December 2017

Our e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions.

Enterprise Risk Management (ERM): 

Can Value-Based Models Control Claim Costs?

Can providers in value-based reimbursement agreements with health insurance plans increase their Healthcare Effectiveness Data and Information Set (HEDIS) scores?  A new study provides interesting insights into the effectiveness of these agreements for health and casualty insurance environments.   Read more >>

Claim Settlement, Medicare, and Medicare Set Asides:

CA Study Finds WCMSAs Include Significant Opioid Use

A recent California study of Workers’ Compensation (WC) Medicare Set Aside (MSA) cases shows almost 70% include future funding for opioid use, even as the nation faces an opioid epidemic.  The cases often exceed federal and state clinical guidelines which place claimants at a high level of risk for dependence and multi-drug interactions causing adverse effects.  Read more >>

Healthcare:

Caregiver Resources for Chronic Care

There are about 43.5 million Americans who care for loved ones with a chronic illness, disability, or frailty. Family caregivers provide an average of 24 hours of care per week.  Last month, the Administration for Community Living (ACL) provided an update to their programs as part of National Caregivers Month.   Read more >>

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