Australia Healthcare Insurance Market Analysis

Australia Healthcare Insurance Market Analysis


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Australia's healthcare insurance market is projected to grow from $24.31 Bn in 2022 to $48.81 Bn by 2030, registering a CAGR of 9.1% during the forecast period of 2022-2030. The main factors driving the growth would be government policies, increasing awareness, rising healthcare costs and the growing geriatric population. The market is segmented by component, the provider, coverage, health insurance plans and end-user. Some of the major players include Pheonix Health fund, NIB, HBF, St. Lukes's and Latrobe.

ID: IN10AUHS008 CATEGORY: Healthcare Services GEOGRAPHY: Australia AUTHOR: Neha Davda

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Australia Healthcare Insurance Market Executive Summary

Australia's healthcare insurance market is projected to grow from $24.31 Bn in 2022 to $48.81 Bn by 2030, registering a CAGR of 9.1% during the forecast period of 2022-2030. Australia's healthcare expenditures in 2019–20 were $202.5 Bn, or $7,926 per person. The actual rise in healthcare spending was smaller at 1.8% than the decade average of 3.4%. In Australia, the government pays for the majority of healthcare expenses, but patients are also responsible for a considerable portion of the tab.

Australia's government and private health insurance companies both contribute to the cost of providing healthcare services. Australia's national healthcare program is known as Medicare. Australian citizens can receive healthcare through Medicare for nothing or at a significant discount. Every Australian pays taxes, which go towards paying for it.

Although not all of them, many necessary therapies are covered by Medicare. It includes things like visits to the doctor, some medications, and medically essential hospital operations in public facilities. Treatments received in private hospitals, ambulance services, and supplemental services like spectacles, dental care, and alternative therapies are not covered. For this reason, a lot of Australians opt for private health insurance.

Australia Healthcare Insurance Market

Market Dynamics

Market Growth Drivers

The Australian healthcare Insurance market is expected to be driven by factors such as:

  1. Government policies- The Medicare Levy Surcharge and the Lifetime Health Cover Loading are some of the policies that the Australian government has put in place to encourage people to get private health insurance. The market for healthcare insurance is projected to continue to expand with the help of these products
  2. Increasing awareness- Australians are looking for insurance solutions that cover preventative healthcare and wellness services as they become more conscious of the value of maintaining excellent health and wellness
  3. Rising healthcare costs- For the past ten years, Australia's healthcare costs have been continuously growing due to factors like increased use of technology and rising drug prices. This will probably lead to a rise in the need for health insurance to help with these expenses
  4. Growing geriatric population- In Australia, the percentage of people over 65 is expected to rise from about 15% in 2020 to about 23% in 2050. The demand for healthcare services and insurance is projected to rise as a result of this demographic change

Market Restraints

The following factors are expected to limit the growth of the healthcare insurance market in Australia:

  1. Affordability- Australian healthcare insurance prices have been rising more quickly than the rate of inflation, which can make it difficult for some people and families to afford coverage. This might prevent the market for health insurance from expanding, especially among lower-income households
  2. Regulatory environment- Australia's heavily regulated healthcare insurance sector can make it difficult for new insurers to enter the market and prevent established insurers from innovating and introducing new products
  3. Consumer trust- Several high-profile scandals and conflicts in the healthcare sector may have damaged customer confidence in both private insurers and the larger healthcare system. If consumers do not think insurance products offer genuine value or protection, this may restrict the expansion of the healthcare insurance market

Competitive Landscape

Key Players

  • Pheonix Health fund (AUS)- Phoenix Health is a not-for-profit health fund that has provided its members with high-quality, reasonably priced health insurance for more than 68 years. Exclusively for the benefit of Stewarts and Lloyds workers, Phoenix Health was established. Phoenix Health has persisted in providing exclusive Private Health Insurance to the numerous firms that currently represent Stewart's and Lloyds over time. Phoenix Health now proudly allows anyone who wants to join the fund to become a member of private health insurance
  • NIB (AUS)- One of Australia's health funds with the fastest growth rates is NIB, which was founded in 1952. More than 1.5 Mn people living in Australia and New Zealand have access to health and medical insurance. Also, they offer health insurance to more than 1.8 Mn foreign workers and students in Australia
  • HBF (AUS)- HBF was founded as the Metropolitan Hospitals Benefit Fund of Western Australia in 1941 with the primary objective of offering Western Australians access to cheap healthcare. It was created to act as a money reserve for the members' continuous access to cheap healthcare. HBF was founded and has since developed into Western Australia's top health insurance company. HBF offers hospital, ancillary, urgent ambulance, and coverage for complementary therapies health insurance
  • St. Lukes's Health (AUS)- Australians have had access to private health insurance through St. Luke's health since 1952. As a non-profit corporation founded in Tasmania, St. Luke's sHealth has always placed a priority on offering its customers the health care that is most appropriate for their lifestyle and budget. A group of Launceston businesses established the fund after realising the state of Tasmania's lack of a private health insurance fund
  • Latrobe (AUS)- A non-profit private health insurer with Australian ownership, Latrobe Health Services was founded in 1951.  They are renowned for providing members with wonderful, old-fashioned service and for being a health fund that supports the neighbourhood.  Latrobe Health only exists for the benefit of its members, giving individuals in need of access to healthcare options

Notable Deals

February 2023- Phoenix Group bought ReAssure, a UK-based life insurance provider, in 2020 and has now partnered with TCS to develop synergies and improve the customer experience for ReAssure's clients. ReAssure's operations will change as a result of the expanded relationship, consolidating the legacy business on the same digital platform, TCS BaNCSTM, that Phoenix Group uses to manage its other books of business.

