Fierce Healthcare July 13, 2022
The Medicare Advantage market has been under the microscope of late, and a new study from Brookings adds more fuel to the fire that major insurers may be taking advantage of their size to pad their bottom lines.
The analysis finds that the majority (67%) of MA beneficiaries are concentrated among five big insurers: UnitedHealthcare, Humana, Aetna, Kaiser Permanente and Anthem, now Elevance Health. These firms are also broad, integrated businesses that can keep a number of member services in-house.
Brookings notes that profits earned by related businesses are not subject to medical loss ratio (MLR) requirements, and that suggests items that appear as costs to the MA plan are actually still profits to the...
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