New E-book Released about Medical Loss Ratios on Care Delivery Models | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

New E-book Released about Medical Loss Ratios on Care Delivery Models

January 19, 2011
by root
| Reprints

MEDecision Inc., a Wayne, Pa.-based provider of collaborative health management solutions, published an e-book, “Medical Loss Ratios: Important Implications for Care Management,” which examines the impact that healthcare reform and the new U.S. Department of Health and Human Services (HHS) medical loss ratio (MLR) mandates have on care delivery models. The e-book also explores the critical role of health information technology (IT) as health plans work to meet the new requirements, improve the quality of care and drive down costs.

MLR is defined by the 2010 Patient Protection and Affordable Care Act (health reform) as the minimum percentage of premiums health plans must devote to clinical services and quality improvement efforts. Starting this year, health plans must meet the new MLR ratios or refund the difference to policyholders beginning in 2012.

The e-book outlines what the HHS considers to be medical and quality-related activities for health plans within the MLR parameters. Investments in health IT qualify as such and should be considered an important part of the equation to not only help health plans work to meet the MLR requirements but also to improve the overall quality and cost of care for their members.



Survey: By 2019, 60% of Medicare Revenues will be Tied to Risk

Medical groups and health systems that are members of AMGA (the American Medical Group Association) expect that nearly 60 percent of their revenues from Medicare will be from risk-based products by 2019, according to the results from a recent survey.

83% of Physicians Have Experienced a Cyber Attack, Survey Finds

Eighty-three percent of physicians in a recent survey said that they have experienced some sort of cyber attack, such as phishing and viruses.

Community Data Sharing: Eight Recommendations From San Diego

A learning guide focuses on San Diego’s experience in building a community health information exchange and the realities of embarking on a broad community collaboration to achieve better data sharing.

HealthlinkNY’s Galanis to Step Down as CEO

Christina Galanis, who has served as president and CEO of HealthlinkNY for the past 13 years, will leave her position at the end of the year.

Email-Related Cyber Attacks a Top Concern for Providers

U.S. healthcare providers overwhelmingly rank email as the top source of a potential data breach, according to new research from email and data security company Mimecast and conducted by HIMSS Analytics.

Former Health IT Head in San Diego County Charged with Defrauding Provider out of $800K

The ex-health IT director at North County Health Services, a San Diego County-based healthcare service provider, has been charged with spearheading fraudulent operations that cost the organization $800,000.