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Health Insurers Spent Less Than 1% of Premium Dollars on Care Improvement in 2011

Health insurance companies reported spending an average of less than 1 percent of the premiums they collected from policyholders in 2011 on activities directly supporting improvement of health care quality, according to a Commonwealth Fund study.

The report, by Mark A. Hall and Michael J. McCue, looks at differences in medical loss ratios, consumer rebates, and quality improvement expenses, based on insurers' corporate structure and ownership. The authors find that insurance companies spent a combined $2.3 billion on direct quality improvement activities—an average of $29 per subscriber.

The Affordable Care Act's medical loss ratio rule requires insurers to spend at least 80 or 85 percent of premiums on medical claims and quality improvement activities—those likely to improve health outcomes, prevent hospital readmissions, improve patient safety, and increase wellness and health promotion—or else pay rebates to consumers.

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