Tip 41- Much Ado About Nothing?

Health reform set strict guidelines requiring insurers to use 80 or 85 cents of every premium dollar for payment of medical care. This has set off months of handwringing as regulators continue to debate: Just what is “medical care?”

• Are Wellness Programs “medical care?”
• What about an insurer’s Health Risk Assessment?
• How about Nurse Line advocacy, or a disease management program?

Consumer protection advocates have argued for years that insurer administrative costs and profits are too high. When and if the new “Medical Loss Ratio” rules are finalized, at least we can move on to new debates.
Here’s a little something you should know:
“According to a 2009 analysis on health care spending by the Centers for Medicare Services, 89% of premiums for private insurance went to pay for health care services.”
– Milwaukee Journal Sentinel 10‐9‐2011