2023 HMO Industry Report

Overview of the Report

The global health insurance market, with a valuation of approximately $1.7 trillion in 2022, is expected to experience a robust compound annual growth rate (CAGR) of 7.11% from 2023 to 2028 . From our perspective, the pivotal drivers propelling growth within the insurance healthcare sector encompass the escalating expenses associated with healthcare, heightened consciousness regarding the imperative nature of health insurance catalysed by the COVID-19 pandemic, and the mounting prevalence of chronic ailments on a global scale. In Nigeria, Health Management Organisations (HMOs) play a critical role in serving as the fulcrum between enrollees and healthcare providers. HMOs are essential in providing affordable healthcare and they are also key agents for promoting preventive healthcare and the overall wellness of citizens. In addition, HMOs are crucial to boosting infrastructure development in the health sector as they are seen as a mechanism for attracting resources to support development.

The National Health Insurance Authority Act (‘’NHIAA’’ or ‘’the Act’’) 2022 presents a major bright spot for the Nigerian HMO industry. Prior to the Act, the NHIA coped with several challenges which significantly constrained the Health Insurance Industry. Among the several concerns was the role definition of NHIS, as some of the regulatory body’s actions were believed to be in contradiction with those of private operators (HMOs). In addition, the absence of mandated health insurance for certain insurance programmes reduced demand for the Industry’s services. We feel that the new Act will be strategic in transforming the Nigerian health insurance landscape. The National Health Insurance Authority (NHIA) Act 2022, in our opinion, would promote increased investments across Nigeria’s healthcare value chain, including the HMO industry, and will drive health insurance coverage. The implementation of mandated health insurance for all inhabitants will improve health insurance penetration and stimulate new entries into the industry, particularly in the retail segment. In addition, the implementation of the NHIA Act 2022 will effectively tackle the persistent obstacles that have hindered the achievement of comprehensive healthcare access for all in Nigeria. In the near to medium term, it is anticipated that there will be a surge in collaborative efforts among key stakeholders, with the aim of enhancing the operational efficiency and overall performance of operators.

The report includes;
• An overview of the HMO industry globally and in Nigeria
• An overview of the competitive landscape of the Industry
• An analysis of the Industry’s regulatory and policy environment
• An analysis of the Industry’s growth potential
• An outlook of the Industry’s performance in the short to medium term

We believe the information, analyses and opinions contained in this industry report will prove indispensable to;

  • Bankers who wish to assess the credit worthiness of Industry players
  • Industry participants seeking to keep abreast of the key developments in the Industry
  • Analysts, investors and other users of financial information who require an in-depth understanding of the Industry
  • Regulators and policy makers seeking knowledge of pressing issues in the Industry