Hurricanes can have a significant operational and financial effect on healthcare providers, insurers, and payers. Organizations that deliver or finance healthcare services in impacted areas must consider the various outcomes resulting from any disruptions. In this article, Milliman’s Lynn Dong, Scott Jones, and Michael Polakowski highlight a list of short-term and long-term effects for organizations to evaluate.
The Medicaid “Mega Reg” final rule now makes medical loss ratios (MLRs) a requirement for Medicaid managed care programs in every state. While the Medicaid MLR formula largely follows the commercial and Medicare Advantage formula, there are some key differences between the three. In this report, Milliman consultants discuss several issues that state agencies and managed care organizations need to consider in the development and completion of MLR reporting.
Medical loss ratios (MLRs) will become a required part of financial reporting and prospective rate setting for Medicaid managed care programs in every state, effective for managed care contracts beginning on or after July 1, 2017. The creation of minimum MLR standards for Medicaid managed care follows the precedents set by the commercial health insurance market in 2011 and the Medicare Advantage (MA) market in 2014.
Join Milliman’s Ian McCulla, Scott Jones, and Jill Brostowitz for the webinar “Medical loss ratios in the Medicaid mega reg” on Friday, June 24, at 12 p.m. EST. They will discuss the release of the final Medicaid and Children’s Health Insurance Program (CHIP) managed care rule (final rule). To register, click here.