Trending...
- Data Tiles Strengthens U.S. Presence with Chief Revenue Officer John Goode
- CCHR Condemns Behavioral Treatment After FDA's Missed Deadline to Ban Shock Device
- Brilliant Minds to Gather in Fort Worth for National Mensa Event
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
- Century Fasteners Corp. Exhibiting at 2026 Farnborough International Airshow
- Compton to host first Juneteenth celebration with We Are Us Festival
- Wayne Homes Refreshes Its Pittsburgh Area Model Home Center Page
- DuoKey Launches Quantum Risk Score to Help Enterprises Prioritise Post-Quantum Cryptography Migration
- Top 5 Most Reliable Used Vans in the UK in 2026
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
- Dominican Fashion Designer Raiza Bonaparte presents the Sovereign Despampanante Collection at the Library of Congress
- Roohid Parast on How AI Is Changing What Bench Scientists Can Do
- What Happens When Congress Says No? New Book Examines the Boland Amendments, Iran-Contra Affair & Jamaican Posse, as US Congress Debate Over Military
- Warm, Dry Summer Forecast Points to a Stronger Wasp and Yellowjacket Season Across the Pacific Northwest
- Qscription Technologies Appoints Anurag Velekkatt Sunil Kumar to Drive Enterprise Scale
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
- UK Financial Ltd Publishes Maya Preferred Public Proof Package and CoinMarketCap Supply Verification Evidence
- Justice Advisory Group Expands Federal Sentencing, Prison Preparation and Reentry Support Services
- Advancing High-Potential Nevada Critical Minerals Portfolio as Major Drill Program Nears Assay Results: Glenstar Minerals: Stock Symbol: GSTRF
- Allstream Energy Partners to Host 6th Executive Networking After 2026 Energy Projects Conference
- CAPHRA: Australia and Thailand show nicotine prohibition fuels illicit markets
- Custom Disposables - Wholesale Packaging Solutions for restaurants, food chains, and food distributors
- California Security Glass is an affordable bulletproof glass installation company in LA serving a variety of neighboring cities
- Allstream Energy Partners Announce Media Partnership with the 2026 EPC Show - The Energy Projects Conference
- STO Foundation Launching June 29, 2026 to Advance the Global Tokenization Industry
- West Virginia Leaders Announce Support for Election Integrity Network's Model Election Laws Handbook
- CCHR Condemns Behavioral Treatment After FDA's Missed Deadline to Ban Shock Device
- Brilliant Minds to Gather in Fort Worth for National Mensa Event
- UK Financial Ltd Completes One Of The Most Extensive CoinMarketCap Supply Verification Packages For Maya Preferred PRA (MPRA)
- Data Tiles Strengthens U.S. Presence with Chief Revenue Officer John Goode
- Haven Media Solutions Offers Web Design and PPC Services in Atlanta GA
- 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