The Latest Leading Cost Drivers in the Blue System

BHI Thought Leadership

Using our massive data repository and powerful analytic tools, BHI regularly examines high-level cost and utilization trends.  In the most recent dive into our big data, comprised of more than 19 billion claims from over 190 million members, three trends stood out. PMPM Costs Continue to Climb At a macro level, total commercial health plan PMPM costs rose 6.5% — …

Getting to the Root of High-Cost Claimants

BHI Thought Leadership

Among regional health plans, a recent Blue Health Intelligence (BHI) analysis found that the number of very high-cost claimants (HCCs) — members with more than $500,000 in annual claims — has nearly doubled over the last five years. Previous research shows that specialty pharmacy is a major factor in this growth. However, out-of-area claims are not a large factor in this growth.   …