The company says it is protecting nursing home residents by curbing unnecessary hospital transfers. Whistleblowers allege cost-cutting tactics have endangered the elderly
Scenario A: The company takes in $1B in premiums. They spend $800M of it on healthcare costs. They pocket $200M.
Scenario B: The company takes in $1B in premiums. They deny coverage for $100M. They spend $700M of it on healthcare costs. They rebate their subscribers $100M. They pocket $200M.
How did those denials put more in their pocket? It’s 20% no matter how you slice it.
Scenario A: The company takes in $1B in premiums. They spend $800M of it on healthcare costs. They pocket $200M.
Scenario B: The company takes in $1B in premiums. They deny coverage for $100M. They spend $700M of it on healthcare costs. They rebate their subscribers $100M. They pocket $200M.
How did those denials put more in their pocket? It’s 20% no matter how you slice it.
In scenario B they don’t rebate that money. They keep that. Where did you get this idea they rebate money?
The law? What do you mean
That does not exist.
Huh?
There is no law that they must refund anything. They already have the money.
I’m… baffled that there’s now 3 of you trying to answer my question who don’t even know the absolute basics of the subject matter…
This is all starting to make a lot more sense now.
What’s baffling is that you’re not stopping to consider that you might be the confused one, rather than literally everybody else.
So I’m hallucinating the ACA?
Are you talking about the 80/20 rule? https://www.healthcare.gov/health-care-law-protections/rate-review/
What else would I be talking about?