RWJF Content Alert - Journal Articles Focus on Medical Loss Ratios and High-Deductible Health Plans

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Journal Articles Focus on Medical Loss Ratios and High-Deductible Health Plans

Peer-reviewed studies published this month in the March issue of American Journal of Managed Care look at aspects of what Americans receive for their health care dollars. 

One study, funded by the Robert Wood Johnson Foundation’s (RWJF) Changes in Health Care Financing and Organization (HCFO) program looks at the potential impact of medical loss ratios (MLRs) on the individual health insurance market. A provision of the Affordable Care Act, MLRs are designed to ensure that the bulk of an insured person’s premium goes to clinical services, rather than administrative costs or excess profitability. The study finds that in several states, at least half of health insurers would likely fail to meet the minimum threshold (80 percent) for the proportion that must be spent on care. While full implications are uncertain, the authors conclude that MLRs have the potential to significantly affect the individual market.

Read the article (subscription required)