Posted on February 17, 2017
In January 2015, the US Department of Health and Human Services (DHHS) established new goals for Medicare to improve value while controlling costs. The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) will help achieve these goals:
Goal 1: by the end of 2016, 30% of Medicare payments are tied to quality...
Posted on October 13, 2016
Author, Economics and Financial Management for Nurses and Nurse Leaders, 3rd Edition, 2016, and adjunct faculty at the University of San Francisco School of Nursing and Health Profession
The third edition of Economics and Financial Management for Nurses and Nurse Leaders was published in August. This post shares some of...
Posted on December 16, 2014
This blog post was authored by: Susan J. Penner, RN, MN, MPA, DrPH, CNL
What is a medical loss ratio (MLR), and why should you care? The MLR represents the portion of a health insurance plan’s expenses that contribute to direct services for enrollees. These direct services include medical care and quality improvement efforts.
Another term for the MLR is the 80/20 rule. If 80...