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Navigating the Changing Healthcare Landscape

Sponsored White Paper

Examining Medical Loss Ratio Amidst the End of Federal Emergency

Presented By

CitiusTech

Document Info

Published on Jul 10, 2023

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Disclaimer

This white paper represents the views of the author, not America’s Health Insurance Plans (AHIP). The publication, distribution or posting of this white paper by AHIP does not constitute a guaranty of any product or service by AHIP.

Overview

Amidst a flurry of changes, the healthcare industry underwent a tumultuous journey in the last three years. As we move further into 2023, the healthcare industry continues to evolve and adapt to the different impact vectors, including the challenges posed by the COVID-19 pandemic. The pandemic has reshaped payer market dynamics and health plans are strategizing their next big move to increase their footprint, which will help them serve their members better. As we continue to track these changes, we are witnessing major shifts in the way health plans are partnering, operating, and trying to generate value for their members through value-based care initiatives, price transparency regulations, merger and acquisition (M&A) strategies, etc.

As an annual practice, we monitor the Medical Loss Ratios (MLR) of six health plans operating in the United States, namely United Health Group (UHG), Cigna, Centene, Molina, Elevance Health, and Aetna. Our objective is to gain valuable insights into changes in trends and strategies by examining shifts in their membership composition, M&A strategies, and other relevant factors.