Sherlock Benchmarks
Sherlock Benchmarks are often called the "gold standard" to measure and manage health plan performance. They are critical tools to inform annual budget targets, identify and improve areas of operational efficiency and inform multi-year cost saving initiatives. They also support strategic initiatives ranging from management of the product portfolio, vendor negotiations, outsourcing and business combinations.
The carefully validated, well-populated benchmarking reports provide an unbiased ranking and helps prioritize cost management activities to have the greatest impact on improving your health plan's overall operating performance. The current environment rewards organizations that optimize their costs, and the Sherlock Benchmarks are an appropriate and necessary tool to achieve this goal.
The twenty-eighth annual Sherlock Benchmarks supplies comprehensive and highly granular financial and operational metrics to help health plans identify whether they operate at best practice and which functional areas provide the highest returns on management efforts to enhance plan performance. The broad scope of the metrics facilitates drill-downs to identify specific operational issues that can be used to map solutions to performance variances.
The broad scope and deep granularity of the benchmarks are shown in the Tables of Contents found in the table below. These are 2024 Tables of Contents which we expect to be similar to 2025 editions. Sherlock Benchmarks are provided in two electronic forms and hard copy upon request. The PDF version permits users to copy the reports for use throughout their organization in a form that is identical to the hard copies. The Microsoft Excel ® version allows desktop access to each analysis and metric of the Reports.
Tables of Contents and Summaries
| Volume I | Volume II | |||||
| Financial Metrics | Staffing Metrics | Operational Metrics | Medical Management Metrics | Utilization Metrics | Free Summaries | |
| Blue Cross Blue Shield | ||||||
| Larger Plans | ||||||
| Independent / Provider-Sponsored | ||||||
| Medicaid | ||||||
| Medicare | ||||||
| Third-Party Administrators | ||||||
The 2025 Benchmarks represents the cumulative experience of more than 1,000 health plan years. In 2025, at least 30 health plans serving approximately 55 million members are expected to participate. Since June of 2022, participants and licensees together serve more than 170 million insured, or most Americans covered by private insurance. Consulting firms use our benchmarks in service to their clients and our Benchmarks have been used for public policy purposes.
Additional Information
Additional information on applying your Sherlock Benchmarks to your organization are linked below.
Description of Universes
The Peer Groups in Our Universe of Participating Health Plans
Products Offered by Universes
Products offered by the Participating Plans
Quality Assurance
Since benchmarks are useful to the degree that they are reliable, we are deeply committed to their quality.
Licensing the Sherlock Benchmarks
Pricing information is available upon request.