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

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

Explore the Stacks: A System for Exploration in Large Digital Libraries

Providing access to large digital library collections to novice users requires novel interfaces that are not built around the concept of search, as novice users frequently struggle to formulate appropriate queries. This paper presents the "Explore the Stacks" system, which provides a novel, browsing-focused interface for exploring digital library collections that is applicable to Big Data scale digital libraries. The system is demonstrated using a collection of approximately one million book illustrations provided by the British Library

Noise and disturbance in quantum measurements: an information-theoretic approach

We introduce information-theoretic definitions for noise and disturbance in quantum measurements and prove a state-independent noise-disturbance tradeoff relation that these quantities have to satisfy in any conceivable setup. Contrary to previous approaches, the information-theoretic quantities we define are invariant under relabelling of outcomes, and allow for the possibility of using quantum or classical operations to `correct' for the disturbance. We also show how our bound implies strong tradeoff relations for mean square deviations.Comment: v3: to appear on PRL (some issues fixed, supplemental material expanded). v2: replaced with submitted version; 5 two-column pages + 6 one-column pages + 3 figures; one issue corrected and few references added. v1: 17 pages, 3 figure

Individual Differences and Task Behaviour

The Interactive Social Book Search track at CLEF has run the same experiment, task, and interface for two years. This provides an opportunity to study the individual differences between two separately recruited participant cohorts, rather than between sub-sets of a single cohort. Overall the results show no significant differences in how the participants used the three main stages of the interface for the two tasks. However, at the detail level there are some quite significant changes in exactly how participants use the available functionality

Comparing Individual Health Coverage On and Off the Affordable Care Act's Insurance Exchanges

The new health insurance exchanges are the core of the Affordable Care Act's (ACA) reforms, but how the law improves the nonsubsidized portion of the individual market is also important. This issue brief compares products sold on and off the exchanges to gain insight into how the ACA's market reforms are functioning. Initial concerns that insurers might seek to enroll lower-risk customers outside the exchanges have not been realized. Instead, more-generous benefit plans, which appeal to people with health problems, constitute a greater portion of plans sold off-exchange than those sold on-exchange. Although insurers that sell mostly on the exchanges incur an additional fee, they still devote a greater portion of their premium dollars to medical care. Their projected administrative costs and profit margins are lower than are those of insurers selling only off the exchanges

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