Monthly Archives: May 2015

Risk Management/Workers’ Compensation Resume

Richard Krasner, MA, MHA
7151 Summer Tree Drive
Boynton Beach, FL  33437
(561) 738-0458, cell (561) 603-1685
richard_krasner@hotmail.com
http://www.linkedin.com/in/richardkrasner
Skype: richard.krasner

Professional Profile

Detail-oriented, Risk Management Generalist with over ten years’ experience in Risk Management and Property & Casualty Insurance, Claims Management and  Risk Analysis  and RMIS and Insurance Data Processing.

Risk Management/P & C Insurance

  • Risk Management Consulting
  • Client Account/Brokerage
  • Knowledge of Risk Management and Insurance terms, concepts, policies
  • Interacted with various Risk Management, Insurance, Legal and Medical personnel

Claims Management/Claims Analysis

  • WC, GL and P&C claims management and analysis
  • Wrap-up Claims Administration
  • Interacted with Adjusters, TPA’s, cost-containment and rehab services, investigation services

RMIS/Insurance Data Processing

  • @Venture, Corporate Systems, Dorn, POINT, Tropics, WINS, ModMaster
  • WC Statistical Reporting
  • Data Analysis
  • Data Gathering
  • Data Management
  • Data Reporting
  • Strong financial, organizational, written and verbal communications skills.
  • Strong analytical and problem solving skills.
  • Strong database management and quality assurance skills.
  • Able to respond to complex questions from internal and external customers.
  • Able to work independently; team player; self-motivated.
  • MS Office, Windows.

Education

Florida Atlantic University, Boca Raton, Florida
Master’s in Health Administration

New York University, New York, New York
M.A., History

SUNY Brockport, Brockport, New York
B.A., Liberal Arts

Professional Experience

Blogger, Transforming Workers’ Compensation blog, Boynton Beach, FL            2012 – Present

  • Publishing articles to promote the implementation of medical tourism into Workers’ Compensation.

Risk Management Consulting Services, Boynton Beach, FL                                             2002 – 2010

For Strategic Outsourcing, Inc., a professional employment organization (PEO) in Charlotte, NC with more than 830 clients and 33,000 assigned employees.

  • Performed detailed risk and loss analysis on all lines of property & casualty coverage, with emphasis on workers’ compensation and general liability.
  • Worked on the design and analysis to create internally or purchase an effective Risk Management Information System (RMIS).

For Environamics, Inc., a commercial construction company in Charlotte, NC.

  • Worked with the Human Resources Manager and insurance broker to create fully developed losses in all lines of insurance and loss development factors.
  • Developed the analysis to determine the best levels of self-insurance and deductibles. Created fully functional loss spreadsheets.

For the Fredrick C. Smith Clinic, one of the largest physician-owned medical clinics in Ohio.

  • Conducted detailed risk and loss analysis in their workers’ compensation program.
  • Developed the criteria to use to select a third party claims administrator.
  • Designed an effective strategy to reduce frequency and severity of workers’ compensation claims.

For Bonitz, Inc., a commercial construction company (sub-contractor) in Columbia, SC, with over 1000 associates (employees), with 16 locations in 6 states, specializing in ceiling, drywall and flooring.

  • Under supervision of Director of Human Resources, designed a more effective safety program with special emphasis on Workers’ Compensation claims and claims costs.
  • Assisted in the set-up and implementation of claims database system (RMIS).
  • Worked on wrap-up claims, policies and programs on an as needed basis.

Sr. Specialist/Data Mgmt., Aon Risk Services of TX, Inc., Houston, TX                         2001 – 2002

  • Responsible for processing internal/external client requests for data.
  • Analyzed changes in clients’ Experience Modification Factors.

Risk Management Consultant, Dallas, TX                                                                         1995 – 2001

Various assignments in Texas and Florida in Risk Management, Claims Administration and Data Management.

Data Analyst, Stirling Cooke, Dallas, TX

  • Responsible for data integrity; data and system reconciliation; running claims and policy reports; running monthly loss runs; coordinating and compiling TPA claims data; responsible for month-end processing.

BPO Compliance Analyst, PMSC, Sarasota, FL

  • Gathered, analyzed, defined and implemented requirements and procedures for electronic reporting of WC data.
  • Documented data reporting requirements. Developed and executed test plans.
  • Compiled, analyzed and verified WC exposure, premium and claims data for statistical bureau reporting.
  • Tested and analyzed data reporting software. Coordinated resolution of programming issues with programmers.

Data Services Consultant, NCCI, Inc., Boca Raton, FL

  • Analyzed, researched and resolved issues for all data types, requests and collection systems for all data reported to company.
  • Responded to complex questions and data requests from internal and external customers.
  • Researched and resolved carrier appeals to ensure equitable application of data reporting incentive programs.
  • Participated in internal carrier visitations and end-user training.

Underwriting Data Analyst (Contract), Allstate, Boca Raton, FL

  • Performed data analysis and data management tasks to support underwriting operations.

Additional Experience

Claims Coding Supervisor, Reliance National Insurance Company, NY, NY

  • Supervised work of coding staff. Assisted in testing of database software during data conversion process from current database to new database.

Claims Administrator, Hamond & Regine Inc., Mineola, NY

  • Managed and improved administration of Construction/Maintenance OCIP “wrap‑up” claims program (WC, GL, and Builders’ Risk) for retail insurance broker, resulting in improved operational and insurance program analysis.
  • Created and generated Loss Control Analysis Reports, improving risk analysis and exposure identification.
  • Interacted with Loss Control/Safety personnel to improve monitoring of claims and incidents. Reduced errors and omissions by more than 50%.
  • Investigated, analyzed and coordinated correction of claims data discrepancies, saving client over $100,000 in additional premium.
  • Conducted periodic claims file reviews and audits. Gathered and prepared claims data for renewal process.

