New Medicaid medical-loss ratio won't strip insurer profits
By Bob Herman | May 27, 2015
The federal government is loosely capping the profits of Medicaid managed-care insurers. But many large companies already live within the proposed ratio, raising questions about the regulation's influence.
Starting in 2017, lump sum rates paid to Medicaid managed-care plans should follow an 85% medical-loss ratio, the CMS said Tuesday. That mark indicates at least 85 cents of every premium dollar must be spent on medical care, while the remaining 15% can go toward administration and profits.
http://www.modernhealthcare.com/article/20150527/NEWS/150529909
By Bob Herman | May 27, 2015
The federal government is loosely capping the profits of Medicaid managed-care insurers. But many large companies already live within the proposed ratio, raising questions about the regulation's influence.
Starting in 2017, lump sum rates paid to Medicaid managed-care plans should follow an 85% medical-loss ratio, the CMS said Tuesday. That mark indicates at least 85 cents of every premium dollar must be spent on medical care, while the remaining 15% can go toward administration and profits.
http://www.modernhealthcare.com/article/20150527/NEWS/150529909