Health Payer Intelligence October 15, 2020
Kelsey Waddill

Medicare Advantage average gross margins are the highest that they have ever been, increasing by on average $64 per member per month over June 2019 levels.

Compared to 2019, the fully-insured group health insurance markets and Medicare Advantage markets have seen their margins increase and loss ratios decrease in the first half of 2020, with Medicare Advantage gross margins emerging far ahead of other markets, according to a Kaiser Family Foundation issue brief.

The issue brief relies on data from the National Association of Insurance Commissioners from 2013 to 2020.

The researchers observed payers’ gross margins—the average amount of premium income that remains after enrollee’s claim costs have been satisfied for the month.

“Gross margins are an indicator of performance,...

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