Publications

Medical Tourism and Workers’ Compensation: What are the barriers? Medical Travel Today.com, PERSPECTIVES, published online on November 14, 2012.
http://medicaltraveltoday.com/medical-tourism-and-workers-compensation-what-are-the-barriers/

Implementing international medical providers into the U.S. workers’ compensation system, Part 1, Insurance Thought Leadership.com, published online November 12, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/implementing-international-medical-providers-
into-the-u.s.-workers-compensa/#axzz2C24xFI2P

Implementing international medical providers into the U.S. workers’ compensation system, Part 2, Insurance Thought Leadership.com, published online November 15, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/implementing-international-medical-providers-
into-the-u.s.-workers-com/#axzz2CJE7Uukv

Implementing international medical providers into the U.S. workers’ compensation system, Part 3, Insurance Thought Leadership.com, published online November 28, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/workers-compensation/articles/implementing-international-
medical-providers-into-the-u.s.-workers-com1/#axzz2EcQHmlo3

Implementing international medical providers into the U.S. workers’ compensation system, Part 4, Insurance Thought Leadership.com, published online December 4, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/workers-compensation/articles/implementing-international-
medical-providers-into-the-u.s.-workers-com2/#axzz2EcQHmlo3

Implementing international medical providers into the U.S. workers’ compensation system, Part 5, Insurance Thought Leadership.com, published online on December 14, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/benefits-long-term-care/articles/implementing-international-
medical-providers-into-the-u.s.-workers-com3/#axzz2F2z8jZwY

Implementing Medical Tourism into Worker’s Compensation, CASE STUDY, Medical Travel Today.com, published online on January 2, 2013.
http://medicaltraveltoday.com/newsletter/v7-1.html#IndustryNews2

The Stars Aligned: Mexico as a medical tourism destination for Mexican-born US workers under Workers’ Compensation, PERSPECTIVES, Medical Travel Today.com, published online on January 16, 2013.
http://medicaltraveltoday.com/richard-krasner-the-stars-aligned-mexico-as-a-medical-tourism-destination-for-mexican-born-us-
workers-under-workers-compensation/

Immigration Reform On The Horizon: What It Means For Medical Tourism And Workers’ Compensation, Insurance Thought Leadership.com, published online February 10, 2013.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/immigration-reform-on-the-horizon-what-it-
means-for-medical-tourism-and-wor/#axzz2KYcHw6HV

Immigration Reform on the Horizon – What it Means for Medical Tourism and Workers’ Compensation, PERSPECTIVES, Medical Travel Today.com, published online February 13, 2013
http://medicaltraveltoday.com/richard-krasner-immigration-reform-on-the-horizon-what-it-means-for-medical-tourism-and-workers-
compensation/

Spinal Fusion Outcomes in Washington State, PERSPECTIVES, Medical Travel Today.com, published online February 27, 2013.
http://medicaltraveltoday.com/richard-krasner-spinal-fusion-outcomes-in-washington-state/

Implementing international medical providers into the U.S. workers’ compensation system, Part 1, Costa Rica Medical Tourism, Inc. published online on March 2, 2013.
http://www.medtourismcr.com/blog/2013/03/02/Implementing-International-Medical-Providers-Into-The-US-Workers-Compensation-
System-Part-1.aspx

Employee vs. Employer Choice of Physician Revisited: Additional Commentary on How Best to Incorporate Medical Tourism into Workers’ Compensation, TBD Consulting.com, published online on March 4, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/03/employee-vs-employer-choice-of-physician-revisited-additional-
commentary-on-how-best-to-incorporate-.html

Rising Hospital Costs: What they mean for Workers’ Compensation and Medical Tourism, TBD Consulting.com, published online on March 13, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/03/rising-hospital-costs-what-they-mean-for-workers-compensation-and-
medical-tourism.html

Legal Barriers to Implementing International Providers into Medical Provider Networks for Workers’ Compensation: A White Paper, WordPress.com, published online on March 15, 2013.
http://wp.me/p2QJfz-ap

What I Learned at the 5th World Medical Tourism & Global Healthcare Congress, and Why It Matters to the Workers’ Compensation Industry, TBD Consulting.com, published online on March 20, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/03/what-i-learned-at-the-5th-world-medical-tourism-global-healthcare-
congress-and-why-it-matters-to-the.html

A ‘Case Study’ in Implementing Medical Tourism into Workers’ Compensation, TBD Consulting.com, published online on April 3, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/a-case-study-in-implementing-medical-tourism-into-workers-
compensation.html

What Can Medical Tourism Do about Pain Medication Abuse?, Medical Tourism Today.com, published online on April 5, 2013.
http://medicaltourismtoday.com/what-can-medical-tourism-do-about-pain-medication-abuse/

Medical Tourism and Workers Compensation: What are the Barriers?, TBD Consulting.com, published online on April 10, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/medical-tourism-and-workers-compensation-what-are-the-barriers.html

Point/CounterPoint: A Virtual Dialogue on the Merits of Implementing Medical Tourism into Workers’ Compensation, Part 1, TBD Consulting.com, published online on April 17, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/part-1-pointcounterpoint-a-virtual-dialogue-on-the-merits-of-
implementing-medical-tourism-into-worke.html

Point/CounterPoint: A Virtual Dialogue on the Merits of Implementing Medical Tourism into Workers’ Compensation, Part 2, TBD Consulting.com, published online on April 18, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/part-2-pointcounterpoint-a-virtual-dialogue-on-the-merits-of-
implementing-medical-tourism-into-worke.html

Ensuring Patient Safety: Making Sure Medical Tourism Puts Its Money Where Its Mouth Is, Medical Sea.org, published online on April 22, 2012.
http://www.medicalsea.org/ensuring-patient-safety-making-sure-medical-tourism-puts-its-money-where-its-mouth-is/

Ensuring Patient Safety: Making Sure Medical Tourism Puts Its Money Where Its Mouth Is, OPINION, Medical Travel Today.com, published online on April 24, 2013.
http://medicaltraveltoday.com/ensuring-patient-safety-making-sure-medical-tourism-puts-its-money-where-its-mouth-is/

Ten Years On: Medical Tourism Industry a decade out, Medical Tourism Today.com, published online on May 24, 2013.
http://medicaltourismtoday.com/ten-years-on-medical-tourism-industry-a-decade-out/

Healthcare Transparency, Healthcare Talent Transformation.com, published online on June 6, 2013.
http://www.healthcaretalenttransformation.com/2013/06/07/healthcare-transparency/

Surgical Shenanigans: How Workers’ Compensation is being ripped off, Medicalsea.org, published online on June 24, 2013.
http://www.medicalsea.org/surgical-shenanigans-how-workers-compensation-is-being-ripped-off/

My Defense of Implementing Medical Tourism into Workers’ Compensation, Healthcare Talent Transformation.com, published online on July 8, 2013.
http://www.healthcaretalenttransformation.com/2013/07/08/my-defense-of-implementing-medical-tourism-into-workers-
compensation/#more-947

The Faith of My Conviction: Integrating Medical Tourism into Workers’ Compensation is Possible — and not a Pipe Dream, PERSPECTIVES, Medical Travel Today.com, published online on July, 17, 2013.
http://medicaltraveltoday.com/the-faith-of-my-conviction-integrating-medical-tourism-into-workers-compensation-is-possible-and-not-
a-pipe-dream/

