How Has the Affordable Care Act Affected Health Insurers' Financial Performance?

Starting in 2014, the Affordable Care Act transformed the market for individual health insurance by changing how insurance is sold and by subsidizing coverage for millions of new purchasers. Insurers, who had no previous experience under these market conditions, competed actively but faced uncertainty in how to price their products. This issue brief uses newly available data to understand how health insurers fared financially during the ACA's first year of full reforms. Overall, health insurers' financial performance began to show some strain in 2014, but the ACA's reinsurance program substantially buffered the negative effects for most insurers. Although a quarter of insurers did substantially worse than others, experience under the new market rules could improve the accuracy of pricing decisions in subsequent years

Estimating the Impact of the Medical Loss Ratio Rule: A State-by-State Analysis

Outlines the healthcare reform law's requirement that insurers spend a minimum ratio of 80 to 85 percent of premiums on medical care expenses or rebate the difference to policy holders. Estimates rebates in each state if it had been in effect in 2010

Insurers' Responses to Regulation of Medical Loss Ratios

The Affordable Care Act's medical loss ratio (MLR) rule requires health insurers to pay out at least 80 percent of premiums for medical claims and quality improvement, as opposed to administrative costs and profits. This issue brief examines whether insurers have reduced administrative costs and profit margins in response to the new MLR rule. In 2011, the first year under the rule, insurers reduced administrative costs nationally, with the greatest decrease -- over $785 million -- occurring in the large-group market. Small-group and individual markets decreased their administrative costs by about$200 million each. In the individual market, insurers passed these savings on to consumers by reducing their profits even more than administrative costs. But in the large- and smallgroup markets, lower administrative costs were offset by increased profits of a similar amount. Stronger measures may be needed if consumers are to benefit from reduced overhead costs in the group insurance markets

n-Heptane hydroconversion over sulfated-zirconia-supported molybdenum carbide catalysts

Tertiary Education Trust Fund (TETFUND) NigeriaPeer reviewedPublisher PD

The effects of moderate aerobic exercise and satyanda yoga on long-term stress, selected cognitive and somatic measures, and learning of a motorskill in response to an acute stressor

The purpose of this investigation was to compare the effects of a 10 week training program of moderate aerobic exercise and satyanda yoga on long-term stress, selected cognitive and somatic measures, and learning a motor skill in response to an acute stressor. The subjects were 44 female (mean age = 19.5yrs) undergraduate students from the University of Wollongong who were considered to be of below average fitness and had no formal stress management experience. All subjects based on their scores on the Jenkins Activity Survey were categorised as Type B. Subjects were randomly assigned to one of four groups: (1) a moderate aerobic exercise group in which subjects participated in a 10-week fitness program consisting of weight training and aerobic/floor stations; (2) a group which practised 10 weeks of satyanda yoga techniques; (3) a placebo group which met once per week for 10 weeks to attend weekly lunch time musical performances; and (4) a no stress control group which underwent initial testing without being exposed to the acute stressor, prior to and at the end of a 10 week period

Using music interventions in the care of people with dementia

The therapeutic properties of music have been recognised since antiquity. There is now a growing evidence-base to support claims to its benefit for individuals with certain health conditions, including dementia. It has been reported that music interventions can lead to improvements in cognition, behaviour and psychosocial well-being in people with the condition, as well as offering support for carers. There are a variety of types of music interventions that can be used, and it is suggested that nurses consider harnessing music’s potential as part of the care they provide. This article explores the evidence-based use of music in dementia care and outlines its potential benefits

Palladium-bismuth intermetallic and surface-poisoned catalysts for the semi-hydrogenation of 2-methyl-3-butyn-2-ol

The effects of poisoning of Pd catalysts with Bi and annealing in a polyol (ethylene glycol) were studied on the semi-hydrogenation of 2-methyl-3-butyn-2-ol (MBY). An increase in the Pd:Bi ratio from 7 to 1 in the Bi-poisoned catalysts decreased the hydrogenation activity due to blocking of active sites, but increased maximum alkene yield from 91.5% for the Pd catalyst to 94–96% for all Bi-poisoned Pd catalysts, by decreasing the adsorption energy of alkene molecules and suppressing the formation of β-hydride phase. Annealing of the catalysts induced the formation of intermetallic phases and decreased its activity due to sintering of the catalytic particles and low activity of intermetallic compounds. Langmuir–Hinshelwood kinetic modelling of the experimental data showed that poisoning of Pd with Bi changed the relative adsorption constants of organic species suggesting ligand effects at high Bi content

The Federal Medical Loss Ratio Rule: Implications for Consumers in Year 3

For the past three years, the Affordable Care Act has required health insurers to pay out a minimum percentage of premiums in medical claims or quality improvement expenses—known as a medical loss ratio (MLR). Insurers with MLRs below the minimum must rebate the difference to consumers. This issue brief finds that total rebates for 2013 were $325 million, less than one-third the amount paid out in 2011, indicating much greater compliance with the MLR rule. Insurers' spending on quality improvement remained low, at less than 1 percent of premiums. Insurers' administrative and sales costs, such as brokers' fees, and profit margins have reduced slightly but remain fairly steady. In the first three years under this regulation, total consumer benefits related to the medical loss ratio—both rebates and reduced overhead—amounted to over$5 billion. This was achieved without a great exodus of insurers from the market

What's Behind Health Insurance Rate Increases? An Examination of What Insurers Reported to the Federal Government in 2013-2014

The Affordable Care Act requires health insurers to justify rate increases that are 10 percent or more for nongrandfathered plans in the individual and small-group markets. Analyzing these filings for renewals taking effect from mid-2013 through mid-2014, this brief finds that the average rate increase submitted for review was 13 percent. Insurers attributed the great bulk of these larger rate increases to routine factors such as trends in medical costs. Most insurers did not attribute any portion of these medical cost trends to factors related to the Affordable Care Act. The ACA-related factors mentioned most often were nonmedical: the new federal taxes on insurers, and the fee for the transitional reinsurance program. On average, insurers that quantified any ACA impact attributed about a third to these new ACA assessments

The Federal Medical Loss Ratio Rule: Implications for Consumers in Year Two

For the past two years, the Affordable Care Act has required health insurers to pay out a minimum percentage of premiums in the form of medical claims or quality improvement expenses—known as a medical loss ratio (MLR). Insurers with MLRs below the minimum must rebate the difference to consumers. This issue brief finds that total rebates for 2012 were $513 million, half the amount paid out in 2011, indicating greater compliance with the MLR rule. Spending on quality improvement remained low, at less than 1 percent of premiums. Insurers continued to reduce their administrative and sales costs, such as brokers' fees, without increasing profit margins, for a total reduction in overhead of$1.4 billion. In the first two years under this regulation, total consumer benefits related to the medical loss ratio—both rebates and reduced overhead—amounted to more than $3 billion