Using PHIAC data FY2014
Claims Ratio (CR) = [Hospital Treatment Benefits Paid] divided by [Hospital Treatment Premiums]
Fortunately you can go down to state level with PHIAC data.
Medibanks national CR is 89.9% for the hospital benefits table hence pays out close to 90 cents in claims for every $1 earned in premium revenue.
Since Calvary is a major player in ACT, South Australia and Tasmania you would expect Medibank's CR to be higher in those states compared to their National CR as Medibank says Calvary not affordable on price.
Medibank's CR for each of the states are:
South Australia 84.4%
ACT 85.7%
Tasmania 86.8%
I do not think Calvary's problem is affordability - Medibank is more profitable in state where Calvary is.
Source for PHIAC data:
http://www.apra.gov.au/PHI/PHIAC-Ar...te-Health-Insurers-Annual-Report-2013-14.aspx
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