Results from Aon’s 2021 Captive Benchmarking Survey show the amount of Gross Written Premium (GWP) underwritten by healthcare captives has risen by 73% since 2016 – a larger than average increase when compared with many other industries. We believe that this upward trend is set to grow as organizations increasingly recognize the value-add that captives bring to the healthcare sector, particularly in the US, where 93% of healthcare captive parent companies are located.1
Healthcare systems in the US are growing – there are far fewer regional players nowadays – including, for example, hospitals, skilled nursing facilities and home healthcare facilities. Many healthcare systems are facing the challenge of rising retentions and that is where captives are stepping in to help these systems control certain costs, as well as their risk management.
Drivers of demand
There are three main drivers for healthcare providers looking to captives for support.
Cyber is the first. The impact of cyber attacks on the healthcare industry are particularly significant due to the highly sensitive nature of patient data and the potentially life-threatening consequences of systems being brought down. Since 2016, we have seen a 161% increase in cyber GWP written by captives in this industry.2
Secondly, with the impact of COVID-19 and its variants, captives are adding value by devoting program funding for issues such as physician burnout, employee burnout and recovery programs.
Finally, supply chain issues have reduced access to certain supplies for many organizations. Captive structures can provide a cost-effective way of managing this risk as well.
Captives offer control
Insurance program control is also a key reason for captive appetite among larger healthcare providers. Hospital systems are focused on continuous improvement as a general matter and the attractiveness of receiving/issuing/offering grants within captive programs to reinvest money back into the system is crucial.
Bespoke solutions available to captives are often not offered in standard insurance programs. These solutions allow systems to buy supplies and equipment and help improve safety programs.
Captives are a natural fit for healthcare because of the flexibility and options offered – particularly with the grant programs – including to free up collateral, continuously improve systems and allow providers to focus on their core business knowing that robust risk mitigation is in place.
1 Aon-managed healthcare captive parent companies, according to data from Aon's 2021 Captive Benchmarking Survey
2 Aon's 2021 Captive Benchmarking Survey
Insurance entities under management
in Gross Written Premium (USD)
Lines of business written
Percentage of Aon-managed insurance entities writing line of business
Medical Professional Liability
Medical Stop Loss
Type of entity
Percentages rounded to nearest whole number