Retirement & Health Benefits Industry: KPIs
Medical loss ratio (MLR), claim settlement cycle time, and claims denial rate are some KPIs for the US health plans industry. Pension fund KPIs include cost of risk benefits and market value of fund among others. These and other findings are outlined below.
OpsDog Health Insurance KPIs
- Fortune 500 consulting agency OpsDog identified the top 5 health plan KPI metrics for health insurance companies in the US.
- OpsDog leverages 25 years of consulting expertise and business improvement services to Fortune 500 companies.
- First is Medical Loss Ratio (MLR), which is a percentage of premium dollars a health plan spends on medical claims and quality optimization instead of administrative expenses.
- Second is Claim Settlement Cycle Time (Medical) which indicates the average number of days needed for a health insurance payer to process and payout a claim.
- Third is Claims Denial Rate which has an average rate of 5-10 percent across the healthcare industry.
- Fourth is Provider Contracting Cycle Time or turnaround time for an insurance company to enroll a new healthcare provider in its network.
- Fifth is First Contact Resolution Rate (Member Services) or the percentage of resolved calls/mail/contacts by the Service Desk on the first customer interaction.
Strategy2Act Retirement Process KPIs
- KPI resource Strategy2Act lists around 20 KPIs for companies' Retirement process.
- Strategy2Act is a commercial library of KPI measures where businesses can obtain Balanced Scorecards with 12 to 15 KPIs.
- The top KPIs for retirement process include retirement planning estimate which factors in sources of income, expenses, savings program, and management of assets and risk.
- The percentage of employees aged 50 years old and above is also included as a top KPI for the retirement process.
- The percentage of senior executives and management officers nearing retirement age are also included.
- Lastly, the percent of voluntary retirements per year are included in the top 5 KPIs for retirement process.
- Other KPIs include distribution of organizational workforce, breakdown of employees into part-time and full time workers, and male to female ratio among others.
Strategy2Act Health Insurance KPIs
- Strategy2Act also lists around 20 KPIs for health insurance for companies.
- The top KPIs include health insurance and financial perspective which indicates whether the firm's strategy and operations deliver value to their shareholders.
- New business premiums is another KPI which measures the premium acquired from new policies for a specific year.
- Internal rate of return (IRR) on new business represents the interest rate at which net present cash value flows from an investment or project equal zero.
- External funds management of cash flow sourced outside the company completes the top 5 KPIs for health insurance.
- Other KPIs include operating profit, operation, number and value of policies sold among others.
- KPI Library Pension Fund also indicates the following KPIs: Number of investments above 5% of net assets, cost of risk benefits, number of days to pay out exit benefits, and market value of pension fund.
- IBISWorld reports that the US Retirement and Pension Plans market size will reach $669.5 billion this 2020.
- The market grew by 6% per year from 2015 to 2020.
- The US retirement and pension plan market is the 4th ranked Finance and Insurance industry by market size in the country.