NAICS 621491 Quarterly Industry Report
HMO Medical Centers
Comprehensive industry research for valuation professionals, business owners, buyers, and lenders
NAICS Code: 621491Sector: Health Care and Social Assistance (62)Updated: Q1 2026
About This Report
This industry profile for HMO Medical Centers (NAICS 621491) draws on data from the U.S. Census Bureau[9], Bureau of Labor Statistics[7], Kaiser Family Foundation[6], and SBA size standards database[8]. Published by Fair Market Value and updated quarterly, it provides valuation professionals, managed care analysts, and healthcare investors with current market data. All quantitative claims are sourced to publicly verifiable databases.
Industry Snapshot
Key metrics for the hmo medical centers industry.
NAICS Sector
62
Health Care and Social Assistance
Industry Definition & Overview
HMO Medical Centers (NAICS 621491) encompasses establishments of health maintenance organizations (HMOs) that provide health care services through their own employed staff of physicians, nurses, and allied health professionals per the U.S. Census Bureau[5]. These centers provide a range of medical services on a prepaid basis where subscribers pay a fixed periodic fee and receive health services as needed. HMO medical centers integrate insurance coverage and care delivery within a single organizational structure.
Roughly 1,280 establishments generated $11.4 billion in revenue per Census economic survey data. About 13 percent of covered workers were enrolled in HMO plans per the Kaiser Family Foundation[6] employer health benefits survey. Kaiser Permanente operates the largest HMO system with 12.2 million members across eight regions, while Group Health Cooperative, Health Alliance Plan, and Geisinger Health Plan maintain regional HMO networks. Ambulatory health care services added an average of 332,600 jobs annually over the past five years per the Bureau of Labor Statistics[7].
Per the SBA Table of Size Standards[8], the size standard is $39 million in average annual receipts. Federal regulations under 42 CFR Part 417 govern HMO qualification, including requirements for basic and supplemental health services, quality assurance programs, and grievance procedures. Medicare Advantage standards supersede state laws except for licensing and financial solvency requirements. HMO medical centers operate under capitated payment models where per-member-per-month fees create incentives for preventive care and chronic disease management rather than fee-for-service volume. Value-based care metrics, population health management platforms, and electronic health record integration drive operational decision-making in these vertically integrated delivery systems.
What's Included in This Industry
- Primary care physician office visits and wellness exams
- Specialist consultation and referral management services
- Preventive care and immunization program delivery
- Chronic disease management and population health programs
- On-site pharmacy and prescription management services
- Diagnostic laboratory and radiology services
- Urgent care and same-day appointment capacity
- Behavioral health counseling and psychiatric services
- Capitated payment administration and member enrollment
- Quality assurance and health outcome reporting programs
NAICS Classification Hierarchy
| Level | Description | Code |
|---|---|---|
| Sector | Health Care and Social Assistance | 62 |
| Subsector | Ambulatory Health Care Services | 621 |
| Industry Group | Outpatient Care Centers | 6214 |
| NAICS Industry | Other Outpatient Care Centers | 62149 |
| National Industry | HMO Medical Centers | 621491 |
Related NAICS Codes
| Code | Description | Relationship |
|---|---|---|
| 621111 | Offices of Physicians (except Mental Health Specialists) | Offices of Physicians (General) provide fee-for-service medical care as an alternative to the HMO staff-model approach, with independent physician practices competing for commercially insured patients who may choose between HMO and non-HMO plan options |
| 524114 | Direct Health and Medical Insurance Carriers | Direct Health and Medical Insurance Carriers underwrite health coverage that HMO medical centers integrate with care delivery, with the HMO model combining insurance administration and clinical services under a single organizational structure |
| 622110 | General Medical and Surgical Hospitals | General Medical and Surgical Hospitals provide inpatient services for HMO members requiring hospitalization, with many HMO systems owning or contracting with hospitals to manage the full continuum of care |
| 621498 | All Other Outpatient Care Centers | All Other Outpatient Care Centers provide walk-in and urgent care services that overlap with HMO medical center outpatient capabilities, with retail clinics serving as lower-cost alternatives for minor health needs |
| 621610 | Home Health Care Services | Home Health Care Services extend HMO-ordered care to homebound members, with home health agencies executing treatment plans prescribed by HMO physicians as part of post-discharge and chronic disease management programs |
| 621493 | Freestanding Ambulatory Surgical and Emergency Centers | Freestanding Ambulatory Surgical Centers provide outpatient surgical alternatives that HMO systems may own or contract with to deliver lower-cost procedures outside hospital operating room settings |
Geographic Concentration
Top states by share of national establishments.
