Trending...
- Obsolete Industrial Expands Its Membership
- Nadi Plumbing Leads Charlotte in Private Fire Hydrant Services, Eyes Regional Expansion
- Re:InvestorHub Launches the First AI-Powered Operating System Built for Real Estate Investors
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
- Michael Fischer, President and CEO of Client 1st Financial, Named to LVB 300
- Easwe Lightweight Electric Wheelchair Collection with Travel-Focused Mobility Solutions
- Dr. Pen Official Introduces Advanced Microneedling Technology for Precision Skincare at Home
- Bspin Launches Lightning-Fast Crypto Gaming Expansion With Sportsbook, Poker, VIP Rewards, and Bitcoin Lightning Network Integration
- From Temecula Wine Country to Canyon Lake: Parkway Construction Transforms Outdoor Spaces for Inland Homeowners
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
- Tim Tebow to Headline BSI CORE Annual Summit, Bringing Nearly 400 Business Leaders Together at Bethlehem's SteelStacks
- Pipeliners Tour Brings Appalachian Basin Rally to Western Pennsylvania
- Gigasoft 2026 JavaScript Chart Comparison: ProEssentials, Highcharts, SciChart, LightningChart, ECharts
- Experienced eXp Realty Agent Kerri Lawless Guides Buyers and Sellers Through Life's Next Chapters in St. Tammany Parish
- Supreme Garage Door Repair Redirects Marketing Dollars Into North Texas Communities
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.
0 Comments
Latest on The PennZone
- Grace Montessori School Earns Prestigious American Montessori Society Accreditation
- Revenue Optics Launches Pricing and Revenue Growth Management Practice, Names Shafohi Alamgir Vice President
- Popular AI planner Voiset launches version 2.0 and enters MENA at LEAP 2026 with full Arabic support
- CasaPerks and CredHub Partner to Help the Multifamily Industry Strengthen Resident Activation Through Credit-Building Rewards
- NaturismRE expands international research programme with Health & Wellbeing Survey
- L2 Aviation and Gotonomi Extend UAV Connectivity Beyond Cellular Reach
- LATO AI Solidifies Future in Pittsburgh with North Shore Headquarters
- Re:InvestorHub Launches the First AI-Powered Operating System Built for Real Estate Investors
- Nadi Plumbing Leads Charlotte in Private Fire Hydrant Services, Eyes Regional Expansion
- Obsolete Industrial Expands Its Membership
- FindCostSeg Launches Nationwide Directory for Cost Segregation Providers
- Master Of Science, Juggernaut Of The Screen: Landon Brittain Emerges As Hollywood's Most Unlikely Leading Man
- Black Dog Venture Partners and VC Fast Pitch to Host "San Francisco Investors and Innovators" Networking Event
- Four-Time Olympian Joetta Clark Diggs to Compete at World Masters Athletics Championships in Daegu
- New Book, The KI of Marketing, Helps Small Businesses Grow Without Trying to Outspend Bigger Competitors
- The Alistair Apartments Reaches 95% Occupancy in Downtown Lancaster, PA
- Food Journal Magazine Focuses Its Los Angeles Dining Coverage Across Three Editorial Verticals
- Where Do Missouri Plane Crashes Really Happen? Not Where You'd Think
- LCC Asia Pacific Sponsors CubeSatPlus 2026 at UNSW Sydney
- Kellyn Endorses National Push to Expand Food is Medicine