IEHP and Its Medical Loss Ratio
Medical loss ratio refers to the percentage of dollars actually spent on medical care versus administrative costs or profit by an HMO. The higher the ratio, the more money is being spent on actual delivery of care. Components of the medical loss ratio include payments to physicians, IPAs, hospitals, pharmacists and other providers of health care.
IEHP has a current medical loss ratio of 91 percent, meaning that 91 cents out of every dollar we receive goes to our practitioners and providers. One of the significant components of our payments to practitioners is the PIP 2000 program, which reimburses physicians directly for preventive services such as Well Child and adult physical examinations, immunizations and early prenatal visits. We are pleased that the success of this program will result in $5-6 million of direct reimbursement to physicians for this fiscal year.
If you have any questions about IEHP, please feel free to contact Dr. Brad Gilbert, IEHP Medical Director, at (909) 890-2030.
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