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Plan Management Navigator

Navigator provides analytics for health plan administration. It is intended to provide commentary and observations on the management of health plan expenses under the direct control of the management team. Topics addressed include the cost of administration in each functional area, drivers of administrative costs such as product mix and operational metrics, economics of scale and other important topics.

This publication is available periodically, for no charge, via e-mail and through on-line access.

The most recent edition of Navigator is available here:

Past editions of Navigator are available here:

  • Mid July 2010
  • - Independent / Provider - Sponsored Plans' Administrative Costs were 8% of Premium in 2009

  • June 2010
  • - SEER Participation as Indicator of Administrative Cost Focus
  • Late April 2010
  • - Interactions Between Claims Processing Costs and Other Functions for Medicare and Medicaid Plans
  • Mid April 2010
  • - Drivers of Claims Processing Costs for Medicare and Medicaid Plans

  • Early April 2010
  • - Medicare, Medicaid, Health Care Reform and Administrative Expenses

  • February 2010
  • - Recent Operational Metric Trends - Provider Management, Corporate Services and HR/Compensation/Staffing

  • Late January 2010
  • - Recent Operational Metric Trends - Account and Membership Administration

  • January 2010
  • - Recent Operational Metric Trends - Sales and Marketing

  • Late October 2009
  • -Growth in Medicaid Plans' Core Administrative Costs Declines in 2008

  • October 2009
  • -Medicare Plans’ Administrative Costs Increase on Marketing Growth in 2008

  • August 2009
  • -Blue Cross Blue Shield Plans Post Decline in Growth of Administrative Costs in 2008

  • July 2009
  • -Independent-Provider Sponsored Plans Post Increase in Administrative Costs, and Decline in Ratios, in 2008

  • April 2009
  • -Best Practices for Health Plans: An Enterprise View

  • February 2009
  • -The Promise of Information Systems

  • December 2008
  • -Reform and Administrative Costs of Small Group and Individuals

  • November 2008
  • -Review of Blue Cross Blue Shield Operational Trends

  • Late October 2008
  • -Medicare-Oriented Plans' Administrative Cost Growth Increases Remain Modest in 2007

  • October 2008
  • -Medicaid-Oriented Plans' Administrative Expense Benchmarks Available

  • September 2008
  • -Independent/Provider-Sponsored Plans Post Decline in Administrative Cost Growth Rate in 2007

  • August 2008
  • -Blue Cross Blue Shield Plans Versus Independent / Provider-Sponsored Plans

  • July 2008
  • -Blues Post Modest Trends in Administrative Costs in 2007

  • June 2008
  • -Scalability of Health Plan Administration

  • November 2007
  • -Medicaid-Oriented Plans' Administrative Expense Benchmarks

  • October 2007
  • -Medicare Advantage Performance Benchmarks Released

  • Late August 2007
  • -Performance Benchmarks for Larger Plans Released

  • August 2007
  • -Provider-Sponsored Administrative Expense Benchmarks Published

  • July 2007
  • -Blue Cross Blue Shield Administrative Expense Benchmarks Published

  • June 2007
  • -Sherlock Expense Evaluation Status Report

  • April 2007
  • -Benchmarking and Business Combinations
    -New Innovations in SEER

  • March 2007
  • -If Not Scale, Then What?

  • January 2007
  • -Scale Somewhat Affects Administrative Expenses of Blue Cross Plans

  • November 2006
  • -Administrative Expense Benchmarks for Medicare Advantage Health Plans

  • August 2006
  • -Provider-Sponsored Administrative Expenses Surge

  • Late July 2006
  • -Blue Cross Blue Shield Administrative Expense Benchmarks Published

  • July 2006
  • -Blue Cross and Blue Shield Plans Report Modest Expense Growth in 2005

  • May 2006
  • -Administrative Expenses for Provider Sponsored Plans Increase Last Year

  • April 2006
  • -Medicare Advantage Administrative Expense Costs

  • January 2006
  • -Lessons for Health Plans from the Investments industry- Part 2

  • November 2005
  • -Lessons for Health Plans from the Investments Industry- Part 1

  • October 2005
  • -Evolution of the Health Insurance Product and Its Effects

  • September 2005
  • -Medicaid Administrative Expense Costs Published

  • August 2005
  • -Provider-Sponsored Administrative Expense Benchmarks Published

  • July 2005
  • -Blue Cross Blue Shield Administrative Expense Benchmarks Published

  • June 2005
  • -Early Results Suggest Effective Administrative Cost Management
    -From Benchmarking to Actions Steps

  • May 2005
  • -Administrative Benchmarks for Medicare-Oriented Plans

  • April 2005
  • -Benchmarks as a Catalyst for Change

  • January 2005
  • -Benchmarking in 2005
    -Medicare Advantage

  • December 2004
  • -Best Practices for Customer Service

  • September 2004
  • -Comparison Between Provider-Sponsored and Other Plans

  • August 2004
  • -Administrative Expense Benchmarks for Publicly Traded Companies
    -Background on the Public Companies and SEER

  • July 2004
  • -Administrative Expense Benchmarks Published

  • June 2004
  • -Blue Cross Blue Shield System Financial Analysis Available

  • April 2004
  • -Administrative Expense Benchmarks for Larger Health Plans Published
    -Outsourcing for Health Plans

  • March 2004
  • -Best Practices for Blue Cross Blue Shield Plans
    -New Study on Very Large Health Plans

  • January 2004
  • -Benchmarks for Medicaid-Oriented Plans’ Administrative Expenses: 2003

  • October 2003
  • -Administrative Expense Benchmarks for Provider Sponsored Health Plans Published

  • September 2003
  • -Sherlock Company Releases Operational Benchmarks for Health Plans

  • August 2003
  • -Administrative Expense Benchmarks for Publicly Traded Companies Published

  • July 2003
  • -Administrative Expense Benchmarks for Health Plans Published

  • June 2003
  • -Kaiser Permanente Chooses SunGard’s MACESS.exp to Implement Improvements
    -Wakesoft’s Server to Support Harford’s Group Benefits

  • May 2003
  • -Sherlock Expense Evaluation Reports: Are These Firms My Peers?

  • April 2003
  • -Blue Cross and Blue Shield of Rhode Island Team Up With Perot Systems
    -Staffing Analyses of SEER Participants

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