Surgical Shenanigans: How Workers’ Compensation is being ripped off, Healthcare Talent Transformation.com, published online on July 22, 2013.
http://www.healthcaretalenttransformation.com/2013/07/22/surgical-shenanigans-how-workers-compensation-is-being-ripped-off/

On the Bright Side, Medicasea.org, published online on August 4, 2013.
http://www.medicalsea.org/on-the-bright-side/

And Now For Something Completely Different, Medicalsea.org, published online on August 9, 2013.
http://www.medicalsea.org/and-now-for-something-completely-different/

Founding Fathers and the ACA, Healthcare Talent Transformation.com, published online on August 26, 2013.
http://www.healthcaretalenttransformation.com/2013/08/26/founding-fathers-and-the-aca/

Lessons, Medicalsea.org, published online on August 28, 2013.
http://www.medicalsea.org/lessons/

Addendum

Publications

Far In Front of the Crowd, Medicalsea.org, published online on August 30, 2013.
http://www.medicalsea.org/far-in-front-of-the-crowd/

Medical Tourism Industry a Decade from Now: Part 1, Healthcare Talent Transformation.com, published online on October 9, 2013.
http://www.healthcaretalenttransformation.com/2013/10/09/medical-tourism-industry-a-decade-from-now-part-1/

Medical Tourism Industry a Decade from Now: Part 2 Outpatient Costs, Healthcare Talent Transformation.com, published online on October 16, 2013.
http://www.healthcaretalenttransformation.com/2013/10/16/medical-tourism-industry-a-decade-from-now-part-2-outpatient-costs/

Medical Tourism Industry a Decade from Now: Part 3 Consolidation of US Hospitals, Healthcare Talent Transformation.com, published online on October 18, 2013.
http://www.healthcaretalenttransformation.com/2013/10/18/medical-tourism-industry-a-decade-from-now-part-3-consolidation-of-us-
hospitals/

“Have I Got A Deal For You?” — The Medical-Device Tax Shuffle and Medical Tourism, Medicalsea.org, published online on October 20, 2013.
http://www.medicalsea.org/have-i-got-a-deal-for-you-the-medical-device-tax-shuffle-and-medical-tourism/

Medical Tourism Industry a Decade from Now: Part 4 Cost to Employees, Healthcare Talent Transformation.com, published online on October 23, 2013.
http://www.healthcaretalenttransformation.com/2013/10/23/medical-tourism-industry-a-decade-from-now-part-4-cost-to-employees/

Medical Tourism Industry a Decade from Now: Part 5 Immigration Reform, published online on October 25, 2013.
http://www.healthcaretalenttransformation.com/2013/10/25/medical-tourism-industry-a-decade-from-now-part-5-immigration-reform/

Medical Tourism Industry a Decade from Now: Part 6 Technology, published online on October 30, 2013.
http://www.healthcaretalenttransformation.com/2013/10/30/medical-tourism-industry-a-decade-from-now-part-6-technology/

Interview, SPOTLIGHT, Medical Travel Today.com, published online on October 31, 2013.
http://medicaltraveltoday.com/richard-krasner-medical-tourism-blogger/

Ten Years On: One Person’s View of Where the Medical Tourism Industry Will be a Decade from Now INDUSTRY NEWS, Medical Travel Today.com, published online on October 31, 2013.
http://medicaltraveltoday.com/ten-years-on-one-persons-view-of-where-the-medical-tourism-industry-will-be-a-decade-from-now/

Medical Tourism Industry a Decade from Now: Observations and Conclusion, Healthcare Talent Transformation.com, published online on November 1, 2013.
http://www.healthcaretalenttransformation.com/2013/11/01/medical-tourism-industry-a-decade-from-now-observations-and-
conclusion/

Cross-border Workers’ Compensation A Reality In California, Medicalsea.org, published online on December 3, 2013.
http://www.medicalsea.org/cross-border-workers-compensation-a-reality-in-california/

Knee Surgery in Costa Rica — A Less Expensive Alternative, Medicalsea.org, published online on December 31, 2013.
http://www.medicalsea.org/knee-surgery-in-costa-rica-a-less-expensive-alternative/

Cross-border Workers’ Compensation A Reality In California, Medicalsea.org, published online on January 22, 2014.
http://www.medicalsea.org/cross-border-workers-compensation-a-reality-in-california-2/

What to know before providing Medical Tourism Services, Medicalsea.org, published online on February 14, 2014.
http://www.medicalsea.org/what-to-know-before-providing-medical-tourism-services/

Can Medical Tourism Relieve Stress in Workers’ Comp?, Medicalsea.org, published online on February 19, 2014.
http://www.medicalsea.org/can-medical-tourism-relieve-stress-in-workers-comp/

Beware the IRS: What to Know Before Using Medical Tourism for Group Health Plans, Medicalsea.org, published online on February
25, 2014.
http://www.medicalsea.org/beware-the-irs-what-to-know-before-using-medical-tourism-for-group-health-plans/

Statutes are not Statues ― Why Workers’ Comp Must Open up and Be Flexible, Medicalsea.org, published online on
April 8, 2014.
http://www.medicalsea.org/statutes-are-not-statues-%E2%80%95-why-workers-comp-must-open-up-and-be-flexible/

ACA to Lead to Physician Shortages ― Possible Effects for Medical Tourism in Work Comp, Healthcare Talent Transformation.com,
published online on April 14, 2014.
http://www.healthcaretalenttransformation.com/2014/04/14/aca-to-lead-to-physician-shortages-%E2%80%95-possible-effects-for-
medical-tourism-in-work-comp/

Why Medical Tourism for Workers’ Comp is an Idea Whose Time Has Come, U.S. Domestic Medical Travel.com, published
online on April 16, 2014.
http://www.usdomesticmedicaltravel.com/email/v1-10.html#story8

Why Medical Tourism for Workers’ Comp is an Idea Whose Time Has Come, Medical Travel Today.com, published online
on May 1, 2014.
http://medicaltraveltoday.com/newsletter/v8-1.html#

Miami Beach: Fun, Sun and Medical Tourism, Medicalsea.org, published online on May 14, 2014.
http://www.medicalsea.org/miami-beach-fun-sun-and-medical-tourism/

Travel expense may be reimbursed under certain conditions, Medicalsea.org, published online on July 3rd, 2014
http://www.medicalsea.org/travel-expense-may-be-reimbursed-under-certain-conditions/

