Healthcare Finance News July 15, 2022
Authors said the major insurers are padding their bottom lines by disguising profits as costs.
As enrolment in the Medicare Advantage (MA) program grows, so are concerns and uncertainly over the profits providers are reaping and whether or not “overpayment” is an issue.
A report from the Brookings Institute indicates the five major insurers — UnitedHealthcare, Humana, Aetna, Kaiser Permanente and Elevance Health (formerly Anthem) –are padding their bottom lines by disguising profits as costs.
The report points out insurers are able to do this because profits accrued through related businesses are not regulated by medical loss ratio (MLR) requirements.
In certain cases, spending on related businesses can reach more than 70%, the report noted.
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