Latest news with #Navigator
Yahoo
15 hours ago
- Business
- Yahoo
Independent / Provider-Sponsored Plans' Administrative Expenses Decelerate in 2024
PHILADELPHIA, July 15, 2025--(BUSINESS WIRE)--Holding product mix constant, Independent / Provider-Sponsored plans' per member costs grew by 6.2% in 2024 compared with 8.4% in 2023. The growth in Medicare Advantage and decline in Medicaid membership led to as reported growth of 9.5%, compared with 10.5% in 2023. Median PMPM costs for all reporting plans was $55.67 PMPM. While most Sales and Marketing functions decelerated, the plans emphasized Customer Services, Actuarial and Rating and Underwriting. There was also notable growth in Information systems, and acceleration in Medical Management. Staffing ratios, compensation and outsourcing increased. The results are summarized in Plan Management Navigator, posted at The Navigator draws from the 2025 Independent / Provider-Sponsored plan edition of the Sherlock Benchmarks. It analyzes and details results from in-depth surveys of 12 IPS Plans serving 8.7 million members, a high share of such health plans and especially of the members served by this industry segment. We will discuss the results via a free web conference on Wednesday, July 16th, from 2:00 PM to 3:00 PM Eastern Daylight Time. Douglas Sherlock will offer a brief presentation, followed by questions and answers. To participate in the web conference, please register at Once registered, dial-in information and a link to connect will be provided in a confirmation email. The Sherlock Benchmarks are the health plan industry's "gold standard" metrics of administrative activities, costs and operational drivers. They reflect 28 consecutive years and more than 1,000 health plan years of experience. Health plans use the Sherlock Benchmarks to determine whether their administrative costs are optimal and to prioritize improvements among numerous specific activities. Other applications include informing strategic corporate planning and cost-benefit analyses. This year, collectively, Benchmark participants serve 58 million Americans in Blue and other universes. Other universes include Blue Cross Blue Shield plans, Medicare plans and Medicaid plans. Health plan users of the Sherlock Benchmarks serve over 170 million members since June 2022. Sherlock Company ( based in Gwynedd Valley, Pennsylvania, provides informed solutions for health plan financial management. Since its founding in 1987, Sherlock Company has been known for its impartiality and technical competence in service to its clients. View source version on Contacts Douglas B. Sherlock, CFA215-628-2289sherlock@
Business Wire
15 hours ago
- Business
- Business Wire
Independent / Provider-Sponsored Plans' Administrative Expenses Decelerate in 2024
PHILADELPHIA--(BUSINESS WIRE)--Holding product mix constant, Independent / Provider-Sponsored plans' per member costs grew by 6.2% in 2024 compared with 8.4% in 2023. The growth in Medicare Advantage and decline in Medicaid membership led to as reported growth of 9.5%, compared with 10.5% in 2023. Median PMPM costs for all reporting plans was $55.67 PMPM. While most Sales and Marketing functions decelerated, the plans emphasized Customer Services, Actuarial and Rating and Underwriting. There was also notable growth in Information systems, and acceleration in Medical Management. Staffing ratios, compensation and outsourcing increased. The results are summarized in Plan Management Navigator, posted at The Navigator draws from the 2025 Independent / Provider-Sponsored plan edition of the Sherlock Benchmarks. It analyzes and details results from in-depth surveys of 12 IPS Plans serving 8.7 million members, a high share of such health plans and especially of the members served by this industry segment. We will discuss the results via a free web conference on Wednesday, July 16 th, from 2:00 PM to 3:00 PM Eastern Daylight Time. Douglas Sherlock will offer a brief presentation, followed by questions and answers. To participate in the web conference, please register at Once registered, dial-in information and a link to connect will be provided in a confirmation email. The Sherlock Benchmarks are the health plan industry's 'gold standard' metrics of administrative activities, costs and operational drivers. They reflect 28 consecutive years and more than 1,000 health plan years of experience. Health plans use the Sherlock Benchmarks to determine whether their administrative costs are optimal and to prioritize improvements among numerous specific activities. Other applications include informing strategic corporate planning and cost-benefit analyses. This year, collectively, Benchmark participants serve 58 million Americans in Blue and other universes. Other universes include Blue Cross Blue Shield plans, Medicare plans and Medicaid plans. Health plan users of the Sherlock Benchmarks serve over 170 million members since June 2022. Sherlock Company ( based in Gwynedd Valley, Pennsylvania, provides informed solutions for health plan financial management. Since its founding in 1987, Sherlock Company has been known for its impartiality and technical competence in service to its clients.
