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> The ACA mandates that at least 80% of premiums must go towards medical expenses. This is not precisely accurate. The medical loss ratio (80% for individual p
by clcaev 2y ago
> The ACA mandates that at least 80% of premiums must go towards medical expenses.
This is not precisely accurate. The medical loss ratio (80% for individual plans) can also be spent on quality improvement. There is a blurry line between administrative costs and QI initiatives. For example, a plan-provided coordinator could be QI rather than administrative.
- FireBeyond 2y agoNow all that money will go into AI QI bots and training...
- blactuary 2y agoThis is correct, but I can tell you from experience that that stuff is a tiny amount of what goes into the claims in the numerator