Tip 99- Turning The Focus On Claims

The Business Journal reported last week on hospital system profits. In case you missed it, here’s
a re‐cap of their 3rd quarter results:

• Aurora’s operating income was less than 1% of revenues
• Froedtert’s income was only about 4.3% of revenues
• Pro‐Health earned 5%
• Wheaton actually lost money

These margins are significantly lower than just a few years ago.
Under provisions of the Affordable Care Act, health insurer margins are also tightly regulated.
And yet, premiums continue to rise.

The cost of health care represents 85% or more of every health insurance premium dollar.
Insurance “reform” has focused on the 15% of premiums that goes toward administrative
expenses.

OK. Now let’s get started on the real work.