Medical expenditures in the United States were down steeply in 2020 due to deferred and forgone care associated with the COVID-19 pandemic, leading to historically low medical loss ratios (MLRs) for insurers. For carriers, which must comply with state and federal minimum MLR regulations or pay costly rebates and remittances, this state of affairs brings with it both challenges and new opportunities for strategic investment. This white paper discusses how insurers can navigate this environment, using it to invest in next-generation medical management or digitally transform their analytics and reporting. In doing so, they can positively impact the efficiency and quality of medical care for members and patients.
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Pandemic-induced medical loss ratio opportunities
Historically low MLRs give commercial insurers a unique opportunity to make targeted investments in quality improvement and efficiency measures.