Payer Overview
PRESBYTERIAN HLTHCARE SERV GRP Market Analysis: Market Share and Coverage by State
Presbyterian Healthcare Serv Grp is a regionally concentrated health insurer focused on New Mexico with a dominant local market position. Its scale is significant within its primary state but limited nationally.
Payer Overview
Presbyterian Healthcare Serv Grp operates as a regionally focused health insurer with a concentrated position in New Mexico. The organization ranks as the #44 largest US A&H payer by premium, writing $4.26B in US premium and holding a 0.3% US market share while operating across 1 states. The carrier reports an estimated 418.8K total members and holds the top market position in New Mexico, operating through 2 affiliated subsidiaries.
This concentrated footprint — with the vast majority of commercial premium and membership centered in a single state — shapes both negotiating leverage and network strategy. For multi-state provider groups, Presbyterian Healthcare Serv Grp represents a deep, localized opportunity rather than a broad regional contracting target.
2 rows
| Subsidiary | Domicile |
|---|---|
| Presbyterian Health Plan Inc | NM |
| Presbyterian Insurance Company Inc | NM |
National Market Presence
National Market Footprint
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| NM | 36.92% | $4.26B | 418.8K |
| National Total | — | $4.26B | 418.8K |
Presbyterian Healthcare Serv Grp shows a highly concentrated national footprint, with virtually all premium and membership localized in New Mexico. The payer writes $4.26B of premium and covers 418.8K members in that state, indicating deep regional penetration rather than a dispersed national presence. This concentration gives the payer strong influence over local provider networks in New Mexico but limited negotiating leverage outside that market.
For provider contracting strategy, the carrier’s concentrated presence implies that negotiations and reimbursement benchmarks should be tailored to New Mexico market conditions. National provider groups should treat Presbyterian Healthcare Serv Grp as a critical local partner in the Southwest rather than a system-wide counterparty for multi-state agreements.
Estimated Member Demographics
| Age Band | New Mexico | National Total |
|---|---|---|
| Under 6 | 20084 | 20084 |
| 6–18 | 57846 | 57846 |
| 19–25 | 35464 | 35464 |
| 26–34 | 48972 | 48972 |
| 35–44 | 59622 | 59622 |
| 45–54 | 55455 | 55455 |
| 55–64 | 63182 | 63182 |
| 65–74 | 45229 |
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.