Pandemic induced medical loss ratio opportunities

Medical expenditures in the US were down steeply in 2020 due to deferred and forgone care associated with the COVID-19 pandemic, leading to historically low medical loss ratios (MLR) for insurers. For insurers, who must comply with state and federal minimum MLR regulations or pay costly rebates and remittances, this state of affairs brings with it both challenges and new opportunities for strategic investment.

Due to the three year rolling window for commercial MLR calculation, commercial insurers in particular have a unique opportunity to improve their MLR position while furthering strategic goals through targeted investment in quality improvement activities.

Milliman has been helping many of our clients navigate this opportunity strategically as they consider how to invest in next generation medical management or digitally transform their analytics and reporting. Many of our solutions and services can be classified in the clinical services and quality improvement category and thus count towards an organization’s MLR requirement. Join us to learn how Milliman can help your organization navigate an MLR strategy.


Will Fox, FSA, MAAA
Principal & Consulting Actuary, Milliman

Jeff Milton-Hall
Principal & Consulting Actuary, Milliman

David Mirkin, MD
Principal & Chief Medical Officer, Milliman MedInsight