answersLogoWhite

0


Best Answer

Medicaid has approx a 3% overhead, wheras Insurance companies strive for an overhead of 15% OR MORE.


"Medical care ratio (MCR), also known as medical cost ratio or medical loss ratio, is a metric used in managed health care

to measure medical costs as a percentage of premium revenues.[1] It is calculated by dividing those premiums allocated for

fully insured or self-funded health care coverage into the total expenses for inpatient, professional (physicians and

other licensed providers), outpatient, and pharmacy. (Briefly, MCR = Costs/Premiums.) As a general rule, a medical cost

ratio of 85% or less is desirable. Some insurers now call MCR "benefit cost ratio" (BCR). In the United States, the term

is Medical Loss Ratio."

http://en.wikipedia.org/wiki/Medical_care_ratio

MLR Breakdown:


From "Insurance Company Health Plans Make More Money, Pay Less in
2005." Chicago Sun Times. Sept. 2006.
http://www.suntimes.com/business/73050,CST-FIN-health27.article

Whereas 10 years ago many plans had medical-cost ratios in the high
80s or 90s, now the highest percentage among large, publicly traded
health insurers is Health Net, at 83.9%. Aetna, which had a
medical-cost ratio well into the 90s when CEO John Rowe, MD, took over
in 2000, recorded a ratio of 76.9% in 2005, Dr. Rowe's final full year
before his retirement. That was the lowest medical-cost ratio for the
nation's largest publicly traded plans. Medical-cost ratios for 2005
(Source: Company 10-K, year-end filings with the Securities and
Exchange Commission):

* 76.9% - Aetna
* 82.3% - Cigna
* 83.9% - Health Net
* 83.2% - Humana
* 78.6% - UnitedHealth Group
* 80.6% - WellPoint

User Avatar

Wiki User

15y ago
This answer is:
User Avatar

Add your answer:

Earn +20 pts
Q: What is the Medicaid vs private insurance overhead?
Write your answer...
Submit
Still have questions?
magnify glass
imp
Related questions

Govt post service vs private post service?

govt services Vs private services?


Who is at fault when someone backs into you while driving in a private parking lot in wyoming?

Situation dependent, but it really comes down to their insurance company vs. yours... the police won't issue a citation on private property.


What are the release dates for Private Snafu vs- Malaria Mike - 1944?

Private Snafu vs- Malaria Mike - 1944 was released on: USA: March 1944


How long does it take a bankrupt insurance co to do a runoff?

Depends on the type and length of the policies (yearly car policy vs. mortgage insurance vs. whole life).


Can you buy private mortgage insurance directly from an insurance company vs. going through the mortgage co.?

In some cases this is governed by state law, in other cases by the rules of the lender themselves. You would have to discuss this with your lender. In general, it would usually be better to do it through them. Certainly easier!


What are some of the Julius Caesar's main themes and ideas?

Fate vs. Freewill Public vs. Private Misinterpretations vs. Misreadings Inflexability vs. Compromise Rhetoric and Power


Applied overhead vs actual overhead?

APPLIED Overhead is computed using the predetermined overhead rate and is the amount of costs applied (or estimated) to be allocated (needed) for specific jobs. ACTUAL Overhead is found after the manufacturing process is complete which gives the actual amount of used/consumed resources (or total costs) that it needed to complete the job. The two amounts can then be compared afterward which is known as Under- or Overapplied Manufacturing Overhead. When Manufacturing Overhead has a DEBIT balance, overhead is said to be UNDERAPPLIED, meaning that the overhead applied to work in process or to the certain job is LESS than the overhead incurred. On the contrary, when manufacturing overhead has a CREDIT balance, overhead is OVERAPPLIED, meaning that the overhead assigned to work in process or to the certain job is GREATER than the overhead incurred.


When was the Delgado vs Del Rio case conducted?

The Delgado vs. Del Rio case was conducted January 9TH, 2012. She was convicted of defrauding Medicaid of one point four million dollars by the jury.


What are the release dates for Common Ave- - 2003 Public vs- Private 1-4?

Common Ave- - 2003 Public vs- Private 1-4 was released on: USA: 23 July 2003


Will your insurance rate be lower if you lease your car vs your company leasing it?

1st question, is it your company or one you work for? If your company leases it, it will no longer be a private auto policy so yes, the rates are different. Call your agent to find the answer.


What does HIB mean?

Medicare HIB stands for Hospital Insurance Benefits (vs. SMIB, or Supplemental Medical Insurance Benefits).


What does Medicare HIB mean?

Medicare HIB stands for Hospital Insurance Benefits (vs. SMIB, or Supplemental Medical Insurance Benefits).