Payer Overview
Healthfirst Inc Grp Market Analysis: Market Share and Coverage by State
Healthfirst Inc Grp is a regional health insurer focused on a concentrated state footprint and modest national presence. This analysis highlights where the payer writes premium, its member base, and implications for provider contracting.
Payer Overview
Healthfirst Inc Grp is a regional health insurer with a concentrated but meaningful footprint in the United States, operating as the #29 largest US A&H payer by premium. Its US premium is $6.91B, representing a 0.48% US market share and operating across 1 states. The organization reports an Estimated Total Members base of 1.16M and operates through 2 affiliated subsidiaries.
This payer does not hold a #1 ranking in any state. The firm's concentration in a single state market shapes both its negotiating leverage and network strategies, with implications for multi-state provider groups seeking consistent contracting terms across broader geographies.
2 rows
| Subsidiary | Domicile |
|---|---|
| Healthfirst Health Plan Inc | NY |
| Healthfirst Insurance Company Inc | NY |
National Market Presence
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| NY | 8.41% | $6.91B | 1.16M |
| National Total | — | $6.91B | 1.16M |
Healthfirst Inc Grp's premium and membership are highly concentrated in New York, with $6.91B of premium written and 1.16M estimated members located in a single state. That single-state concentration creates strong regional negotiating power with providers in New York but limits leverage in national contracting talks. For provider networks, the payer's presence represents significant volume in New York, meaning localized reimbursement strategies and network adequacy efforts will be most important.
Because the payer operates primarily within one state, its national contracting risk is limited: multi-state providers should prioritize tailored agreements and operational workflows for New York, where 1.16M members reside and most premium is written.
Estimated Member Demographics
| Age Band | New York | National Total |
|---|---|---|
| Under 6 | 68,355 | 68,355 |
| 6–18 | 167,625 | 167,625 |
| 19–25 | 109,756 | 109,756 |
| 26–34 | 154,421 | 154,421 |
| 35–44 | 161,838 | 161,838 |
| 45–54 | 158,472 | 158,472 |
| 55–64 | 171,390 | 171,390 |
| 65–74 | 100,312 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.