Independent / Provider - Sponsored Plan Costs Accelerated in 2021

This 20th analysis of IPS plans is based on a peer group of fifteen Independent / Provider – Sponsored plans who collectively serve approximately 10.6 million people with Comprehensive products. In addition to the Comprehensive members, these plans also served 253,000 Managed Long Term Services and Supports members. We believe this universe to be quite robust. Participants in this year’s study serve about 52% of all membership in plans served by non-staff model plans of the Alliance of Community Health Plans and 35% of all membership served by commercial members of the Health Plan Alliance. The plans were geographically disbursed, serving 24 states.

Administrative expenses for the Independent / Provider – Sponsored plans increased in 2021 after experiencing a decline in 2020, but the rate of increase remained much lower than two years ago. Total expenses grew by 4.2%, which was higher than 2018 but well below the increase in 2019. The key area Account and Membership Administration, which composes 36% of total expenses, increased by 3.2%, but this was the second slowest rate since 2014.

This analysis is based on the twenty-fifth annual edition of our performance benchmarks for health plans. The Sherlock Benchmarks (Sherlock Expense Evaluation Report or SEER) represent the cumulative experience of, we expect by year end, more than 960 health plan years. Each peer group in the Sherlock Benchmarks is established to be relatively uniform. So, within that constraint, participation in this set is open to Independent / Provider – Sponsored plans possessing the ability to compile high-quality, segmented financial and operational data.

Event Date: Wednesday, July 20, 2022

Event Webpage (Available for subscribers only)

Category(s): Health Plans

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