Politics & policy

Insight into federal and state health care legislation & CMS regulation

California: Where the premium dollar goes

A California Medical Association study suggests that not-for-profit health plans in the state generally spend more money on medical expenses than their for-profit counterparts do. Not-for-profits broke even, on average, during fiscal 1996 — 97, while for-profits pocketed small gains. Among California health insurers and managed care companies with 50,000 or more enrollees, Kaiser Foundation Health Plan spent the greatest portion of each premium dollar on medical care — for the fifth year in a row.

Medical loss ratios

Top and bottom four plans with 50,000 or more members, by percentage of revenue spent on medical care

SOURCE: KNOX-KEENE HEALTH PLAN EXPENDITURES SUMMARY, CALIFORNIA MEDICAL ASSOCIATION, SAN FRANCISCO, 1998

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