Saturday, August 9, 2014

Update III - MLR update


Some previous blog entries referencing the MLR:
MLR - Year 2 - Jun 22, 2013
Latest MLR update Dec 4th, 2011
The MLR saga continues - May 13th, 2011
Misc update (MLR) - Mar 26th, 2011
Misc update - V - Feb 13th, 2011
Misc updates - MLR - Oct 25th, 2010
MLR Redux - Aug 24th, 2010
MLR update - Jun 27th, 2010

The MLR - medical loss ratio - was in the news again... First, it was announced that "... U.S. health insurers will send out about $330 million in rebates to employers and individuals this summer... The rebates will go to about 6.8 million people and have a value of about $80 per family. They are to be sent by Aug. 1 either directly to consumers or to the employer providing the health coverage, who is required to pass the savings onto employees..."

Second, a detailed GAO report provided information on the MLR, including: "... When the MLR rules were being considered, there was some concern that insurers would categorize spending on routine operations, such as utilization review, as QI, Jost said. Doing so would move these costs from administration to claims, and thus help them avoid paying MLR rebates to consumers and businesses. “But that does not seem to be happening in a major way" and "...insurers spent less than 1.6 percent of their annual premium income on quality improvements (QI). In 2011, health insurers’ average spending on QI activities as a percentage of net premiums ranged from a low of 0.2 percent (in Wyoming) to a high of 1.5 percent (in Tennessee). The 2012 numbers were similar — Wyoming was still the lowest (at 0.3 percent) and New Mexico was highest at 1.6 percent..." and "... Contrary to predictions that MLR rules would drive up insurers’ costs, the GAO report found that the rules had little influence on insurer spending...", see:


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