“We’re Not No. 1!” We’re No. 11, Healthcare Talent Transformation.com published online on July 17, 2014.
http://www.healthcaretalenttransformation.com/2014/07/17/were-not-no-1-were-no-11/

From Pariah to Player: South Africa’s Journey towards Becoming a Medical Tourism Destination, Medicalsea.org, published online on July 21, 2014.
http://www.medicalsea.org/from-pariah-to-player-south-africas-journey-towards-becoming-a-medical-tourism-destination/

Corruption Not Limited To US Health Care, Medicalsea.org, published online on July 21, 2014.
http://www.medicalsea.org/corruption-not-limited-to-us-health-care/

Top 10 Causes of Workplace Injuries: How Medical Tourism Can Save Employers Money, U.S. Domestic Medical Travel.com, published online on September 15, 2015. http://www.usdomesticmedicaltravel.com/email/v2-2-full.html#story5

Paralysis by Analysis: Or the Only Thing We Have to Fear Is, Fear Itself, U.S. Domestic Medical Travel.com published online on October 20, 2015. http://www.usdomesticmedicaltravel.com/email/v2-3-full.html#story2

Follow-up Visits After Surgery: Telehealth, Medical Travel and Workers’ Comp, U.S. Domestic Medical Travel.com published online on October 20, 2015. http://www.usdomesticmedicaltravel.com/email/v2-3-full.html#story3

Interview, SPOTLIGHT, Medical Travel Today.com, published online on November 3, 2015. http://www.medicaltraveltoday.com/newsletter/v8-19-full.html#story1

California is Going to Pot

For Maria

No, this post is not about the water shortage in California, but whether or not, medical marijuana will be allowed in workers’ comp.

David De Paolo’s posts about workers’ comp in California makes me wonder at times to ask, “What are they smoking?”, but in the following article, it is not the California system that is smoking pot, but a claimant who wants to, and have it paid for under workers’ comp.

The article, from UR Nation is here.

——————————————————————————————————————————-

I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

Medical Tourism Resume

Richard Krasner, MA, MHA
7151 Summer Tree Drive
Boynton Beach, FL 33437
561-738-0458
561-603-1685, cell
richard_krasner@hotmail.com
http://www.linkedin.com/in/richardkrasner
Skype: richardkrasner
Blog: https://richardkrasner.wordpress.com

Professional Profile

Detail-oriented, Insurance and Risk Management Generalist transitioning into Medical Tourism industry. Over ten years’ experience in Workers’ Compensation Claims Analysis and Claims Management, Risk Management and Property & Casualty Insurance, and RMIS and Insurance Data Processing.

Claims Management/Risk Analysis
• WC, GL and P&C claims management and analysis
• Wrap-up Claims Administration
• Interacted with Adjusters, TPA’s, cost-containment and rehab services, investigation services
• Familiar with WC and Medical Claims Coding (CPT, DRG’s, ICD-9)

Risk Management/P & C Insurance
• Risk Management Consulting
• Client Account
• Brokerage
• Knowledge of Risk Management and Insurance terms, concepts, policies
• Interacted with various Risk Management, Insurance, Legal and Medical personnel

RMIS/Insurance Data Processing
• @Venture, Corporate Systems, Dorn, POINT, Tropics, WINS, ModMaster
• WC Statistical Reporting
• Data Analysis
• Data Gathering
• Data Management
• Data Reporting Core Skills

• Strong financial, organizational, written and verbal communication skills.
• Strong analytical and problem solving skills.
• Strong database management and quality assurance skills.
• Able to respond to complex questions from internal and external customers.
• Able to work independently; team player; self-motivated.
• MS Office, Windows.

Education

Florida Atlantic University, Boca Raton, Florida
Master’s in Health Administration

New York University, New York, New York
M.A., History

SUNY Brockport, Brockport, New York B.A.,
Liberal Arts

Professional Experience

Blogger, Transforming Workers’ Compensation Blog, Boynton Beach, FL            2012 – Present

• Published over 150+ articles to promote the implementation of medical tourism into Workers’ Compensation. Presented “Barriers, Obstacles, Opportunities and Pitfalls” at 5th Mexico Health and Wellness Travel Show in Reynosa, Mexico, November 2014.

Risk Management Consulting Services, Boynton Beach, FL                                                 2002 – 2010

For Strategic Outsourcing, Inc., a professional employment organization (PEO) in Charlotte, NC with more than 830 clients and 33,000 assigned employees.
• Performed detailed risk and loss analysis on all lines of property & casualty coverage, with emphasis on workers’ compensation and general liability.
• Worked on the design and analysis to create internally or purchase an effective Risk Management Information System (RMIS).

For Environamics, Inc., a commercial construction company in Charlotte, NC.
• Worked with the Human Resources Manager and insurance broker to create fully developed losses in all lines of insurance and loss development factors.
• Developed the analysis to determine the best levels of self-insurance and deductibles. Created fully functional loss spreadsheets.

For the Fredrick C. Smith Clinic, one of the largest physician-owned medical clinics in Ohio.
• Conducted detailed risk and loss analysis in their workers’ compensation program.
• Developed the criteria to use to select a third party claims administrator.
• Designed an effective strategy to reduce frequency and severity of workers’ compensation claims.

For Bonitz, Inc., a commercial construction company (sub-contractor) in Columbia, SC, with over 1000 associates (employees), with 16 locations in 6 states, specializing in ceiling, drywall and flooring.
• Under supervision of Director of Human Resources, designed a more effective safety program with special emphasis on Workers’ Compensation claims and claims costs.
• Assisted in the set-up and implementation of claims database system (RMIS).
• Worked on wrap-up claims, policies and programs on an as needed basis.

Sr. Specialist/Data Mgmt., Aon Risk Services of TX, Inc., Houston, TX                         2001 – 2002
• Responsible for processing internal/external client requests for data.
• Analyzed changes in clients’ Experience Modification Factors.

Risk Management Consultant, Dallas, TX                                                                              1995 – 2001
Various assignments in Texas and Florida in Risk Management, Claims Administration and Data Management.

Data Analyst, Stirling Cooke, Dallas, TX
• Responsible for data integrity; data and system reconciliation; running claims and policy reports; running monthly loss runs; coordinating and compiling TPA claims data; responsible for month-end processing.

BPO Compliance Analyst, PMSC, Sarasota, FL
• Gathered, analyzed, defined and implemented requirements and procedures for electronic reporting of WC data.
• Documented data reporting requirements. Developed and executed test plans.
• Compiled, analyzed and verified WC exposure, premium and claims data for statistical bureau reporting.
• Tested and analyzed data reporting software. Coordinated resolution of programming issues with programmers.