Mint
2 days ago
- Business
- Mint
Gold nears breakout as Trump tariffs shake markets, says Emkay; sees uptrend ahead
Gold prices continued their upward momentum in domestic markets on Monday, July 14, buoyed by growing global uncertainty following fresh tariff threats from the United States. With US President Donald Trump escalating his trade offensive and investor appetite for safe-haven assets strengthening, Emkay Wealth Management believes the yellow metal is poised to break out of its current consolidation phase and enter a fresh uptrend. Gold futures for August delivery on MCX were trading 0.31 percent higher at ₹ 98,117 per 10 grams early Monday, reflecting rising investor nervousness after Trump threatened to impose a 30 percent tariff on imports from Mexico and the European Union beginning August 1. The move has raised concerns over renewed trade tensions, leading to increased volatility in global markets and prompting investors to seek refuge in gold. Trump has targeted over 22 countries with new tariff announcements, justifying the move with claims of trade imbalances and 'common sense' economics. In response, the European Union has opted to extend its suspension of countermeasures against the US until August 1, 2025, hoping to reach a diplomatic resolution. According to Emkay Wealth Management's latest Navigator report, gold is currently in a consolidation phase internationally—a pattern that typically precedes a strong upward movement. The wealth management firm noted that earlier in 2025, robust demand from China had helped support gold prices. However, with Chinese selling between April and May, this factor has faded in influence. In contrast, the recent strengthening of the US dollar and rising US bond yields have exerted short-term downward pressure on gold. Emkay highlighted two key triggers for a potential upside in gold. The first is the trajectory of US interest rates. With the Federal Reserve still undecided on rate changes due to uncertain inflation dynamics, one of the main catalysts for gold remains subdued. However, Emkay believes a rate cut by the Fed remains likely before the end of the calendar year, driven by soft inflation and macroeconomic challenges. The second potential trigger is the weakening of the US dollar. The Dollar Index has fallen by nearly 10 percent since the beginning of 2025, already reflecting in gold's performance. Emkay, however, believes a further drop in the dollar—possibly caused by rate cuts and declining yields—could create fresh upside for gold. The firm also pointed out that the US government's proposed $4.6 trillion in spending could place further strain on bond yields, complicating the dollar's outlook. Overall, with global trade tensions intensifying and uncertainty clouding the economic outlook, investor interest in safe-haven assets like gold continues to grow. Emkay Wealth Management sees the current consolidation as a potential launchpad for higher gold prices, especially if the Federal Reserve initiates rate cuts and the US dollar weakens further. While silver has already taken the lead in the recent commodity rally, gold could soon follow with renewed strength amid the evolving macroeconomic backdrop. Disclaimer: The views and recommendations made above are those of individual analysts or broking companies, and not of Mint. We advise investors to check with certified experts before making any investment decisions.
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Business Standard
5 days ago
- Business
- Business Standard
Gold in a holding pattern? Why investors should watch Fed rates, not China
If you've been wondering whether it's time to buy gold, Emkay Wealth Management's latest Navigator report offers a subtle yet important cue: gold may be taking a breather before its next sprint. In their July outlook, the firm notes that global gold prices are currently in a consolidation phase—a technical holding pattern that often precedes a strong upward move. For Indian investors tracking global cues, this isn't just a charting insight—it could influence how and when you increase exposure to the yellow metal. Historically, gold has had a love-hate relationship with interest rates. When US rates rise, gold struggles. When they fall, gold shines. Right now, markets are in limbo—the Federal Reserve is on pause, weighing the inflationary impact of new US tariffs. But there's a growing consensus that a rate cut may be on the cards by year-end, given softening inflation and sluggish retail demand. If and when that happens, gold could break out of its current range. Emkay cites technical support at US$ 3,297 and US$ 3,248, suggesting any short-term dip may offer long-term opportunity. Equally important is the Dollar Index, which has slipped nearly 10% since January. A weaker dollar makes gold more attractive globally, especially to emerging-market buyers, as it becomes cheaper in local currency terms. 'The likely path for gold is upward, but it's contingent on US rate action and dollar weakness,' Emkay Wealth notes. What about China's demand? It's no longer the main story Until recently, China's central bank buying spree was one of the dominant bullish triggers for gold. But with selling reported in April and May, that factor has faded. In other words, the rally ahead won't be China-led—it'll be dollar and Fed-led. For Indian investors, this is significant. Much of the local appetite for gold—whether through sovereign gold bonds, ETFs, or physical bullion—is influenced by international pricing, even if rupee-dollar dynamics and duties affect final prices. "The Dollar index is at 97.00 and this marks a fall of close to 10 % over the last six months, and a fall of about 10 % since the beginning of this calendar year. This has been already priced in the gold prices in the international markets, but what we need to see is a further fall in the Dollar caused by official rate cuts and a fall in market yields. There is a strong view that with the new budgeted spends to the tune of US$ 4.60 trillion, the situation could become murkier because the resultant borrowings may put upward pressure on the yields," said Emkay in a note. What should retail investors do? If you're holding gold, now is not the time to exit in a hurry. If you're looking to enter, start gradually. Dollar-cost averaging through gold ETFs or SGBs may help you ride out short-term volatility while staying positioned for long-term upside.
