Tweet This

Minimum Medical Loss Ratio for Insurers

Ratio of insurance expenditures used on care as opposed to administrative or other costs. Under ACA insurance companies are required to issue rebates to consumers if too large a share of the expenditures are allocated to costs not directly associated with care (max of 15% for large group plans, max of 20% for individual or small group plans).

Sustainable Growth Rate (SGR)

A target growth rate for Medicare spending enacted by law in 1997 that, if exceeded, is supposed to trigger physician payment cuts. The SGR-triggered cuts…