The Market

Health Insurance Coverage

While everyone seems to agree that health insurance is a big problem–that most practices/providers hate dealing with–the facts about health insurance coverage reveal why practices may struggle if they don’t try to offer some benefit for patients with health insurance.

  • Health Insurance Demographics (Click Here)
    • 10% of Americans have no insurance.
    • 30% of Americans are Medicare/Medicaid/Tricare.
      • 7.5% Traditional Medicare
      • 7.5% Medicare Advantage
      • 15% Medicaid
    • 60% of Americans have private plans.
      • 35% Employer-based plans non-HMO
      • 15% Employer-based plans HMO
      • 7% of private individual plans non-HMO
      • 3% of private individual plans HMO
    • Target populations for private practices.
      • 90% of Americans have some form of insurance.
      • Most affluent groups are traditional Medicare and individual non-HMO plans (14.5%)
      • Remaining 85.5% (no insurance, Medicaid and employer plans) may not be a good fit.

Articles

  • “Walmart will close all of its health care clinics,” Nathaniel Meyersohn. CNN Business, April 30, 2024 (CLICK HERE).
  • “Walgreens Shutters 160 VillageMD Clinics after $6 Billion Loss.” American Hospital Association, April 9, 2024 (CLICK HERE).
  • “BIG INSURANCE 2022: Revenues reached $1.25 trillion thanks to sucking billions out of the pharmacy supply chain – and taxpayers’ pockets,” Wendell Potter. Health Care un-covered, February 27, 2023 (CLICK HERE).
  • “Humana to exit employer insurance business to focus on government plans.” Reuters, February 23, 2023 (CLICK HERE).

e3Business Articles

  • The Elephant and I&FM: A Parable (CLICK HERE)
    • One of the problem with integrative, holistic and functional medicine is that there is not a generally accepted definition of integrative, holistic and functional medicine–or what it looks like.
  • “Rise, Crash and Burn: Looking Back at a Las Vegas Medical Group Launch and the Lessons Learned,”  e3Business Article (CLICK HERE)
    • A case study in the launch, management and failure of a concierge practice.
  • “Direct Primary Care Goes Thud,” e3Business Article (CLICK HERE)
    • Three examples of Direct Primary Care that were not successful.
  • “Making Money with Functional Medicine,” e3Business Article (CLICK HERE)
    • For years, people have been talking about how functional medicine is going to very lucrative, but that isn’t necessary the case.
  • Failure to Launch (CLICK HERE)
    • What are the market forces that have suppressed I&FM practices?
  • “Functional Medicine Data Fallacies,” e3Business Article (CLICK HERE)
    • We have access to more data than ever before, but not all of it means what we think it does.
  • “The Source of Provider Compensation,” e3Business Article (CLICK HERE)
    • Are cash-pay providers really that much of an outlier?
  • “There’s a New Sheriff with an IFM Digital Badge,” e3Business Article (CLICK HERE)
    • The Institute for Functional Medicine’s new certification change including enforcement powers is a big, big change for functional medicine providers.

IFM Data

Since 2016, e3Business has periodically tracked the changes of the physicians listed on the Find a Provider page of The Institute for Functional Medicine (IFM).

Note: Some time in 2025 or 2026, IFM changed the “Find a Practitioner” listings to include all practitioners licensed in a state rather than just those physically practicing in each state, which makes it much more difficult to track the number of active providers.

Archived Case Studies and Competition

This area is no longer updated on a regular basis, but provides information on current and former integrative, holistic and functional medicine practices.