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Global MLR
Subpopulation MLRs
Other special MLR
Task Set
Compute medical loss ratios for various segments of the beneficiary population (e.g., by age, by gender, by chronic disease classification, by type of intervention [hospital stay, specialty care, etc.], by region, etc.)
Compare MLR from previous periods to determine historical trends in healthcare spending
Action plans on how these trends can be better managed, and what kind of interventions might be needed (regulation, legislative changes, changes to health insurance policy and directives, training, etc.) to lower the MLR
Check to see whether the interventions had the desired effect
Measurable Outcomes
Reduction of claims costs or increase of revenues
MLR sufficient to pay all claims and be able to maintain reserve fund at appropriate level
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