Administrative Cost Trends for Medicare Plans

Administrative expenses for Medicare-focused plans increased by 0.6% from 2020 to 2021. The largest cluster of functions, Account and Membership Administration, increased by 0.3%. Ten plans participated in the 2022 edition of the Medicare Sherlock Benchmarks, measuring 2021 data. The ten participating plans collectively served 12.3 million members. A median of 34% of revenues of these companies were in Medicare Advantage and Medicare SNP (“Special Needs Plans”) products. Eight plans participated in both the 2021 and 2022 benchmarking cycles and these were used for trend purposes.

This analysis is based on the nineteenth annual edition of our performance benchmarks for Medicare-focused health plans. The Sherlock Benchmarks (Sherlock Expense Evaluation Report or SEER) represent the cumulative experience of 963 health plan years. Each peer group in the Sherlock Benchmarks is established to be relatively uniform. So, within that constraint, it is open to all Medicare-focused plans possessing the ability to compile high-quality, segmented financial and operational data. This 19th analysis of Medicare plans is based on a peer group of 10 plans who collectively serve 12.3 million people. Of the ten plans, eight were repeat participants from a year ago.

Event Date: Thursday, September 15, 2022

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Category(s): Health Plans, Medicare

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