The company says it is protecting nursing home residents by curbing unnecessary hospital transfers. Whistleblowers allege cost-cutting tactics have endangered the elderly
That they have maxed the profit portion of it for one. That they don’t more reliably increase the portion they get to keep that ends up as profits for another.
Do you understand that they can lose money if the medical costs are too high?
I absolutely have not. Not once has anyone given me an answer that shows the simple math I outlined is wrong.
Just hostility from what I can only presume is a desperation to save face after you said so many blatantly incorrect things (which, unlike you, I’m happy to quote for you of you don’t believe me).
You should really reflect on why it pains you so much to just admit you didn’t know how the ACA worked.
How are you smart enough to set up an instance but not smart enough to understand companies cutting costs increases profits and that companies are good at breaking laws and getting away with it?
Premiums are revenue. You posted stats showing they are not already getting the 20% portion for themselves, and that 20% portion is for running the business. Rebates never come into play because they never hit the 20%.
If they only get 15% of the revenue from premiums they are only getting 75% of their potential cut which is used to run the fucking business before the possibility of profit comes into play. That means they have a huge incentive to cut any costs they can to approach their 20% cut WHICH THEY ARE NOT ALREADY GETTING.
I already posted the simplest math possible. Your math is wrong. Your assumptions are wrong. Just fucking accept that you don’t understand and believe literally everyone else that understands how this works including the people who write professional articles about the topic.
Overall, the unweighted average loss ratio was 1.6% higher in Q2 2024 at 85.8% compared to Q2 2023 at 84.2%, as all carriers except Elevance increased year-over-year. The increases are: CVS Health (Aetna) (86.2% to 89.6%), UnitedHealthcare (83.2% to 85.1%), and Cigna (81.2% to 82.3%).
So looks right in line with the 80-85% requirement.
That they don’t more reliably increase the portion they get to keep that ends up as profits for another.
Increase the portion of premiums they get to keep? How…
Do you understand that they can lose money if the medical costs are too high?
Of course. But that doesn’t change the fact that they can’t keep a larger portion of the premiums after medical costs and rebates if the medical costs get lower.
I see two other people who have also clearly explained this to you but apparently you can’t let your incorrect assumptions about the 20% go.
What incorrect assumptions about the 20%?
That they have maxed the profit portion of it for one. That they don’t more reliably increase the portion they get to keep that ends up as profits for another.
Do you understand that they can lose money if the medical costs are too high?
Another downvote, but still no answer. Why?
It’s wild that you can’t just admit you were wrong after being so hostile to me for so long.
No answer…
Removed by mod
I absolutely have not. Not once has anyone given me an answer that shows the simple math I outlined is wrong.
Just hostility from what I can only presume is a desperation to save face after you said so many blatantly incorrect things (which, unlike you, I’m happy to quote for you of you don’t believe me).
You should really reflect on why it pains you so much to just admit you didn’t know how the ACA worked.
How are you smart enough to set up an instance but not smart enough to understand companies cutting costs increases profits and that companies are good at breaking laws and getting away with it?
Therefore, no matter how much you drop
b,dis still always going to be 20% ofa.Where does the extra amount in
dcome from?Premiums are revenue. You posted stats showing they are not already getting the 20% portion for themselves, and that 20% portion is for running the business. Rebates never come into play because they never hit the 20%.
If they only get 15% of the revenue from premiums they are only getting 75% of their potential cut which is used to run the fucking business before the possibility of profit comes into play. That means they have a huge incentive to cut any costs they can to approach their 20% cut WHICH THEY ARE NOT ALREADY GETTING.
I already posted the simplest math possible. Your math is wrong. Your assumptions are wrong. Just fucking accept that you don’t understand and believe literally everyone else that understands how this works including the people who write professional articles about the topic.
Really? What’s the average Medical Loss Ratio of major insurers then?
Edit: https://www.oliverwyman.com/our-expertise/insights/2024/sep/health-insurer-financial-insights-q2-2024.html
So looks right in line with the 80-85% requirement.
Increase the portion of premiums they get to keep? How…
Of course. But that doesn’t change the fact that they can’t keep a larger portion of the premiums after medical costs and rebates if the medical costs get lower.