Data Services Consultant, NCCI, Inc., Boca Raton, FL
• Analyzed, researched and resolved issues for all data types, requests and collection systems for all data reported to company.
• Responded to complex questions and data requests from internal and external customers.
• Researched and resolved carrier appeals to ensure equitable application of data reporting incentive programs.
• Participated in internal carrier visitations and end-user training.

Underwriting Data Analyst (Contract), Allstate, Boca Raton, FL
• Performed data analysis and data management tasks to support underwriting operations.

Additional Experience

Claims Coding Supervisor, Reliance National Insurance Company, NY, NY
• Supervised work of coding staff. Assisted in testing of database software during data conversion process from current database to new database.

Claims Administrator, Hamond & Regine Inc., Mineola, NY
• Managed and improved administration of Construction/Maintenance OCIP “wrap-up” claims program (WC, GL, and Builders’ Risk) for retail insurance
broker, resulting in improved operational and insurance program analysis.
• Created and generated Loss Control Analysis Reports, improving risk analysis and exposure identification.
• Interacted with Loss Control/Safety personnel to improve monitoring of claims and incidents. Reduced errors and omissions by more than 50%.
• Investigated, analyzed and coordinated correction of claims data discrepancies, saving client over $100,000 in additional premium.
• Conducted periodic claims file reviews and audits. Gathered and prepared claims data for renewal process.

No-Fault Claims Supervisor, American Colonial Insurance Company, NY, NY
• Administered Automobile No-Fault claims unit.

WC Claims Examiner, Greater New York Mutual Insurance Co., NY, NY
• Processed, investigated and paid WC & Disability claims.

Publications

Medical Tourism and Workers’ Compensation: What are the barriers? Medical Travel Today.com, PERSPECTIVES, published online on November 14, 2012.
http://medicaltraveltoday.com/medical-tourism-and-workers-compensation-what-are-the-barriers/

Implementing international medical providers into the U.S. workers’ compensation system, Part 1, Insurance Thought Leadership.com, published online November 12, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/implementing-international-medical-providers-
into-the-u.s.-workers-compensa/#axzz2C24xFI2P

Implementing international medical providers into the U.S. workers’ compensation system, Part 2, Insurance Thought Leadership.com, published online November 15, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/implementing-international-medical-providers-
into-the-u.s.-workers-com/#axzz2CJE7Uukv

Implementing international medical providers into the U.S. workers’ compensation system, Part 3, Insurance Thought Leadership.com, published online November 28, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/workers-compensation/articles/implementing-international-
medical-providers-into-the-u.s.-workers-com1/#axzz2EcQHmlo3

Implementing international medical providers into the U.S. workers’ compensation system, Part 4, Insurance Thought Leadership.com, published online December 4, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/workers-compensation/articles/implementing-international-
medical-providers-into-the-u.s.-workers-com2/#axzz2EcQHmlo3

Implementing international medical providers into the U.S. workers’ compensation system, Part 5, Insurance Thought Leadership.com, published online on December 14, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/benefits-long-term-care/articles/implementing-international-
medical-providers-into-the-u.s.-workers-com3/#axzz2F2z8jZwY

Implementing Medical Tourism into Worker’s Compensation, CASE STUDY, Medical Travel Today.com, published online on January 2, 2013.
http://medicaltraveltoday.com/newsletter/v7-1.html#IndustryNews2

The Stars Aligned: Mexico as a medical tourism destination for Mexican-born US workers under Workers’ Compensation, PERSPECTIVES, Medical Travel Today.com, published online on January 16, 2013.
http://medicaltraveltoday.com/richard-krasner-the-stars-aligned-mexico-as-a-medical-tourism-destination-for-mexican-born-us-
workers-under-workers-compensation/

Immigration Reform On The Horizon: What It Means For Medical Tourism And Workers’ Compensation, Insurance Thought Leadership.com, published online February 10, 2013.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/immigration-reform-on-the-horizon-what-it-
means-for-medical-tourism-and-wor/#axzz2KYcHw6HV

Immigration Reform on the Horizon – What it Means for Medical Tourism and Workers’ Compensation, PERSPECTIVES, Medical Travel Today.com, published online February 13, 2013
http://medicaltraveltoday.com/richard-krasner-immigration-reform-on-the-horizon-what-it-means-for-medical-tourism-and-workers-
compensation/

Spinal Fusion Outcomes in Washington State, PERSPECTIVES, Medical Travel Today.com, published online February 27, 2013.
http://medicaltraveltoday.com/richard-krasner-spinal-fusion-outcomes-in-washington-state/

Implementing international medical providers into the U.S. workers’ compensation system, Part 1, Costa Rica Medical Tourism, Inc. published online on March 2, 2013.
http://www.medtourismcr.com/blog/2013/03/02/Implementing-International-Medical-Providers-Into-The-US-Workers-Compensation-
System-Part-1.aspx

Employee vs. Employer Choice of Physician Revisited: Additional Commentary on How Best to Incorporate Medical Tourism into Workers’ Compensation, TBD Consulting.com, published online on March 4, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/03/employee-vs-employer-choice-of-physician-revisited-additional-
commentary-on-how-best-to-incorporate-.html

Rising Hospital Costs: What they mean for Workers’ Compensation and Medical Tourism, TBD Consulting.com, published online on March 13, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/03/rising-hospital-costs-what-they-mean-for-workers-compensation-and-
medical-tourism.html

Legal Barriers to Implementing International Providers into Medical Provider Networks for Workers’ Compensation: A White Paper, WordPress.com, published online on March 15, 2013.
http://wp.me/p2QJfz-ap

What I Learned at the 5th World Medical Tourism & Global Healthcare Congress, and Why It Matters to the Workers’ Compensation Industry, TBD Consulting.com, published online on March 20, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/03/what-i-learned-at-the-5th-world-medical-tourism-global-healthcare-
congress-and-why-it-matters-to-the.html

A ‘Case Study’ in Implementing Medical Tourism into Workers’ Compensation, TBD Consulting.com, published online on April 3, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/a-case-study-in-implementing-medical-tourism-into-workers-
compensation.html

What Can Medical Tourism Do about Pain Medication Abuse?, Medical Tourism Today.com, published online on April 5, 2013.
http://medicaltourismtoday.com/what-can-medical-tourism-do-about-pain-medication-abuse/

