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Medical care ratio (MCR), also known as medical cost ratio, medical loss ratio, and medical benefit ratio, is a metric used in managed health care and health insurance to measure medical costs as a percentage of premium revenues. [1]
For insurance, the loss ratio is the ratio of total losses incurred (paid and reserved) in claims plus adjustment expenses divided by the total premiums earned. [1] For example, if an insurance company pays $60 in claims for every $100 in collected premiums, then its loss ratio is 60% with a profit ratio/gross margin of 40% or $40.
For the third quarter, UnitedHealth's medical loss ratio - the percentage of premiums spent on medical care - stood at 85.2%, higher than the 82.3% reported a year earlier, as well as analysts ...
Those Medical Loss Ratio rules require insurers to pay out on claims at least 80% of the money they take in as premiums from customers, or issue rebate checks. (The minimum is 85% for large groups.)
Efficiency can be reported then as a ratio of outputs to inputs or a comparison to optimal productivity using stochastic frontier analysis or data envelopment analysis. An alternative approach is to look at latency times and delay times between a care order and completion of work, and stated accomplishment in relation to estimated effort.
Yahoo Finance’s Brian Sozzi, Julie Hyman, and Myles Udland break down Centene’s latest earnings report and outlook for the healthcare industry with Centene CEO, Michael Neidorff.
Frequently reported in medical research studies is the confidence interval (CI), which indicates the consistency and variability of the medical results of repeated medical trials. In other words, the confidence interval shows the range of values where the expected true estimate would exist within this specific range, if the study was performed ...
HCUP Logo. The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).