The Dog That Didn’t Bark...

In the classic Sherlock Holmes case, the great detective was able to solve the mystery by the absence of a certain behavior. In essence, he could deduce the solution because something didn’t happen.

In real life, we don’t always have that luxury.

Case in point is this story from the Dayton Daily News:

“More than one-third of Montgomery County's employees in the Anthem health-insurance network switched their coverage to UnitedHealthcare last month…

Another employer with significant migration from Anthem to United was Children's Medical Center. About 200 employees there shifted during last year's normal open enrollment.”

While these may seem to be pretty substantial defections, the numbers themselves are pretty meaningless.

Why?

Well, two reasons. First, it’s a pretty poorly-kept secret that between them, Anthem and United pretty much “own” the Dayton market. There’s a joke among most of the agent/broker community that there exists a secret tunnel between the two 800# gorillas, and that each year they just swap files with each other. My point is that the story does not tell us how far – if at all – these changes deviate from the normal back-and-forth between the two carriers. It also doesn’t look to see what other factors may be involved. It’s deceptively poor logic, because it implies a correlation from facts not in evidence. For example, the implication is that Anthem has “lost” so many members solely or primarily because of the Premier kerfuffle. But would it have been helpful to know that this year, UHC’s rates were 20% less than Anthem’s? I’m not saying they were, just that rates are also important, and there is no attempt in the article to take them into account, nor to at least examine if there were other significant differences which could account for this apparently dramatic shift.

The other dog whose yelps were absent is how many UHC members have gone over to Anthem in the same time period. I have no idea, but neither does the article even bring this up. I do know that I’ve personally written Anthem business (both group and individual) even during this time, including moving cases from United to Anthem.

What does that prove? Well, frankly, nothing. Which is exactly the same as the article.