March 2016

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

Enterprise Risk Management (ERM) 

Last month we presented the results of our recent survey of Chief Financial Officers, Chief Risk Officers and Board Directors regarding the use of the Total Cost of Risk (TCOR) metrics. The respondents found TCOR tools are helpful in balancing the costs and benefits of an effective risk management program. Read more >>

Claim Settlement, Medicare, and Medicare Set Asides

On February 16, 2016, the Centers for Medicare & Medicaid Services (CMS) and various industry groups announced they are working together through the Core Quality Measures Collaborative to identify core sets of quality measures that payers have committed to using for reporting as soon as feasible. Also, earlier in the month on February 9, 2016, CMS announced an initiative to improve response times for industry participants. Since October 2015, the Centers for Medicare & Medicaid Services’ (CMS) Commercial Repayment Center (CRC) assumed responsibility for the recovery of conditional payments where CMS is pursuing recovery directly from a liability insurer (including a self-insured entity), no-fault insurer or workers’ compensation (WC) entity as the identified debtor. Read more >>

Healthcare

During the past month, several researchers have found new data to show how increased economic insecurity and complaints of physical pain are correlated. Could it be true that experiencing financial stress may lead to physical pain?  Read more >>