Trending...
- R&B Artist Mike Davis Announces Debut Full-Length Album Full Circle, Releasing April 7
- Ocean County College Introduces Pathways to Simplify the Student Journey and Strengthen Career Connections
- Blue Sparrow Coffee named Best Matcha in Westword's Best of Denver 2026
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
- Everwild Music Festival Unveils 2026 Schedule: No Overlapping Sets, Longer Performances, and Epic Late-Night Sets!
- 300 Episodes. One Mission: Brother Marcus Ignites a Global Movement of Inspiration
- Riggo Production Studio Launches Monthly Content Package for Growing Brands
- Accelerating into Active Oil Production with over 100 Barrels per day now being produced as Dual-revenue engine begins Generating Cash Flow: $IBG
- Finland emerges as clear Eurovision 2026 favourite – analysis of 12 bookmakers by Vedonlyöntisivut
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
- Mac Mountain Selects netElastic vRouter for LightCraft Broadband-as-a-Service Platform
- 88% Revenue Growth; Charging Into the Future with Explosive Growth, Strategic EV Expansion and Infrastructure Dominance Signal a Breakout Opportunity
- Forge Resources Unlocks Major Gold-Copper System in Yukon as Drilling Success and Strategic Assets Fuel High-Impact Growth Story for: $FRGGF
- Game Day Private Jets Launches REVUP Platform to Transform Fan & Donor Travel Into a Revenue Engine for College Athletics
- Heritage at South Brunswick Team Celebrates Major Wins at NJBA Sales and Marketing 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
- PlanetAI Nature Space (PNS), certificadora Europea, lanza su plataforma EUDR-PNS Ready basada en IA, satélites y trazabilidad blockchain
- Rhealize Strategic Talent Advisory Co-Founder Dona Baker to Speak at DisruptHR YEG 15.0 in Edmonton on Hiring Innovation
- Instant IP Teams: Bringing Enterprise-Grade Collaboration to IP Protection at the Speed of Thought
- Primo Sewer Cleaning Acquires Industry-Leading Hydro Jetter Mongoose Jetter Model 123
- UK Financial Ltd Confirms CATEX Exchange Integration of SMPRA and LTNS 1 Ahead of Compliance-Based Trading Activation
- Best Companies Group Opens Free Registration for Best Credit Unions to Work For Program
- Ashikaga Flower Park's "Great Wisteria Festival 2026"
- Washington County PA Real Estate is Changing Here's What Homeowners Need to Know Before Selling
- Architect of Neurodiversity Will Lead the First U.S. Team of Autistic Children to the "Genius Cup" in Hiroshima, Japan, in 2027
- Deborah E. Jones Introduces Emotional Sovereignty, a Powerful New Book on Emotional Mastery, Resilience, and Intentional Living
- New Research Identifies "The Busy Effect": 89% of Americans Want a Laid-Back Vacation — Only 15% Actually Achieve It
- Alchemy 43 Appoints Shane Smith as CEO to Drive Operational Performance and Scalable Growth
- Best Spiritual Healing, Meditation & Retreats in Sedona — Rise Meditation Helps You Find and Book Transformational Experiences
- $16 Billion Market by 2034 in Underwater Drones Presents Huge Opportunity for AI-Powered Autonomous Vehicle Serving Defense & Commercial Customers
- Appliance EMT Named Among Jacksonville's Top 3 Appliance Repair Companies by ThreeBestRated®
- The Scratch-Off Dead Zone - is your state lottery failing?
- Geekstorians Nominated For Best History Podcast In The 30th Annual Webby Awards
- Quality Water Treatment Unveils SoftPro Elite HE Water Softener for City Water, Setting a New Standard in Residential Water Treatment
- UK Financial Ltd Chooses PUMP.FUN App to Launch Maya Meme's Minor-League Meme Coins and Announces Lifetime Airdrop Program
- Boston Industrial Solutions Expands Its Industry-Leading UV Ink Portfolio with the Launch of a Matte Ink - Natron® UVPZ