1. Executive Summary
1.1 Service Overview
1.2 Global Scenario
1.3 Country Overview
1.4 Healthcare Scenario in Country
1.5 Healthcare Services Market in Country
1.6 Recent Developments in the Country

2. Market Size and Forecasting
2.1 Market Size (With Excel and Methodology)
2.2 Market Segmentation (Check all Segments in Segmentation Section)

3. Market Dynamics
3.1 Market Drivers
3.2 Market Restraints

4. Competitive Landscape
4.1 Major Market Share

4.2 Key Company Profile (Check all Companies in the Summary Section)

4.2.1 Company
4.2.1.1 Overview
4.2.1.2 Product Applications and Services
4.2.1.3 Recent Developments
4.2.1.4 Partnerships Ecosystem
4.2.1.5 Financials (Based on Availability)

5. Reimbursement Scenario
5.1 Reimbursement Regulation
5.2 Reimbursement Process for Services
5.3 Reimbursement Process for Treatment

6. Methodology and Scope

Healthcare Insurance Market Segmentation

By Provider (Revenue, USD Billion):

It mainly includes healthcare insurance that provides safety against the increasing cost of medical treatments and in case of health emergencies such as critical illnesses. Hence, it is the best way to safeguard medical expenses.

  • Public
  • Private

By Coverage Type (Revenue, USD Billion):

In terms of sales and market share, it is anticipated to rule the market over the projection period. This is explained by a number of benefits provided by life insurance, including guaranteed death payout and permanent coverage. Additionally, investing in these kinds of plans enables working professionals to save taxes

  • Life Insurance
  • Term Insurance

By Health Insurance Plans (Revenue, USD Billion):

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Exclusive Provider Organization (EPO)
  • Point of Service (POS)
  • High Deductible Health Plan (HDHP)

By Demographics (Revenue, USD Billion):

  • Minors
  • Adults
  • Seniors

There is a high prevalence of lifestyle disease in the adult population that can increase health risks in the future. The population is more prone to cardiac and other diseases that require hospitalization. Healthcare insurance plans for seniors are more of a necessity, especially in the case of retirement. Also, it carries various advantages such as no medical screening before buying plans, includes coverage of the outpatient department, and provides the benefit of fee annual checkups along with lifetime renewability.

By End-user (Revenue, USD Billion):

  • Individuals
  • ?Corporates

A large number of people buy individual health plans as they are also customizable. Also, it gives more control over deductibles, co-pays, and benefits limits and is not dependent on employment status.

Methodology for Database Creation

Our database offers a comprehensive list of healthcare centers, meticulously curated to provide detailed information on a wide range of specialties and services. It includes top-tier hospitals, clinics, and diagnostic facilities across 30 countries and 24 specialties, ensuring users can find the healthcare services they need.​

Additionally, we provide a comprehensive list of Key Opinion Leaders (KOLs) based on your requirements. Our curated list captures various crucial aspects of the KOLs, offering more than just general information. Whether you're looking to boost brand awareness, drive engagement, or launch a new product, our extensive list of KOLs ensures you have the right experts by your side. Covering 30 countries and 36 specialties, our database guarantees access to the best KOLs in the healthcare industry, supporting strategic decisions and enhancing your initiatives.

How Do We Get It?

Our database is created and maintained through a combination of secondary and primary research methodologies.

1. Secondary Research

With many years of experience in the healthcare field, we have our own rich proprietary data from various past projects. This historical data serves as the foundation for our database. Our continuous process of gathering data involves:

  • Analyzing historical proprietary data collected from multiple projects.
  • Regularly updating our existing data sets with new findings and trends.
  • Ensuring data consistency and accuracy through rigorous validation processes.

With extensive experience in the field, we have developed a proprietary GenAI-based technology that is uniquely tailored to our organization. This advanced technology enables us to scan a wide array of relevant information sources across the internet. Our data-gathering process includes:

  • Searching through academic conferences, published research, citations, and social media platforms
  • Collecting and compiling diverse data to build a comprehensive and detailed database
  • Continuously updating our database with new information to ensure its relevance and accuracy

2. Primary Research

To complement and validate our secondary data, we engage in primary research through local tie-ups and partnerships. This process involves:

  • Collaborating with local healthcare providers, hospitals, and clinics to gather real-time data.
  • Conducting surveys, interviews, and field studies to collect fresh data directly from the source.
  • Continuously refreshing our database to ensure that the information remains current and reliable.
  • Validating secondary data through cross-referencing with primary data to ensure accuracy and relevance.

Combining Secondary and Primary Research

By integrating both secondary and primary research methodologies, we ensure that our database is comprehensive, accurate, and up-to-date. The combined process involves:

  • Merging historical data from secondary research with real-time data from primary research.
  • Conducting thorough data validation and cleansing to remove inconsistencies and errors.
  • Organizing data into a structured format that is easily accessible and usable for various applications.
  • Continuously monitoring and updating the database to reflect the latest developments and trends in the healthcare field.

Through this meticulous process, we create a final database tailored to each region and domain within the healthcare industry. This approach ensures that our clients receive reliable and relevant data, empowering them to make informed decisions and drive innovation in their respective fields.

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Last updated on: 31 May 2023
Updated by: Ritu Baliya

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