Payer Overview
Providence Health Group Market Analysis: Market Share and Coverage by State
Providence Health Group is a regionally focused health insurer with concentrated market exposure in a small number of states. It plays a modest role nationally but can be a dominant local partner where it concentrates membership and premium.
Payer Overview
Providence Health & Services (Providence Health Group) operates as a regional health insurer with a focused footprint and a concentrated premium base. As the #62 largest US A&H payer by reported premium, it records $2.44B in US premium and holds a 0.17% US market share across 2 states. The organization reports an Estimated Total Members figure of 284.6K and operates through 2 affiliated subsidiaries, which supports its regional market operations.
Providence does not hold a #1 position in any state. Its premium concentration is heavily weighted toward a single state market, reinforcing a western regional focus and implying that provider contracting strategies will need to center on a limited set of state markets rather than a broad national network.
2 rows
| Subsidiary | Domicile |
|---|---|
| Providence Health Assurance | OR |
| Providence Health Plan | OR |
National Market Presence
National Market Footprint
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| OR | 9.34% | $2.37B | 273K |
| WA | 0.2% | $66.5M | 11.3K |
| National Total | — | $2.44B | 284.6K |
Providence Health Group's premium is highly concentrated in the Pacific Northwest, with $2.37B of premium in OR and $66.5M in WA, totaling $2.44B nationally. The payer's estimated membership aligns with that concentration: 273K members in OR and 11.3K members in WA, for a national total of 284.6K. This geographic concentration suggests strong negotiating leverage with provider systems in Oregon and a more limited footprint in Washington.
Estimated Member Demographics
| Age Band | Oregon | Washington | National Total |
|---|---|---|---|
| Under 6 | 14749 | 680 | 15428 |
| 6–18 | 39684 | 1670 | 41355 |
| 19–25 | 24162 | 960 | 25122 |
| 26–34 | 35225 | 1600 | 36825 |
| 35–44 | 42396 | 1762 | 44158 |
| 45–54 | 38263 | 1536 | 39799 |
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.