In 2021, Medicare Advantage gross margins averaged $1,730, more than double other insurance markets, the Kaiser Family Foundation report found. The individual market’s gross margins averaged $745 per enrollee, group market’s gross margins averaged $689 per enrollee and Medicaid managed care’s gross margins averaged $768 per enrollee.
Payers appeared to have a profitable 2020, with gross margins per member per month increasing, and administrative costs and medical loss ratios decreasing, a new report shows. But payers still have to contend with rebates their owe per the ACA medical loss ratio provision, which could amount to more than $2 billion.
The progress in artificial intelligence (AI) is reshaping patient care, across various dimensions, from facilitating faster discharge to curating treatment plans and suggesting lifestyle changes.