US health insurers face pressure as medical trends accelerate
25-Aug-25, Insurance Business Magazine
A rise in medical spending in the US challenging health insurers is attributed to higher use of specialty drugs, more physician visits and medical services, an uptick in inpatient admissions and emergency room visits, and a greater number of behavioural health claims.
Insurance%20Business%20Magazine.png "US health insurers face pressure as medical trends accelerate (c)Insurance Business Magazine")
Image: Insurance Business Magazine
While the health insurance industry entered 2025 with higher-than-expected medical and pharmacy utilisation, the first quarter was negatively impacted by elevated respiratory claims due to flu, COVID and pneumonia, according to credit rating agency AM Best.
The negative outlook is also being influenced by operating margins in government programs coming under significant pressure, and narrower margins in the commercial market.