Researchers from Illinois State University Report Recent Findings in Insurance (Health Insurers’ Use of Quality Improvement Expenses To Achieve a Minimum Medical Loss Ratio Requirement): Insurance

Health Policy and Law Daily

2023 FEB 02 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Research findings on Insurance are discussed in a new report. According to news originating from Normal, Illinois, by NewsRx correspondents, research stated, “Health insurer medical loss ratios (MLRs) are the percentage of premium dollar spent on medical claims and healthcare quality improvement expenses (QIEs). QIEs include activities to improve patient health outcomes and safety, reduce medical errors, and prevent hospital readmissions.”

Our news journalists obtained a quote from the research from Illinois State University, “The Affordable Care Act mandates minimum MLRs in certain health insurance markets lest rebates be paid to policyholders. QIEs are reported in all markets regardless of whether that market is subject to minimum MLR requirements. Using health insurer statutory filings for a sample of group market insurers from 2010 to 2018, we employ a mixed regression discontinuity/regression kink approach to evaluate whether QIEs are used by insurers as a potential strategy for meeting the minimum MLR requirement.”

According to the news editors, the research concluded: “We show that health insurers’ QIE increase in the loss ratio until meeting the minimum MLR requirement, have a significant discontinuous jump at the threshold, and decrease above the threshold after the introduction of the MLR mandate.”

This research has been peer-reviewed.

For more information on this research see: Health Insurers’ Use of Quality Improvement Expenses To Achieve a Minimum Medical Loss Ratio Requirement. Journal of Risk and Insurance, 2023. Journal of Risk and Insurance can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA. (Wiley-Blackwell - http://www.wiley.com/; Journal of Risk and Insurance - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1539-6975)

The news correspondents report that additional information may be obtained from E. Tice Sirmans, Illinois State University, Dept Finance Insurance & Law, Campus Box 5490, Normal, IL 61790, United States. Additional authors for this research include Patricia H. H. Born and Petra Steinorth.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/jori.12413. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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