Kaiser Permanente meets medical care spending standards for 2021 in California

9/12/2022
California
As part of the Affordable Care Act, health plan issuers are required to report their medical benefit ratios (MBRs) to the U.S. Department of Health and Human Services on an annual basis. A medical benefit ratio, also known as a medical loss ratio, is the amount of premium revenue spent on medical care and services in a given year.

While Kaiser Permanente initially saw lower utilization during the shelter-in-place orders due to COVID-19, more Kaiser Permanente members are returning for non-urgent and preventive care. The return to pre-COVID utilization has varied across their organization but continues to trend back toward normal levels. 

California Kaiser Permanente’s individual, small group, and large group MBRs satisfied the required standards for 2021. Therefore, Kaiser Permanente will not be required to issue any Affordable Care Act rebates for 2021 experience.

To achieve this goal, Kaiser Permanente relied on the advantages offered by their integrated care delivery model, which, enhanced by the technology they have implemented, brings doctors, hospitals, labs, and pharmacies together to help provide high-quality, affordable health care to their approximately 12.6 million members and the communities they serve.

As a not-for-profit health plan without shareholders, they will continue to reinvest premiums and focus on high-quality member care while maintaining low administrative overhead.