Meaningful Segments

Did you know that payers in the individual market and small group market only spend ~75%-80% of each dollar of premium on medical care? They get to keep the rest of the money to spend on activities like marketing, lobbying, administration, and the paying out of dividends. Meanwhile, payers in the large group market spend ~85% of each dollar of premium on medical care. This percentage is known as the medical loss ratio (MLR).

Where are most of your patients? Have you noticed varying access by market segment? Mark Farrah Associates lists the leaders in each segment. How much of your time and focus are you spending on the difficult part?

Remember, prescription drug spending only accounts for 9% of the $4.3 trillion US health care spending. What costs can be avoided by investing in your drug?