"The relatively low growth of administrative expense as a proportion of total healthcare cost inflation may be driven by several factors, including increased regulatory requirements related to mandated medical loss ratios (MLRs), increased investment in automation for claims and transactional processes, and relatively low wage inflation over the period. In addition, health plans have continued to aggressively compete in the employer and group markets as well as for state Medicaid managed care contracts, which may contribute to greater efficiency and lower administrative rates."