The PennZone

PHILADELPHIA--(BUSINESS WIRE)--In 2020, Independent/Provider-Sponsored plans' costs decreased by 1.0% per member, down from a 7.6% increase in 2019. The comparison is of continuously reporting plans and eliminates the effect of product mix changes between comparison years.

The results are published in Plan Management Navigator and are posted at sherlockco.com/navigator. Navigator excerpts from the 2021 Independent/Provider-Sponsored edition of the Sherlock Benchmarks. This edition of the Sherlock Benchmarks analyzes and reports on the in-depth surveys of 19 IPS plans serving 9.6 million members. Surveyed plans serve the lion's share of members served by independent or provider-sponsored health plans.

The cost decline in Account and Membership Administration was the chief driver of overall cost decline.

More on The PennZone

• Crunchbase Ranks Phinge Founder & CEO Robert DeMaio #1 Globally. Meet him in Las Vegas-Week of CES to Learn About Netverse, Patented App-less Platform
• IODefi Introduces New Web3 Infrastructure Framework as XRP Ledger Development Gains Global Attention
• Terizza Forms Strategic Collaboration with UC San Diego to Pioneer Next-Generation Distributed AI Infrastructure
• BPM Systems Launches New Automated Packaging & Labeling Solution for Manufacturers Across The US
• EnergyStrat Launches Global LNG Risk Outlook 2025–2030

Membership increased. Medicaid and Medicare Advantage increased, as commercial overall declined as ASO share increased.

Staffing ratios decreased by 4% and the Enrollment and Claims functions were affected. Compensation increased by 1%. Outsourcing was relatively stable at 5% overall.

Within the functions, cost trends were consistent with adaptation to COVID-19, such as in Nurse Information and Member and Group Communication, and strengthening Plans' longer term competitive position through higher Risk Adjustment and Medical Management.

We will discuss the results via free web conference on Wednesday, July 21^st, from 2:00 PM to 3:00 PM Eastern Daylight Time. Douglas Sherlock will offer a brief presentation, followed by questions and answers. To participate in the web conference, please register at sherlockco.com/webinar. Once registered, dial-in information and a link to connect will be provided in a confirmation email.

More on The PennZone

• Strong Revenue Gains, Accelerating Growth, Strategic Hospital Expansion & Uplisting Advancements: Cardiff Lexington Corporation (Stock Symbol: CDIX)
• Holiday Decorations Most Likely to Cause Injuries
• UK Financial Ltd Confirms Official Corporate Structure of the Maya Preferred Project and Its Dual-Class Token System
• Zac Arbitman Elected As Co-Chair of Philadelphia Bar Association Federal Courts Committee
• CCHR Florida Joins Global Call to Ban Electroshock Treatment, Citing New Evidence of Widespread Patient Harm

The current operating environment is challenging for health plans. The Sherlock Benchmarks can assist in adapting to this environment and optimizing expenses.

The Sherlock Benchmarks for 2021 will reflect approximately 929 health plan years of experience spanning 24 consecutive years. They are the "gold standard" of benchmarks to measure and manage health plan administrative activities in health plans serving approximately 173 million members. Planning, budgeting and cost benefit analyses are credibly informed by the Sherlock Benchmarks.

Besides the Independent/Provider-Sponsored plans universe, other universes include Blue Cross Blue Shield, Medicare plans and Medicaid plans. Collectively, the 36 participating plans serve 54 million insured Americans.

Sherlock Company (www.sherlockco.com), based in North Wales, Pennsylvania, provides informed solutions for health plan financial management. Since its founding in 1987, Sherlock Company has been known for its impartiality and technical competence in service to its clients.

---

Show All News | Report Violation