Under the health care reform plan, insurers are required to spend a minimum of 80% of each dollar collected in premiums on patient welfare. Insurance groups are currently battling with regulators as to what this requirement should translate into when written into rules.
Some insurers argue that credentialing and other quality improvement costs should be included in the 80% amount since they help to improve the delivery of care to patients. Meanwhile, consumer groups argue that this is an attempt by the companies to get away with charging consumers high administrative costs.
The following article in the The New York Times details the sides in the debate and provides a picture of the current landscape as regulators work to enact health care reform:
Source: The New York Times