Medical Tourism and Workers Compensation: What are the Barriers?, TBD Consulting.com, published online on April 10, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/medical-tourism-and-workers-compensation-what-are-the-barriers.html

Point/CounterPoint: A Virtual Dialogue on the Merits of Implementing Medical Tourism into Workers’ Compensation, Part 1, TBD Consulting.com, published online on April 17, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/part-1-pointcounterpoint-a-virtual-dialogue-on-the-merits-of-
implementing-medical-tourism-into-worke.html

Point/CounterPoint: A Virtual Dialogue on the Merits of Implementing Medical Tourism into Workers’ Compensation, Part 2, TBD Consulting.com, published online on April 18, 2013.
http://tbd-consulting.typepad.com/healthcare_talent/2013/04/part-2-pointcounterpoint-a-virtual-dialogue-on-the-merits-of-
implementing-medical-tourism-into-worke.html

Ensuring Patient Safety: Making Sure Medical Tourism Puts Its Money Where Its Mouth Is, Medical Sea.org, published online on April 22, 2012.
http://www.medicalsea.org/ensuring-patient-safety-making-sure-medical-tourism-puts-its-money-where-its-mouth-is/

Ensuring Patient Safety: Making Sure Medical Tourism Puts Its Money Where Its Mouth Is, OPINION, Medical Travel Today.com, published online on April 24, 2013.
http://medicaltraveltoday.com/ensuring-patient-safety-making-sure-medical-tourism-puts-its-money-where-its-mouth-is/

Ten Years On: Medical Tourism Industry a decade out, Medical Tourism Today.com, published online on May 24, 2013.
http://medicaltourismtoday.com/ten-years-on-medical-tourism-industry-a-decade-out/

Healthcare Transparency, Healthcare Talent Transformation.com, published online on June 6, 2013.
http://www.healthcaretalenttransformation.com/2013/06/07/healthcare-transparency/

Surgical Shenanigans: How Workers’ Compensation is being ripped off, Medicalsea.org, published online on June 24, 2013.
http://www.medicalsea.org/surgical-shenanigans-how-workers-compensation-is-being-ripped-off/

My Defense of Implementing Medical Tourism into Workers’ Compensation, Healthcare Talent Transformation.com, published online on July 8, 2013.
http://www.healthcaretalenttransformation.com/2013/07/08/my-defense-of-implementing-medical-tourism-into-workers-
compensation/#more-947

The Faith of My Conviction: Integrating Medical Tourism into Workers’ Compensation is Possible — and not a Pipe Dream, PERSPECTIVES, Medical Travel Today.com, published online on July, 17, 2013.
http://medicaltraveltoday.com/the-faith-of-my-conviction-integrating-medical-tourism-into-workers-compensation-is-possible-and-not-
a-pipe-dream/

Surgical Shenanigans: How Workers’ Compensation is being ripped off, Healthcare Talent Transformation.com, published online on July 22, 2013.
http://www.healthcaretalenttransformation.com/2013/07/22/surgical-shenanigans-how-workers-compensation-is-being-ripped-off/

On the Bright Side, Medicasea.org, published online on August 4, 2013.
http://www.medicalsea.org/on-the-bright-side/

And Now For Something Completely Different, Medicalsea.org, published online on August 9, 2013.
http://www.medicalsea.org/and-now-for-something-completely-different/

Founding Fathers and the ACA, Healthcare Talent Transformation.com, published online on August 26, 2013.
http://www.healthcaretalenttransformation.com/2013/08/26/founding-fathers-and-the-aca/

Lessons, Medicalsea.org, published online on August 28, 2013.
http://www.medicalsea.org/lessons/

Addendum

Publications

Far In Front of the Crowd, Medicalsea.org, published online on August 30, 2013.
http://www.medicalsea.org/far-in-front-of-the-crowd/

Medical Tourism Industry a Decade from Now: Part 1, Healthcare Talent Transformation.com, published online on October 9, 2013.
http://www.healthcaretalenttransformation.com/2013/10/09/medical-tourism-industry-a-decade-from-now-part-1/

Medical Tourism Industry a Decade from Now: Part 2 Outpatient Costs, Healthcare Talent Transformation.com, published online on October 16, 2013.
http://www.healthcaretalenttransformation.com/2013/10/16/medical-tourism-industry-a-decade-from-now-part-2-outpatient-costs/

Medical Tourism Industry a Decade from Now: Part 3 Consolidation of US Hospitals, Healthcare Talent Transformation.com, published online on October 18, 2013.
http://www.healthcaretalenttransformation.com/2013/10/18/medical-tourism-industry-a-decade-from-now-part-3-consolidation-of-us-
hospitals/

“Have I Got A Deal For You?” — The Medical-Device Tax Shuffle and Medical Tourism, Medicalsea.org, published online on October 20, 2013.
http://www.medicalsea.org/have-i-got-a-deal-for-you-the-medical-device-tax-shuffle-and-medical-tourism/

Medical Tourism Industry a Decade from Now: Part 4 Cost to Employees, Healthcare Talent Transformation.com, published online on October 23, 2013.
http://www.healthcaretalenttransformation.com/2013/10/23/medical-tourism-industry-a-decade-from-now-part-4-cost-to-employees/

Medical Tourism Industry a Decade from Now: Part 5 Immigration Reform, published online on October 25, 2013.
http://www.healthcaretalenttransformation.com/2013/10/25/medical-tourism-industry-a-decade-from-now-part-5-immigration-reform/

Medical Tourism Industry a Decade from Now: Part 6 Technology, published online on October 30, 2013.
http://www.healthcaretalenttransformation.com/2013/10/30/medical-tourism-industry-a-decade-from-now-part-6-technology/

Interview, SPOTLIGHT, Medical Travel Today.com, published online on October 31, 2013.
http://medicaltraveltoday.com/richard-krasner-medical-tourism-blogger/

Ten Years On: One Person’s View of Where the Medical Tourism Industry Will be a Decade from Now INDUSTRY NEWS, Medical Travel Today.com, published online on October 31, 2013.
http://medicaltraveltoday.com/ten-years-on-one-persons-view-of-where-the-medical-tourism-industry-will-be-a-decade-from-now/

Medical Tourism Industry a Decade from Now: Observations and Conclusion, Healthcare Talent Transformation.com, published online on November 1, 2013.
http://www.healthcaretalenttransformation.com/2013/11/01/medical-tourism-industry-a-decade-from-now-observations-and-
conclusion/

Cross-border Workers’ Compensation A Reality In California, Medicalsea.org, published online on December 3, 2013.
http://www.medicalsea.org/cross-border-workers-compensation-a-reality-in-california/

