Dr. Bricker thanks for another great video. Could you please refer to point #3 where you mentioned that lowering admissions make sense for a hospital only if it's part of a plan that could also align it with earning premiums? I'm asking it in regard to another video where you mentioned that the Loss Ratio is 80% meaning you can only keep a max of 20% premium. I hope I got it right. Thank you.
Thank you for your question. In a fee-for-service payment environment, the hospital is incentivize to do more services in order to collect more fees. If a hospital runs a health insurance plan and collects premiums, then it is incentivized to not provide or prevent the need for as much acute care. The hospital would still need to spend 80-85% of the premiums on medical care, per the minimum loss ratio requirement of the Affordable Care Act. Hope that helps a little.
Hi Dr Bricker, long time fan. Not sure how anyone can work in managed health care without this channel. Do you perhaps have the source for this Dr Brent James's video mentioned? Has he published any of above mentioned?
Do you think quality initiatives should be made by providers or health plans?
Providers. Thank you for watching.
Dr. Bricker thanks for another great video. Could you please refer to point #3 where you mentioned that lowering admissions make sense for a hospital only if it's part of a plan that could also align it with earning premiums? I'm asking it in regard to another video where you mentioned that the Loss Ratio is 80% meaning you can only keep a max of 20% premium. I hope I got it right. Thank you.
Thank you for your question.
In a fee-for-service payment environment, the hospital is incentivize to do more services in order to collect more fees.
If a hospital runs a health insurance plan and collects premiums, then it is incentivized to not provide or prevent the need for as much acute care.
The hospital would still need to spend 80-85% of the premiums on medical care, per the minimum loss ratio requirement of the Affordable Care Act.
Hope that helps a little.
Hi Dr Bricker, long time fan. Not sure how anyone can work in managed health care without this channel.
Do you perhaps have the source for this Dr Brent James's video mentioned? Has he published any of above mentioned?
Here is a link to the video: ruclips.net/video/ocfAlCpUcCY/видео.html