Centro de Documentacion de Fundación MAPFRE - Medicare Advantage, Medical Loss Ratio, Service Efficiency, and Efficiently Positive Health Outcomes

Notes: Sumario: Within the context of Medicare's enunciated triple aims of better health, better care, and lower costs, we examine the effectiveness of medical loss ratio (MLR) on health outcomes of Medicare Advantage insurers. We simultaneously examine the effect of an efficiency measure for the insurer performance: medical service utilization efficiency (an assessment of how efficiently an insurer provides medical services). This research is based upon collection and integration of several data sources: health outcome data, financial data, and medical service utilization data. Our results suggest that to enhance health improvement efficiency, medical service utilization efficiency should be incorporated as a cost-efficient regulatory and monitoring indicator when evaluating Medical Advantage insurersRelated records: En: North American actuarial journal. - Schaumburg : Society of Actuaries, 1997- = ISSN 1092-0277. - 06/09/2023 Tomo 27 Número 3 - 2023 , 16 p.Materia / lugar / evento: Modelos actuariales Salud Pérdidas Empresas de seguros Asistencia sanitaria Eficiencia operacional Sistemas de medición Medicare Estados Unidos Otros autores: Brockett, Patrick L.
Other categories: 6

Rights: In Copyright (InC)

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