Trending...
- Wine School of Philadelphia Celebrates 25 Years With Intensive Summer Program
- Greensburg Pennsylvania Martial Arts School Racks Up BJJ Wins
- Golden Visa Countries Outpace Eurozone Growth Over Eight Years, New La Vida Analysis Finds
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
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 21st, 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
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.
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
- TREND Network Announces Miami Based Reality Series "Coming Up Miami" Premiering July 1
- Beemok Hospitality Collection And KLH Group Announce Preferred Partnership
- Expanding Access to Mental Health Care in Toronto with Dr. Stephen Shainbart
- Dr. Stephen Shainbart Launches Expanded Mental Health Support for Anxiety and Depression in Toronto
- Equipment Leases, Inc. Launches Updated Family Office Equipment Financing Page
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 21st, 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
- The $5 Million Man Still Begging: Incumbent Jimmy Panetta Hits Up Voters for More Cash Despite Massive War Chest
- Kevin Francis Design Introduces CHROMA, a Collection of Saturated Solid Color Wool Rugs
- $150+ Million Contracted Backlog, Strategic Acquisitions Adding Millions In Recurring Revenue, Improving Margins & A Clear Path Toward Profitability
- Record Revenue Growth, AI-Driven Healthcare Innovation, Expanding Proprietary Brand and Targeting $200 Million Revenue By 2029: Cosmos Health Inc
- Bergey's Truck Centers Recognized in 2026 MACH Alliance Composable Impact Awards
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.
Filed Under: Business
0 Comments
Latest on The PennZone
- Individual Entrepreneur of Annville, PA, Acquires Mosquito Joe of Lancaster, PA
- Super Lawyers Recognizes Inman & Tourgee Attorneys Mark Tourgee and Jacob Rinn
- PropAccount.com Launches PropGenie, the First Branding Studio Built for Prop Firm Operators
- Rushing Headlong: Health IT's Legacy and the Road to Responsible AI is named 2025 Foreword INDIES Book of the Year Awards Winner
- The Problem With AI Isn't Compute. It's Memory
- Golden Visa Countries Outpace Eurozone Growth Over Eight Years, New La Vida Analysis Finds
- Allstream Energy Partners Announced as Official Media Partner for the 2nd Annual Permian Power Conference
- Wine School of Philadelphia Celebrates 25 Years With Intensive Summer Program
- Greensburg Pennsylvania Martial Arts School Racks Up BJJ Wins
- Dave's Auto Services Sponsors Night of Racing at Action Track USA in Kutztown PA
- CCHR Calls Out Psychiatry's Pattern of Resistance to Antidepressant Deprescribing
- Boston Industrial Solutions Introduces New Natron® 310 Hyper White UV Ink for Enhanced Printing Performance
- New analysis reveals second job workers keep just 80p in every pound they earn
- NRE Health Institute Launches International Study Examining Motivations Behind Non-Sexual Nudity
- American Ethiopian Public Affairs Committee (AEPAC) Applauds Pennsylvania House Recognition of Adwa VictoryDay
- A Foundational Claim in Human Secrecy Goes Public
- Agape Leadership Academy Opens Nationwide Enrollment — State ESA Scholarships Cover Full Tuition for Families in 7 States
- Fourth Annual Free Training Day Mid-Atlantic Returns Sept. 19, 2026
- Las Vegas Headliner Don Barnhart Brings National Touring Comedy Show to Comedy Cabana
- Nevada Boxing Hall of Fame Announces 14th Annual Induction Gala Weekend Honoring Classes of 2025 and 2026