Below are our five takeaways and recommendations based on these benchmarks:

1. You’re measuring benchmarks differently from your competitors.

Some plans (and providers) differ in how they measure even the most standardized clinical metrics. Almost every plan we talked to had different methodologies for their benchmarks so note that you cannot directly compare your plan to another without asking about their methodology.

2. Don’t waste your time searching for perfect data.

We hear many plans debating benchmark methodology instead of improving on the measure. While you need benchmarks to be specific (to your membership) and timely (rather than years old), don’t let perfect be the enemy of good. Whether you are 5% below the average or 35% below the average, the takeaway is that you need to improve in that area.

3. Clinical metrics alone will never show you the full picture.

While benchmarks can be invaluable, it is essential to consider other balanced scorecard metrics, including regulatory requirements, member experience, health equity, and physician experience. Over-indexing on utilization alone can lead to a narrow focus that overlooks other critical aspects of healthcare management.

4. Benchmarks are just numbers until you do something with them.

Make sure you know how you will use benchmarks before you go hunting for them. For example, you could use these benchmarks to prioritize your plan’s clinical investments for this year, to explain to your provider partners why they should participate in a certain initiative, and to set realistic goals for your team.

5. Hitting the benchmark shouldn’t be your goal.

Although benchmarks can help you set realistic goals for your team, do not mistakenly think that hitting the benchmark is the goal. Being average shouldn’t be your goal. Even if you’re average on all clinical metrics, you’re still going to face cost challenges until you are excelling in clinical cost management and care quality.