The MLRs imposed in Obamacare are going to have next to no effect at all on the health care insurance industry.
MLRs are used to set a standard on the amount of money an insurance company must spend on actual health care services.
The whole controversy could have been avoided, Laszewski says, by simply letting the insurers compete on price instead of regulating the MLRs.
If these so-called Medical Loss Ratios, or MLRs, are less than 80% or 85%, HMOs must provide a refund to their plan members.
FORBES: Sebelius' MLR Rules Institutionalize HMOs As Well-Paid Health Middlemen
On the other hand, as a result of health reform HMOs are now regulated like never before, with MLRs just being one example.
FORBES: Big Five Insurers To Break With AHIP, Karen Ignagni--Really?
With government-mandated MLRs, and forced rebates to consumers if you push the MLR down too far, what will be the incentive to keep costs in check?
In the past, these companies purposefully classified some borderline expenses as non-medical expenses, as low MLRs were generally seen as a positive by Wall St. and investors.
That mandate, contained in Section 2718 of the Patient Protection and Affordable Care Act, requires that MLRs in the individual and small-group markets exceed 80%, and 85% in the large-group market.
In the industry, so called medical loss ratios or MLRs will be required to stay above 85% for large group coverage and above 80 cents on the dollar of premium paid for small group and individual coverage.
It was a flame that spearheaded one of the greatest open desert battles in Desert Shield and Desert Storm and led the way as those rockets and missiles from Apaches and MLRS and our strike forces went across and defeated what was supposed to be the mother of all battles.
应用推荐