| # | State | % Est. | Total Est. |
|---|---|---|---|
| 1 | California | 54.1% | 859 |
| 2 | Minnesota | 7.5% | 119 |
| 3 | Colorado | 5.0% | 80 |
| 4 | Oregon | 4.8% | 76 |
| 5 | Georgia | 4.2% | 67 |
| 6 | Hawaii | 3.4% | 54 |
| 7 | Washington | 3.3% | 52 |
| 8 | Pennsylvania | 3.0% | 48 |
| 9 | Maryland | 2.8% | 44 |
| 10 | Florida | 2.5% | 40 |
% Of Establishments
0%
54%
Source: County Business Patterns, U.S. Census Bureau[3]
SBA Lending Summary
32
Total SBA Loans
$10.3M
Total Loan Volume
$321K
Average Loan Size
14 yrs
Average Loan Term
11.01%
Average Interest Rate
120
Jobs Supported
Source: SBA 7(a) Program Data, U.S. Small Business Administration — FY 2025[4]
Key Insight: Per the SBA Table of Size Standards[8], HMO Medical Centers (NAICS 621491) has a size standard of $39 million in average annual receipts for federal contracting purposes. SBA lending programs[10] support facility acquisition, medical technology investment, and service capacity expansion for qualifying HMO medical center operators. Eligible businesses can access SBA 7(a) loans[11] for working capital, equipment, and acquisition financing, while 504 loans[12] support major fixed-asset purchases including real estate and heavy machinery.
Top SBA Lenders
| # | Lender | Loans | Volume | Avg Loan |
|---|---|---|---|---|
| 1 | Touchmark National Bank | 8 | $5.7M | $710K |
| 2 | Live Oak Banking Company | 8 | $4.0M | $500K |
| 3 | U.S. Bank, National Association | 8 | $400K | $50K |
| 4 | TD Bank, National Association | 8 | $200K | $25K |
Frequently Asked Questions
Common questions about this industry.
What is the NAICS code for HMO medical centers?
NAICS 621491 covers HMO medical centers providing health care services through employed physicians and staff on a prepaid basis per the U.S. Census Bureau[5].
How large is the HMO medical center industry?
What is the SBA size standard for HMO medical centers?
The SBA size standard[8] is $39 million in average annual receipts, determining eligibility for federal small business contracting programs and SBA lending products.
What percentage of workers are enrolled in HMOs?
About 13 percent of covered workers were enrolled in HMO plans per the Kaiser Family Foundation[6] employer health benefits survey, with enrollment concentrated in regions where Kaiser Permanente and other staff-model HMOs operate.
Who is the largest HMO system?
Kaiser Permanente operates the largest HMO system with 12.2 million members across eight regions per Kaiser Family Foundation[6] health system data, maintaining fully integrated insurance and care delivery operations.
How do HMO payment models work?
HMO medical centers operate under capitated payment models where per-member-per-month fees fund care delivery, creating incentives for preventive care and chronic disease management rather than fee-for-service volume per CMS[13] managed care program guidelines.
What federal regulations govern HMOs?
Federal regulations under 42 CFR Part 417 govern HMO qualification, including requirements for basic health services, quality assurance programs, and grievance procedures per CMS[13] regulatory guidance, with Medicare Advantage standards superseding state laws except for licensing.
What is value-based care in HMO settings?
Value-based care in HMO settings ties reimbursement to health outcomes rather than service volume, with population health management platforms and electronic health record integration driving preventive care and chronic disease management per Bureau of Labor Statistics[7] industry data.
Sources & References
Government datasets and editorial sources used in this report.
- [1]U.S. Bureau of Labor Statistics, Quarterly Census of Employment and Wages bls.gov
- [2]U.S. Census Bureau, Economic Census census.gov
- [3]U.S. Census Bureau, County Business Patterns census.gov
- [4]U.S. Small Business Administration, SBA 7(a) Loan Program Data data.sba.gov
- [5]U.S. Census Bureau census.gov
- [6]Kaiser Family Foundation kff.org
- [7]Bureau of Labor Statistics bls.gov
- [8]SBA Table of Size Standards sba.gov
- [9]U.S. Census Bureau data.census.gov
- [10]SBA lending programs sba.gov
- [11]SBA 7(a) loans sba.gov
- [12]504 loans sba.gov
- [13]CMS cms.gov
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