While every health plan is different, our reports facilitate the closest comparisons to your plan and our metrics can quantify of any residual differences. Comparability is promoted by segmenting our 60 organization universe into peer groups closely matching size, product mix, or organizational characteristics of your health plan. We also segment administrative activities and costs into product areas to isolate the varying resource consumption of health coverage products.
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 |
Blue Cross |
Larger |
Provider- |
Medicaid- |
Medicare |
TPA |
|
|
|
|
|
|
|
Sample Size |
|
|
|
|
|
|
| Number of Participants | 27 |
6 |
15 |
11 |
10 |
7 |
| Participants' Members (000) | 38,211 |
19,130 |
5,780 |
5,727 |
2,490 |
607 |
| Median Membership (000) | 757 |
2,956 |
316 |
194 |
221 |
99 |
| Mean Membership(000) | 1,415 |
3,188 |
385 |
521 |
249 |
87 |
|
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Supplemental Content |
||||||
| Prod. Memb. from Other Universes | NA |
NA |
NA |
950 |
1,116 |
18,015 |
| Total Product Members | NA |
NA |
NA |
5,670 |
2,155 |
18,622 |
Market Mix (Prem./Fees) |
||||||
Commercial* |
||||||
Median |
67.7% |
65.5% |
66.6% |
0.0% |
32.1% |
NA |
Average |
69.8% |
64.4% |
63.6% |
15.5% |
32.5% |
NA |
Medicare Advantage |
||||||
Median |
4.8% |
8.9% |
26.4% |
3.6% |
57.3% |
NA |
Average |
8.7% |
12.8% |
25.1% |
11.0% |
67.2% |
NA |
Medicaid |
||||||
Median |
0.0% |
0.0% |
6.3% |
96.4% |
0.0% |
NA |
Average |
2.2% |
0.0% |
11.0% |
73.0% |
4.1% |
NA |
|
||||||
Product Mix |
||||||
Pct. Mgd Care (Prem./Fees)** |
||||||
Median |
12.1% |
20.1% |
82.2% |
100.0% |
95.3% |
NA |
Average |
16.3% |
27.8% |
79.1% |
93.7% |
87.7% |
NA |
|
||||||
Percent ASO (Members) |
||||||
Median |
39.6% |
50.3% |
20.3% |
0.0% |
2.6% |
100.0% |
Average |
39.5% |
49.0% |
17.0% |
7.0% |
9.7% |
100.0% |
|
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States Served |
30 |
8 |
15 |
23 |
19 |
11 |
|
|
|
|
|
|
|
As of 9-30-11. Subject to change. |
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| * Commercial excludes FEP. | ||||||
| ** Managed Care is the sum of Medicare Advantage, Medicaid and Commercial HMO. | ||||||
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