number of Pages: 87
  • Format: Electronic (PDF)
  • Historical Range: 2016 - 2020
  • Industry: Healthcare

Report Overview

The U.S. healthcare discount plan market size was valued at USD 1.6 billion in 2021 and is projected to expand at a compound annual growth rate (CAGR) of 10.2% from 2022 to 2030. The strong presence of Discount Medical Plan Organizations (DMPOs) offering affordable discount plans for distinct services, such as health advocacy, vision care, virtual visits, chiropractic care, dental care, alternative medicines, and prescription drugs, in the U.S. is a key factor expected to boost the DMPOs familiarity among the U.S. patient population. The U.S. market has a wide array of highly discounted health programs packaged with multiple benefits, such as individual coverage & family coverage.

U.S. healthcare discount plan market size, by service, 2020 - 2030 (USD Billion)

Furthermore, these programs offer higher discounts as compared to traditional high monthly premium insurance plans. The abovementioned factors accelerate the adoption of healthcare discount plans. Key market players are focusing on devising strategies to increase public-private partnerships, collaborations, & investments and expand business coverage to minimize medication costs and offer users affordable & accessible healthcare solutions. Furthermore, increasing collaborative efforts among care providers and healthcare payers & insurance providers to reduce costs & expenses and enhance patient experience & quality of care is significantly improving clinical outcomes and boosting the market growth.

However, the presence of affordable health insurance companies in the country offering multiple health service plans is hindering the market growth. Some players, such as United Healthcare, Cigna, BlueCross, Kaiser Permanente, and BlueShield, offer affordable and better insurance plans compared to medical discount plans. Thus, the high adoption of cheap insurance coverage plans over conventional discount plans is expected to limit the growth of the market. However, despite the presence of a significant number of players, there is a greater need to reinstate a well-structured insurance market, which is capable of providing healthcare coverage at reasonable prices to most individuals not covered by employer-sponsored insurance policies or who are not considered under public entitlement programs.

COVID-19 U.S. healthcare discount plan market impact: a decline of 5.9% market growth between 2019 and 2020

Pandemic Impact

Post COVID Outlook

The market declined at a rate of 5.9% from 2019 to 2020

The market is estimated to witness a year-on-year growth ranging between 4.6% to 10.1% in the next 5 years

The COVID-19 pandemic caused disruptions across the healthcare industry and forced governments to impose lockdowns and travel restrictions to minimize the transmission of infection

The majority of health insurance and medical discount plan providers in the U.S. are taking initiatives to prevent the spread of the coronavirus by activating their emergency plans to ensure free and easy access to prevention, testing, and treatment

Care facilities and institutes underwent major structural transformations and medical procedures were prioritized. This pandemic has exposed a flaw in the current benefit plans. They do not provide affordable cost coverage for critical services, such as telehealth, prescription drugs, diagnostics, and medical care, associated with pandemic–related illnesses

Some of the government and private healthcare providers are offering additional support & protective equipment to the caregivers, expanding telehealth access, and increasing flexibility in Medicaid benefits, to address COVID-19 public health emergency. The immediate implementation of reforms in the Value-based Insurance Design (V-BID) model by the Centers for Medicare & Medicaid Services (CMS) ensures affordable and easy access to critical, clinical services

 

The growing healthcare costs are driving consumers to rapidly adopt health discount plans. Although healthcare bundled payments offer value for providers, payers, and patients, consumers are not capable of exploiting their full potential. However, a wide range of healthcare discount solutions is being actively developed in the private health sector with the motive of encouraging demand for forward-looking health plans. Key market participants are focusing on devising innovative product & service offerings to expand their portfolio and serve the growing demand. These key players promote affordable medical treatment plans through their service portfolio.

For instance, the Health Care Transformation Task Force-an association of key health payers and health providers including Anthem, Aetna, and state-level Blue Cross Blue Shield plans, Sentara Healthcare, and Geisinger-had around 50.0% of its payer and provider members’ payment arrangements done via APMs in 2017, which is expected to increase to nearly 75.0% by 2020. Similarly, United Healthcare in March 2019, through its California Health Care Investment Program, invested USD 19 million to develop multiple health centers in California, improve the patient care experience, enhance clinical outcomes across California and deliver care to underserved communities of Santa Clara, Solano, and Santa Barbara.

The growing demand for health/medical discount plans to curb rising costs is anticipated to propel market growth. According to Centers for Medicare & Medicaid Services (CMS) and National Health Expenditure Accounts (NHEA) estimates, the healthcare spending in the U.S. in 2020 is USD 4.1 trillion or USD 12,530 per individual, accounting for 19.7% of the country’s overall GDP, thus, making the U.S. healthcare industry one of the largest industries. A growing number of mergers & acquisitions, collaborations, partnerships, and joint ventures among industry players enhance the quality of care, offer affordable treatment options, and deliver patient satisfaction.

