Bob Atlas Quoted in “Obama Seeks to Add Teeth to MLR in Managed Medicaid Overhaul”

Modern Healthcare

Bob Atlas, President of EBG Advisors, Inc., was quoted by Modern Healthcare, in “Obama Seeks to Add Teeth to MLR in Managed Medicaid Overhaul,” by Virgil Dickson. (Read the full version – registration or subscription required.)

Following is an excerpt:

The chances that Congress will consider this proposal before the election is unlikely, especially because it's related to the divisive ACA, according to Bob Atlas, who is president of the EBG Advisors unit of healthcare law firm Epstein Becker and Green.

It's also unclear if managed Medicaid needs a national MLR, Atlas added. Many states already mandate a Medicaid benefits ratio. Twenty-eight of 38 states that outsourced their Medicaid programs to private insurers had average MLRs of at least 85% in 2013, according to the Kaiser Family Foundation.

Second, while states all take different approaches to setting capitation rates, their methods, combined with the federal mandate for actuarial soundness, leave little room for excess MCO profit, Atlas said.

“Overall, there's a lot of transparency and competition,” Atlas said. “It's not easy for MCOs to squeeze providers on payment rates because Medicaid fee-for-service rates, the starting point for most negotiations, are almost always low to begin with.”