Knee Surgery in Costa Rica — A Less Expensive Alternative, Medicalsea.org, published online on December 31, 2013.
http://www.medicalsea.org/knee-surgery-in-costa-rica-a-less-expensive-alternative/

Cross-border Workers’ Compensation A Reality In California, Medicalsea.org, published online on January 22, 2014.
http://www.medicalsea.org/cross-border-workers-compensation-a-reality-in-california-2/

What to know before providing Medical Tourism Services, Medicalsea.org, published online on February 14, 2014.
http://www.medicalsea.org/what-to-know-before-providing-medical-tourism-services/

Can Medical Tourism Relieve Stress in Workers’ Comp?, Medicalsea.org, published online on February 19, 2014.
http://www.medicalsea.org/can-medical-tourism-relieve-stress-in-workers-comp/

Beware the IRS: What to Know Before Using Medical Tourism for Group Health Plans, Medicalsea.org, published online on February
25, 2014.
http://www.medicalsea.org/beware-the-irs-what-to-know-before-using-medical-tourism-for-group-health-plans/

Statutes are not Statues ― Why Workers’ Comp Must Open up and Be Flexible, Medicalsea.org, published online on
April 8, 2014.
http://www.medicalsea.org/statutes-are-not-statues-%E2%80%95-why-workers-comp-must-open-up-and-be-flexible/

ACA to Lead to Physician Shortages ― Possible Effects for Medical Tourism in Work Comp, Healthcare Talent Transformation.com,
published online on April 14, 2014.
http://www.healthcaretalenttransformation.com/2014/04/14/aca-to-lead-to-physician-shortages-%E2%80%95-possible-effects-for-
medical-tourism-in-work-comp/

Why Medical Tourism for Workers’ Comp is an Idea Whose Time Has Come, U.S. Domestic Medical Travel.com, published
online on April 16, 2014.
http://www.usdomesticmedicaltravel.com/email/v1-10.html#story8

Why Medical Tourism for Workers’ Comp is an Idea Whose Time Has Come, Medical Travel Today.com, published online
on May 1, 2014.
http://medicaltraveltoday.com/newsletter/v8-1.html#

Miami Beach: Fun, Sun and Medical Tourism, Medicalsea.org, published online on May 14, 2014.
http://www.medicalsea.org/miami-beach-fun-sun-and-medical-tourism/

Travel expense may be reimbursed under certain conditions, Medicalsea.org, published online on July 3rd, 2014
http://www.medicalsea.org/travel-expense-may-be-reimbursed-under-certain-conditions/

“We’re Not No. 1!” We’re No. 11, Healthcare Talent Transformation.com published online on July 17, 2014.
http://www.healthcaretalenttransformation.com/2014/07/17/were-not-no-1-were-no-11/

From Pariah to Player: South Africa’s Journey towards Becoming a Medical Tourism Destination, Medicalsea.org, published online on July 21, 2014.
http://www.medicalsea.org/from-pariah-to-player-south-africas-journey-towards-becoming-a-medical-tourism-destination/

Corruption Not Limited To US Health Care, Medicalsea.org, published online on July 21, 2014.
http://www.medicalsea.org/corruption-not-limited-to-us-health-care/

Top 10 Causes of Workplace Injuries: How Medical Tourism Can Save Employers Money, U.S. Domestic Medical Travel.com, published online on September 15, 2015. http://www.usdomesticmedicaltravel.com/email/v2-2-full.html#story5

Paralysis by Analysis: Or the Only Thing We Have to Fear Is, Fear Itself, U.S. Domestic Medical Travel.com published online on October 20, 2015. http://www.usdomesticmedicaltravel.com/email/v2-3-full.html#story2

Follow-up Visits After Surgery: Telehealth, Medical Travel and Workers’ Comp, U.S. Domestic Medical Travel.com published online on October 20, 2015. http://www.usdomesticmedicaltravel.com/email/v2-3-full.html#story3

Interview, SPOTLIGHT, Medical Travel Today.com, published online on November 3, 2015. http://www.medicaltraveltoday.com/newsletter/v8-19-full.html#story1

Don’t Drink the Kool-Aid Just Yet

While the Tennessee Legislature has put the issue of opt-out on hold for this year, the South Carolina Legislation is moving ahead with opt-out, according to James Moore’s blog piece today.

David De Paolo and I have both come close to drinking the Kool-Aid on opt-out expansion, but until there is transparency and real data that opt-out offers employers and employees better medical care, opt-out is just another right-wing, anti-worker, pro-business scheme that will take this country back, quoting Grover Norquist, back to the 19th century, when workers had no rights when they got hurt, and had to sue for benefits, if they were lucky to get to court.

It figures that the state that seceded from the Union first, would jump on the opt-out bandwagon.

As I said last week, it’s a double edged sword; only one edge is up against the throat of the American worker.

For opt-out to be truly worthwhile, it has to prove it is better than what we have now, with all that we know about the high cost and abusive practices of certain bad actors, but it also has to provide the injured worker with the opportunity to get medical care where the cost is lower, the quality is better, and is offered as an option.

Given that opt-out’s biggest proponents are funding the organization called ARAWC (A-Rock), there will be many who will oppose or question the push towards opt-out expansion nationwide.

There has to be a better way to lower the cost of medical care in workers’ comp than doing it on the backs of injured workers. In other words, don’t drink the Kool-Aid just yet.

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

Lost-Time Medical Costs Approaching $30K: When Will You See the Light?

Introduction

For the past five years I have been keeping track of the Average Medical Cost per Lost-Time Claim, as reported every year in May at the NCCI Annual Issues Symposium in Orlando, Florida.

The Chief Actuary for NCCI, Kathy Antonello, presented the 2015 State of the Line Report to the Symposium’s attendees this morning.

That is where many folks in the workers’ comp industry are today and tomorrow, including fellow bloggers, David De Paolo and Joe Paduda.

It is thanks to Joe that I was able to find the slides presented today at the Symposium.

Much of what the State of the Line discusses has to do with the financial health of the workers’ comp industry from the standpoint of premiums and other cost drivers.

But it is the Average Medical Cost per Lost-Time Claim that has always grabbed my attention, and what I have cited in my original paper for my MHA degree program class on Health Law and my White Paper.

In addition, I have cited it in my previous posts, Average Medical Claim Costs Still Rising for Workers’ Compensation and Average Medical Claim Costs Still Rising for Workers’ Compensation: 2014 Edition.

