Sunday, June 27, 2010

MLR update

The Aug 28th, 2009 blog entry 'Health care re-form VIII (More nonsense)' discussed the use and abuse of the medical loss ratio, tried to explain what it really represents, and why "... high medical loss ratio good, lower medical loss ratio bad is about as useful a bleat as Animal Farm's "Four legs good, two legs bad! ..." and a misuse of the ratio.

Medical Loss Ratios & Health Insurance: Are You A "Constructionist" or an "Activist?" asks the question: "Will the Patient Protection and Affordable Care Act's (PPACA) 80% to 85% MLR requirement make this mash-up "better?" and suggests there are two ways to look at the subject (... what the writer terms "constructionist" and "activist", and not "yes" or "no").

Medical Loss Ratio: What Really Counts As Quality? asks the question, and gets answers/opinions from five 'experts.'

Meanwhile the Department of Health and Human Services is drawing up the regulations (on this subject) that insurers will have to follow to satisfy the new health law's requirement that insurers spend either 85% of premiums collected on medical expenses (large group market ) or 80% of premiums (small group and individual markets)...

A prediction: in a relatively short period of time, and as a result of this legislation, no health plans will have MLRs that exceed the statutory requirements... (though many do currently).

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