Winnipeg Free Press
01-07-2025
- Health
- Winnipeg Free Press
How Canadian hospitals are trying to break the cycle of readmissions for homeless patients
TORONTO – April Aleman tracks the Uber she ordered for her 82-year-old client as it makes its way to a public health building on a quiet street tucked away from the bustle of downtown Toronto. When the vehicle arrives, Aleman unpacks a walker from the trunk and greets the woman with a warm familiarity. She slows her pace to match her client's as they make their way into the clinic and approach the front desk. 'Hello, we have a dentist appointment,' Aleman tells the receptionist while helping the woman rummage through her purse to find a health card. They sit side-by-side on plastic chairs in a near-empty waiting room, leaning towards each other to complete paperwork on a clipboard. 'Do you have an emergency contact you want to put down?' Aleman, a homeless outreach counsellor at St. Michael's Hospital, asks, pen in hand. 'No, just you people,' her client quips, and they both laugh. Aleman works at the Navigator Program, which helps steer unhoused people through a health-care system that can be especially challenging for patients without a fixed address or means to advocate for themselves. The program was established to break the cycle of hospital readmission and improve health outcomes. Aleman's client said she was admitted to St. Mike's with COVID-19 in late December. When it was time for her discharge on Christmas Day, she was homeless for the first time in her life. She said a family member she was living with had kicked her out of the house. The navigators took over her case and found her a shelter bed. 'I hate to even think about it,' she said of what would have happened if Navigator hadn't intervened and she walked out into the bitter cold with nowhere to go. In late January, Aleman helped her secure an apartment in a Toronto Community Housing senior's building. 'Everything I've been through…they've been there,' said the woman, whom the hospital asked not to be named to respect the privacy of patient health information. Once their hospital treatment ends, patients without housing are discharged back onto the streets, often without a phone, family doctor, health card or shelter. Many return to hospital with worsened health conditions and the cycle continues. Navigator started at Toronto's St. Michael's Hospital in 2019, and expanded to Vancouver's St. Paul's Hospital in 2023, collectively serving more than 1,000 patients since then. One of the first clients from the Vancouver hospital was a woman who landed in the emergency department about 26 times in two months. 'Then I started working with her,' said Alex MacKinnon, an outreach navigator at St. Paul's. MacKinnon said she helped the patient find housing and saw concrete change, despite the ongoing management of chronic illnesses. 'Having checked back in on her ED rates, they went down significantly,' she said. Dr. Stephen Hwang created the program at St. Mike's after examining readmission rates among homeless patients admitted to internal medicine between November 2017 and 2018. He found that 27 per cent of 129 patients returned within 90 days. Roughly a third of participants were readmitted for an identical diagnosis as their initial admission. It's like having a 'super advocate,' said Hwang. A randomized controlled trial is underway to establish whether the program cuts down on return hospital visits. The trial, funded by a Canadian Institutes of Health Research foundation grant, involves 656 people experiencing homelessness. Hwang said there are already striking indicators that the approach works, such as the fact 67 per cent of Navigator patients who needed a family doctor obtained one through the program. Navigator has three outreach workers at St. Mike's and one at St. Paul's, including Aleman in Toronto and MacKinnon in Vancouver. On average, they each see 15 patients at a time for about 90 days. In Toronto it's funded by St. Michael's Hospital Foundation while the Vancouver pilot is funded by Staples Canada. Navigators bring patients coffee, toothbrushes and fresh socks when they're admitted to hospital. These small acts helps build strong relationships between outreach counsellors and their clients, said Dr. Anita Palepu, an internal medicine physician at St. Paul's. 'It's not just a physical poverty. In some cases, it's also deep social poverty and isolation,' said Palepu. The hope is that after three months patients stand on more stable ground with a roof over their head, a family doctor and government benefits. Though the Navigator office door always stays open. One morning in late May, Fred Ellerington, another Toronto navigator, was alerted that one of his patients was in the emergency department. Right away, one of his colleagues left their shared office on the general internal medicine floor to check on them. 'We're embedded,' Ellerington said of the immediate access hospital-based navigators have to patients and their electronic medical records. Ellerington said the patient had cleared standard health tests but his colleague could tell something was off because the patient's behaviour was odd compared to a visit a week earlier. Ellerington said they encouraged a closer look, suspecting a neurological problem 'They just don't have that relationship with the patient,' Ellerington said. While the program's primary goal is improving health outcomes, Ellerington said cutting return visits can also save money and hospital beds. Wednesdays Columnist Jen Zoratti looks at what's next in arts, life and pop culture. Hwang said he is working to launch the program at the University of Montreal Hospital Centre later this year and wants to see it in more hospitals across the country. Long-term, he said he wants policies and programs to address the root causes of homelessness, including making housing and mental health supports more affordable. 'But in the meantime, it's just really important that we serve the people who are right before us in our midst, who have urgent, severe health problems, and who end up literally on the doorstep of the hospital.' This report by The Canadian Press was first published July 1, 2025. Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
