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PULSE

Dashboard for Health Plan Financial Management

PULSE, published monthly, provides a continuing dashboard of norms for health plan performance, enabling managers to identify areas of variance. It includes both capital cost metrics, such as price per member or price earnings multiples, as well as operational metrics such as membership growth, administrative expense to premium ratio, health benefit ratio and premium rate increases. In addition, PULSE provides monthly inserts on key topics ranging from Blue Cross Blue Shield Plans, rate increases, components of administrative expenses and economies of scale. Finally, PULSE reports on trends in earnings, business combinations and financings. Our first edition was published in 1991.

Every month, PULSE reports on key events affecting the health plan industry, including mergers, acquisitions, financial results, conversions, restructurings and other notable events. PULSE also provides detailed financial information on every publicly traded health plan company. Finally, every month PULSE provides indepth analyses of various factors affecting health plans.

View Sample Issue of PULSE
(PDF Format, Requires Adobe Acrobat)

• Health Plan Industry News
• Market, Financial & Operating Statistics for health plans
• Monthly Indepth Analysis ("Insert")

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PULSE Topics

PULSE covers a wide range of topics concerning the health plan industry. To review a list of recently covered topics, click here.

Industry News

This section includes recent news concerning the health plan industry, primarily reported from a financial point of view. Areas that PULSE reports on each month include, health plans':

• Mergers, Acquisitions and Divestitures
• Quarterly and Yearly Earnings Announcements
• Restructurings Undertaken
• Stock Market Performance
• Conversions to For-Profit Status and Other Recapitalizations
• Management Appointments

Health Plan Market, Financial & Operating Statistics

This section includes a four-page printed spreadsheet with detailed financial data for every public HMO company. Financial data reported each month includes:

• Valuation Ratios - including Price / Earnings, Price / Future Expected Earnings, Price to Sales, Price per Member, Price to Net Worth.
• Operating Statistics - such as revenue, premiums PMPM, membership, operating earnings, net earnings and earnings per share.
• Operating Ratios - including medical loss ratios, administrative expense to premium ratios and operating margin.
• Balance Sheet Data - such as long-term debt, equity, working capital, intangibles.
• Balance Sheet Ratios - consisting of debt to capital, return on equity, net worth per share, days of claims payable.

Monthly Indepth Analysis ("Insert")

Each month, PULSE looks at a key topic affecting the health plan industry through a detailed analysis. Analyses are generally eight pages in length. Some of these analyses include:

• BLUES - comprehensive reports on Blue Cross Blue Shield Plans, touching on recent mergers, acquisitions, conversions, financial results and other news concerning Blue Plans.
• Annual Health Plan Pricing Survey - every year we survey every health plan in the U.S. about premium and medical loss expectations for the following year. Response rates are generally 25-35%.
• Investment Policy for Health Plans - Annual survey of health plans and their investment decisions which looks at the investment policies of the publicly traded health plans and summarizes the differences between them.
• Benchmarks for Health Plan Administrative Expenses - Executive summary of our annual report on administrative expenses. Provides administrative expenses on a PMPM basis by key products and functions/departments.
• Compensation for Health Plan Executives - Annual compilation of compensation for health plan executives by company.
• External Capital Sources for Health Plans - Summary of the capital market activities of health plans over the past several years and the factors impacting those activities.
• Economies of Scale - What do the SEER Analyses tell us about the virtues of business combinations, outsourcing and management contracts.
• The Cost of Stock Options Among Health Plans - Who uses them? How do you estimate their costs? How big of a deal are they? To what degree, if any, would margins of health plans be affected?