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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).

Pay for Performance

A health care payment method, which offers incentives to providers in exchange for meeting or exceeding the quality and cost benchmarks. Systems also punish providers…