The company says it is protecting nursing home residents by curbing unnecessary hospital transfers. Whistleblowers allege cost-cutting tactics have endangered the elderly
I literally just told you. Also, I have no clue what you’re imagining with this nonexistent rebate scheme. The patient won’t be paying any more premiums after they’re dead, but they won’t be costing anything, either. Insurance doesn’t have to give back any previously paid premiums.
Scenario A: The company takes in $1B in premiums. They spend $800M of it on healthcare costs. They pocket $200M.
Scenario B: The company takes in $1B in premiums. They deny coverage for $100M. They spend $700M of it on healthcare costs. They rebate their subscribers $100M. They pocket $200M.
How did those denials put more in their pocket? It’s 20% no matter how you slice it.
I literally just told you. Also, I have no clue what you’re imagining with this nonexistent rebate scheme. The patient won’t be paying any more premiums after they’re dead, but they won’t be costing anything, either. Insurance doesn’t have to give back any previously paid premiums.
Scenario A: The company takes in $1B in premiums. They spend $800M of it on healthcare costs. They pocket $200M.
Scenario B: The company takes in $1B in premiums. They deny coverage for $100M. They spend $700M of it on healthcare costs. They rebate their subscribers $100M. They pocket $200M.
How did those denials put more in their pocket? It’s 20% no matter how you slice it.
In scenario B they don’t rebate that money. They keep that. Where did you get this idea they rebate money?
The law? What do you mean
That does not exist.
Huh?
There is no law that they must refund anything. They already have the money.
I’m… baffled that there’s now 3 of you trying to answer my question who don’t even know the absolute basics of the subject matter…
This is all starting to make a lot more sense now.
What’s baffling is that you’re not stopping to consider that you might be the confused one, rather than literally everybody else.
Are you talking about the 80/20 rule? https://www.healthcare.gov/health-care-law-protections/rate-review/