Healthcare DIVE May 18, 2018
Les Masterson

Dive Brief:

  • Despite payers voicing concerns about market instability in the individual insurance market, a new Kaiser Family Foundation (KFF) review of 2017 data found insurance companies are regaining profitability in the marketplace.
  • KFF found that payers struggled with their medical loss ratio (MLR) in 2014 because they did not know how to set premiums for individual insurance in an Affordable Care Act (ACA) world. But MLRs improved in 2016 and averaged 82% in 2017 after large premium increases, leading to more premiums than paid out claims.
  • KFF also found improved gross margins: payers lost $9 per enrollee in 2015, but improved to a gain of $79 by 2017. “These data suggest that insurers in this market are...

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Topics: ACA (Affordable Care Act), Govt Agencies, Insurance, Market Research, Payer, Public Exchange, Trends
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