Medicare Advantage Costs Slightly Accelerated in 2020

PHILADELPHIA--(BUSINESS WIRE)--In 2020, administrative expenses per member for Medicare plans in 2020 grew by 5.6%, slightly faster than the 5.2% in 2019. All clusters besides Corporate Services, which increased by almost 20%, decelerated in their rate of growth. This comparison is of continuously reporting plans and eliminates the effect of product mix changes between comparison years.

These results are excerpted from the Medicare Plans edition of the 2021 Sherlock Benchmarks. Thirteen plans were surveyed for this analysis. On average, 41% of revenues were in Medicare Advantage and SNP combined. The Benchmarks reflects the results of 2.1 million Medicare Advantage members, including plans from other universes, or about 8% of all Medicare Advantage beneficiaries. The results are published in Plan Management Navigator and are posted at sherlockco.com/navigator. Navigator excerpts from the 2021 Medicare edition of the Sherlock Benchmarks.

In March of this year, members in private Medicare Advantage plans accounted for about 43% of Medicare-eligible beneficiaries, up from 40% in 2020 and 13% in 2005.

We will discuss the results via free web conference on Wednesday, September 15, 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 2021 Sherlock Benchmarks analyses will include the results of approximately 36 health plans serving 54 million members. The Benchmarks for each of the universes will be released over the next several months to participants and licensees.

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.