Quality Can Be Improved and Measured Meaningfully
Wednesday, May 26th, 2010
I’ve been in the healthcare field for over 20 years now, and I still believe that the vast majority of those involved—whether on the payer or provider side—truly want what’s best for their patients or members. After all, healthcare quality and cost affects everyone.
In an editorial published earlier this week in the New York Times entitled “The Gaming Begins,” the editors point out the difficult struggle over how to calculate medical loss ratio under the new healthcare law and discussed concerns that insurers could “game” medical loss ratio by spending money on administrative costs, rather than on meaningful measures to improve quality.
Beginning in 2011, the new law requires health insurers to spend 80-85 percent of the premiums they collect on medical services or activities that improve the quality of care (the medical loss ratio). Insurers can then use the remainder of the premiums for things such as marketing, overhead, salaries, and profit. Read the rest of this entry →
