What does the efficiency ratio of a health care plan measure?

The efficiency ratio of a health care plan is a key performance indicator that assesses how effectively a health care organization processes claims in relation to its operational efficiency. The correct answer measures the ratio of covered claims to paid claims, which provides insight into how many of the claims that are submitted have been approved and reimbursed. A higher efficiency ratio indicates a higher level of effectiveness in processing claims, suggesting that the organization is successful in managing claims that align with the covered services of the health plan. This metric is critical for understanding the operational efficiency and effectiveness of a health care provider, and can help identify areas for improvement in claims processing.

The other options, while they may reflect different aspects of a health care plan's performance or financial health, do not accurately capture what the efficiency ratio specifically measures. For example, the total expenses divided by total income relates to overall profitability rather than claims efficiency, the percentage of preventive care services utilized addresses the quality and utilization of specific services, and the number of claims filed in a given period pertains to volume rather than processing efficiency. Thus, understanding the efficiency ratio in the context of claims processing is essential for evaluating the operational competence of health care plans.