Committees & Activities

Medical Loss Ratio Quality Improvement Activities (B) Subgroup
Health Insurance and Managed Care (B) Committee

At the request of the Health Reform Solvency Impact (E) Subgroup, the Health Insurance and Managed Care (B) Committee formed the Medical Loss Ratio Quality Improvement Activities (B) Subgroup to review new quality improvement (QI) initiatives, as reported annually on the Supplemental Health Care Exhibit Allocation Report. The review process, as set out in the Supplemental Health Care Exhibit, will determine compliance with the quality improvement criteria, as provided in section 2717 of the Public Health Service Act (PHSA) and section 1311 of the federal Patient Protection and Affordable Care Act (ACA), and make recommendations to the Secretary of the U.S. Department of Health and Human Services (HHS) for certifying for inclusion or exclusion in the quality improvement expense category of the Supplemental Health Care Exhibit.

Qualifying QI activities are primarily designed to achieve the goals set out in section 2717 of the PHSA and section 1311 of the ACA to: (1) improve health outcomes including increasing the likelihood of desired outcomes compared to a baseline and reducing health disparities among specified populations; (2) prevent hospital readmissions; (3) improve patient safety and reduce medical errors, lower infection and mortality rates; (4) increase wellness and promote health activities; or (5) enhance the use of health care data to improve quality, transparency, and outcomes.

Conference Call Calendar

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2015 Fall National Meeting
National Harbor, Maryland
MLR Quality Improvement Activities (B) Subgroup
Friday, November 20, 2015
11:30am – 1:00pm ET
Gaylord Convention Center – Maryland D – Level 2

MLR Quality Improvement Activities (B) Subgroup
Conference Call
October 19, 2015
3:00 PM ET/2:00 PM CT

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