Enter the paid medical service claims, QIA, premium revenue, and allowable deductions into the calculator to determine the medical loss ratio.

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## Medical Loss Ratio Formula

The following formula is used to calculate the medical loss ratio, MLR.

MLR = PMSC + QIA / PR - AD

- Where MLR is the medical loss ratio
- PMSC is the paid medical services claims ($)
- QIA is the expenses for activities that improve health care quality
- PR is the premium revenue
- AD is the allowable deductibles

## Medical Loss Ratio Definition

The medical loss ratio, or MLR for short, is defined as the proportion of premium revenues spent on clinical services and quality improvement programs.

## MLR Example

How to calculate medical loss ratio? (MLR)

**First, determine the paid medical service claims and QIA.**Calculate the total money spent on medical services and quality improvement programs.

**Next, determine the premium revenue.**Calculate the total premium revenue earned.

**Next, determine the deductibles.**Calculate the total value of any allowable deductions.

**Finally, calculate the MLR.**Calculate the MLR using the formula above.

## FAQ

**What is MLR?**

MLR stands for medical loss ratio and is a measure of the ratio of medical service claims and quality improvement programs to the total premium revenue.