Medical Loss Ratio
Maryland Medicaid calculates the Medical Loss Ratio (MLR) for the HealthChoice managed care organizations (MCOs) each year as part of its rate setting process. The MLR represents the percentage of capitation dollars received by the MCOs for that service year that are spent on eligible mandated medical services for its enrolled recipients in both the HealthChoice and Primary Adult Care (PAC) program. The PAC program ended in CY 2013.
CY 2012-2015 (PDF)