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The Peer Groups in Our Universe of Participating Health Plans

Recent studies include separate universes of health plans, including Blue Cross Blue Shield Plans, Larger health plans, Provider-Sponsored health plans, Medicare-oriented and Medicaid-oriented health plans.

Selected Characteristics
of Universes

Blue Cross
Blue Shield

Larger
Plans

Provider-
Sponsored

Medicaid-
Oriented

Medicare
Advantage

 

 

 

 

 

 

Sample Size

 

 

 

 

 

Number of Participants

23

6

13

8

7

Participants' Members (000)

30,742

   18,150

        4,010

         2,137

             1,248

Median Membership (000)

752

2,900

253

155

124

Mean Membership(000)

1,337

3,025

308

267

178

 

 

 

 

 

 

Market Mix (Prem./Fees)

 

 

 

 

 

Commercial

 

 

 

 

 

Median

87.1%

75.5%

69.4%

7.7%

36.6%

Average

84.6%

74.1%

68.9%

17.7%

35.0%

Medicare Advantage

 

 

 

 

 

Median

1.1%

8.5%

22.0%

0.0%

48.9%

Average

6.4%

13.2%

23.8%

16.5%

56.6%

Medicaid

 

 

 

 

 

Median

0.0%

0.7%

0.0%

74.4%

0.0%

Average

1.5%

4.3%

7.3%

65.1%

8.4%

 

 

 

 

 

 

Product Mix

 

 

 

 

 

Pct. Mgd Care (Prem./Fees)*

 

 

 

 

 

Median

14.9%

20.7%

81.4%

100.0%

86.4%

Average

16.3%

21.9%

76.9%

95.3%

82.0%

 

 

 

 

 

 

Percent ASO (Members)

 

 

 

 

 

Median

37.3%

49.6%

16.4%

0.0%

15.9%

Average

37.4%

45.6%

18.8%

12.0%

20.6%

 

 

 

 

 

 

States Served

24

7

11

6

10

 

 

 

 

 

 

Information subject to change.

 

 

 

 

 

 

* Managed Care is the sum of Medicare Advantage, Medicaid and Commercial HMO.

Summary Results for Various Peer Groups

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