For instance, in April 2020, Cigna & Express Scripts partnered with Buoy Health to provide screening tools for COVID-19 and help customers & members understand their risks regarding the pandemic. In December 2019, Humana acquired Enclara and this acquisition helped Humana advance in its clinical management expertise by expanding and leveraging Enclara’s capabilities.

Service Insights

The others service segment dominated the market in 2020 and accounted for the largest revenue share of 19.8%. The others segment consists of services, such as medical supplies, lab services, LASIK & ultrasound, diabetic supplies, laboratory tests, X-rays, MRI, CT scan, diagnostics, surgeries, urgent care, endoscopies, and mammography. Market players are devising discount plans coupled with additional benefits on these services and the growing awareness about the same among consumers is driving the growth of the segment. For instance, New Benefits, Ltd. offers 10 to 80% off on various laboratory testing services and 40 to 50% off on LASIK surgery costs. On the other hand, the virtual visits segment is anticipated to register the fastest growth rate over the forecast years.

U.S. healthcare discount plan market share, by service, 2021 (%)

This is owing to the rising burden of chronic diseases, increasing healthcare costs & the growing need to reduce out-of-pocket expenses. Launch of new discount plans, increasing startup funding, and growing penetration of health insurance companies to market the discount plans offered by DMPOs, especially in the U.S., are among the factors estimated to boost the market growth in the coming years. For instance, AmeriPlan offers a monthly package of USD 19.95 on telemedicine services, which include online consultation, recommendation, & prescription medication with 24/7 access to doctors on the phone or over video calls.

Such services also help members save out-of-pocket expenditure and avoid long waiting times at the clinics or hospitals. Market participants are partnering and collaborating to launch discount plans promoting quality treatment & care at low costs.

Key Companies & Market Share Insights

Key players are focusing on devising innovative product development strategies through mergers & acquisitions and collaborations to expand portfolios and strengthen the business position. For instance, in January 2020, Cigna and Oscar entered a strategic partnership to deliver commercial health solutions to small businesses, enabling them to expand their network & product choice, while remaining cost-effective. In June 2019, Optum acquired DaVita Medical Group serving more than 80 health plans to lower healthcare costs (primary, specialty, urgent, and surgical care) and improve patient experience & health. Some key participants in the U.S. healthcare discount plan market are:

Discount Medical Plan Organizations (DMPOs)

  • Coverdell

  • Access One Consumer Health, Inc.

  • New Benefits, Ltd.

  • Alliance Healthcard of Florida, Inc.

  • Ameriplan

  • CARRINGTON International Corp.

Marketer

  • Cigna

  • Sam’s West, Inc.

  • United Health Group

  • DentalPlans.com, Inc.

  • American Dental Care Partners, Inc.

  • Humana, Inc.

  • Blue Cross and BlueShield Association

  • Xpress Healthcare

  • Discounts by Design

  • Freshbenies

U.S. Healthcare Discount Plan Market Report Scope

Report Attribute

Details

The market size value in 2022

USD 1.7 billion

The revenue forecast in 2030

USD 3.8 billion

Growth Rate

CAGR of 10.2% from 2022 to 2030

The base year for estimation

2021

Historical data

2016 - 2020

Forecast period

2022 - 2030

Quantitative units

Revenue in USD million/billion and CAGR from 2022 to 2030

Report coverage

Revenue forecast, company ranking, competitive landscape, growth factors, and trends

Segments covered

Service

Country scope

U.S.

Key companies profiled

New Benefits, Ltd.; AmeriPlan; CARRINGTON International Corporation; Florida Health Solution Corp.; Avia Dental Plan; Inc.; Best Care Medical Plan, Inc.; True Dental Discounts; United Health Group; Sam's Club; Cigna; Freshbenies; Humana; Xpress Healthcare

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Segments Covered in the Report

This report forecasts revenue growth at the country level and provides an analysis of the latest industry trends in each of the sub-segments from 2016 to 2030. For the purpose of this study, Grand View Research, Inc. has segmented the U.S. healthcare discount plan market report based on service:

  • Service Outlook (Revenue, USD Million, 2016 - 2030)

    • Health Advocate

    • Virtual Visits

    • Alternative Medicines

    • Prescription Drugs

    • Dental Care

    • Vision Care

    • Hearing Aids

    • Chiropractic Care

    • Nurse Services

    • Vitamins & Supplements

    • Wellness Plans

    • Podiatry Plans

    • Others

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