Blue Cross Blue Shield Plan Administrative Cost Growth was Stable in 2019

PHILADELPHIA--()--Blue Cross Blue Shield Plans had costs in 2019 that increased by 6.6% per member, down from an increase of 6.7% in 2018. This comparison is between continuously reporting plans and eliminates the effect of product mix differences between the two years.

The results are published in Plan Management Navigator, and are posted at sherlockco.com/navigator. It excerpts from the 2020 Blue Cross Blue Shield Plan edition of the Sherlock Benchmarks. The Sherlock Benchmarks analyzes and reports on the in-depth surveys of 20 Blue Plans serving 55 million members. Surveyed Plans comprise 83% of the members of Blue Cross Blue Shield Plans not served by publicly-traded companies.

Cost trends on an as-reported basis reflected a shift in favor of higher cost products as Medicare Advantage was typically the fastest growing product. The Corporate Services Cluster was the only cluster to experience an acceleration in growth and the decline in growth was especially notable in Account and Membership Administration.

Staffing ratios were stable year-over-year, as compensation increased by 0.7%. Non-labor expenses increased more sharply, as outsourcing decreased to 10-11% overall.

We will discuss the results via free web conference on Wednesday, June 24th 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.

The employment trends that are secondary effects of COVID-19 create a volatile operating environment for health plans. The Sherlock Benchmarks can assist in adapting to this environment and achieving operational efficiency.

The Sherlock Benchmarks reflect approximately 895 health plan years of experience spanning 23 consecutive years. They are “the gold standard” of benchmarks used to measure and manage health plan administrative activities. Planning, budgeting and cost benefit analyses are credibly informed by the Sherlock Benchmarks.

Besides the Blue Cross Blue Shield universe, other universes include Independent/Provider-Sponsored plans, Medicare plans and Medicaid plans. Collectively, the approximately 37 participating plans serve 68 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.

Contacts

Douglas B. Sherlock, CFA
215-628-2289
sherlock@sherlockco.com

Release Summary

Blue Plans expense growth was stable. Indications of adaptation to a changing health environment.

Contacts

Douglas B. Sherlock, CFA
215-628-2289
sherlock@sherlockco.com