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:
April 2013 - Could 72,000 Health Plan Employees Lose Their Jobs Under Health Care Reform?
Past editions of Navigator are available here:
March 2013 - Sherlock Company Resources and Health Care Reform
January 2013 - Decisions of Low Cost Independent / Provider - Sponsored Plans in 2011
December 2012 - Decisions of Low Cost Blue Cross and Blue Shield Plans in 2011
November 2012 - ACA and Cost Benchmarks For Three Emerging Markets
October 2012 - Administrative Costs for Medicare Advantage Plans Soar in 2011
Revised Late September 2012 - Medicaid Plans' Administrative Costs Surge in 2011
Early September 2012 - 2011 TPA Benchmarks Published
Late July 2012 - Independent/Provider-Sponsored Plans' Administrative Costs Were 8.7% of Premiums in 2011
July 2012 - Blue Cross Blue Shield Plans' Administrative Costs Were 9.1% of Premiums in 2011
June 2012 - Are Competitors' Publicly Available Financial Statements Actionable for Cost Management
- SEER Function Groups and Health Plan Investment Management
- SEER Universe Update
March 2012 - Participation Robust for Blue Cross Blue Shield and Independent/Provider-Sponsored Universes
- Medicare and Medicaid Universes Being Formed, Growth in Both
- Resolutions of SEER Meeting Discussions
- Mapping the Quality-Cost Tradeoff
February 2012 - The Decisions of Low Cost Independent/Provider-Sponsored Health Plans
- Confluence of Quality and Efficiency
- Dashboard Summary
- Update on SEER Universes
Late January 2012 - Decisions of Low Cost Blue Cross and Blue Shield Plans in 2010
- Dashboard Summary
- New SEER Universes Being Formed
January 2012 - Dashboard Results
- Managing Appropriate Use of Sherlock Benchmarks
- Estimating Cost Performance Using On-Line Tools
November 2011 - Administrative Costs for Medicare Advantage Plans Continue Moderating Trend in 2010
October 2011 - Medicaid Plans' Administrative Costs Increase from Corporate Services' Growth
September 2011 - 2010 TPA Benchmarks Published
Late July 2011 - Independent / Provider - Sponsored Plans' Administrative Costs Were 8.4% of Premiums in 2010.
July 2011 - Blue Cross Blue Shield Plans' Administrative Costs Were 9.2% of Premiums in 2010
April 2011 - Sherlock Benchmark Update
- MLR Context for Administrative Cost Management
- Latest Health Plan Dashboard Results
January 2011 - Summary of Decisions of Low Cost Blue Cross and Blue Shield Plans
- New Benchmarking Calculator Available on Website
Early December 2010 - Summary of Decisions of Low Cost Independent / Provider-Sponsored Health Plans
- Latest Health Plan Dashboard Results
Late October 2010 - Medicare Plans' Administrative Costs Declined in 2009
Early October 2010 - Medicaid Plans' Accelerate Decline in Core Administrative Costs
Mid-September 2010 - New TPA Benchmarks Published
September 2010 - Trends in Health Plan Business Process Outsourcing
August 2010 - Blue Cross Blue Shield Plans' Administrative Costs Grew Modestly in 2009
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 Plan's 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
Viewing Navigator Online Adobe Acrobat Reader is required to view all of Sherlock Company's publications online. The program can be downloaded, free of charge at www.adobe.com .
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