What you will notice in the following article is that the Average Medical Cost per Lost-Time Claim is still rising, despite the fact that from year to year, there may be a slight decrease, but on the whole, the Average Medical Cost is slowly approaching $30,000.

What that means as far as actual cost of medical care for each and every claimant is unclear from the data NCCI provides. For example, does that include the cost of surgery? Does it include the total hospital bill for each patient, because we all know that hospital bills can run into six figures.

What it does not include, and that is made very clear at the bottom of the slide, is any high-deductible policies.

So the Average Medical Cost per Lost-time Claim is only an estimate of the average workers’ comp claim that is reported to NCCI. And bear in mind, that not all fifty states report data to NCCI. Some states only report to state bureaus, and only report to NCCI on interstate rated policies, so again it is not completely accurate.

To illustrate just how bad things have gotten, I am going to show you the previous five Average Medical Cost per Lost-time Claim slides, plus this year’s slide, and my own chart with a trendline that shows the medical cost continuing to rise.

I could have done this for all of the past five years, but even without a trendline, the reader can tell that costs are going up. After all, this is not rocket science, and after having worked at NCCI and doing workers’ comp statistical reporting, I can tell you that there are no geniuses there.

So since this is not rocket science, and since going to the Moon is way more complex than sending workers’ comp claimants to medical tourism facilities abroad where the costs are cheaper, but the quality is equal to or better, then it will be quite clear that the trendline will not change until an alternative is found. That alternative is medical travel.

Average Medical Cost per Lost-time Claim 2009

At the 2010 Annual Issues Symposium, the Average Medical Cost per Lost-time Claim was estimated to be $27,200. As you will see in the slide below, the annual change from years 1991 to 1993 was +1.9%, from 1994 to 2001, it was +8.9%, and from 2002 to 2008, it was +6.6%.

The Average Medical Cost in 1991 was just over $8,000, and by 2009, the preliminary figure was nearly $28,000, which was an increase of 232%. That is a big increase in less than twenty years.

Chart 1

NCCI SOTL_0001

Medical losses amounted to 58% of all total losses in 2009, as seen in Chart 2, and had increased since 1989. For those of you not familiar with workers’ comp. Indemnity refers to the payments made to claimants for lost wages.

What this means is that for each claim, the medical costs represent more than half of the total of the entire claim payments. Lost wages are no longer the main cost driver for the increasing costs of claims.

Chart 2

NCCI SOTL_0002

Average Medical Cost per Lost-time Claim 2010

The following year, the Average Medical Cost per Lost-time claim went up slightly to $27,700, a 70% increase from 1991, or a modest 2% from 2009, as seen on the chart.

The Annual Change for years 1991 to 2001 showed no change, but did show a tenth of a percent increase for the years 2002 to 2008.

Chart 3

NCCI SOTL_0003

Average Medical Cost per Lost-time Claim 2011

One year later, NCCI reported that the Average Medical Cost had a slight increase in 2011, and had reached $28,000. This was a 71% increase from 1991.

The Annual Change decreased for the years 2002 to 2010, to +6.0%, a .6% decrease.

Chart 4

NCCI SOTL_0004

 Average Medical Cost per Lost-time Claim 2012

2012 saw the Average Medical Cost inched up a bit to $28,500, however, the Annual Change for years 2002 to 2011  decreased .3%, probably due to lower year by year rise in medical costs from 2010 to 2012.

Chart 5

NCCI SOTL_0005

Chart 6

Chart 5

Average Medical Cost per Lost-time Claim 2013

Starting in 2014, NCCI dropped the years 1991 to 1994 from the State of the Line report data on Average Medical Cost per Lost-time Claim. There was no explanation given, but there was a moderate increase in the medical claim severity, and medical cost was estimated at $28,800,

Chart 7 and Chart 8, the chart I used in my post, Average Medical Claim Costs Still Rising for Workers’ Compensation: 2014 Edition, are shown below, and with the aid of the treadline, you can see that medical costs are not showing any signs of decline, despite the minor year to year increases.

Annual Change from 1995 to 2012 went up +6.7%.

Chart 7

NCCI SOTL_0006

Chart 8

Chart 6

To drive home the point about the numbers and the slower increase year by year, I provided the reader with the following example:

Doctor:       “Good news, Mr. Jones. We’ve managed to slow the progression of your disease.”

Mr. Jones:   “What’s so good about that? I’m still dying, only slower.”

Average Medical Cost per Lost-time Claim 2014

Finally, we have today’s data, as reported by Kathy Antonello, and we can see that the Average Medical Cost per Lost-time Claim has risen to $29,400, an increase of 69% from 1995, and overall, the Annual Change from 1994 to 2013 has been a whopping +226.7%.

Chart 9

NCCI SOTL_0007

Chart 10

Chart 4

Obviously, something is terribly wrong here, and it is obvious that whatever the workers’ comp industry is doing is not working. Medical costs are still going up, and from the trendline, will continue to go up even further, eventually passing $30,000, perhaps as soon as next year.

Joe Paduda even reported today that the President and CEO of NCCI, Steve Klingel said that there may be storm clouds in the near future for work comp, and his comment was predicated on the reports earlier this year by ProPublica/NPR and OSHA.

Even with all of this data, folks in the workers’ comp world, their employer clients, and many others, refuse to see what is staring them in the face: MEDICAL CARE IN THE US IS TOO EXPENSIVE.

Yet, they refuse to seek out alternatives to high-cost medical care. And what would be so terrible if they did so?

Would they lose money on it? Perhaps the leeches who are draining the system or who have wrapped both the claimants and the system itself in a straitjacket, thrown them both into the padded cell called “workers’ comp” won’t be able to profit from the unfortunate injured workers who are being subjected to all kinds of horrible experiences, as evidenced by the ProPublica/NPR and OSHA reports, by my articles, and by articles by people like David De Paolo, who are bringing to light the dark side of workers’ comp.

The prospect of opt-out on the horizon is a double-edged sword. It promises to save money for employers, but as has been stated by Mother Jones and others, it could be worse for the employee. Like David De Paolo, I too, almost drank the kool aid on opt-out, but still believe that if it is fair to both the employer and the employee, it offers the opportunity to provide better medical care at lower cost to their employees.

But the attendees at this week’s two conferences, and all the other workers’ comp and insurance conferences will go on ignoring the truth, ignoring reality, will drink their favorite cocktails, tell funny stories, play a round or two of golf, etc.; yet, will not listen to me or anyone else when we tell them how things really are.

It is a case ‘see no evil, hear no evil, speak no evil’, but that only means that they are deaf, dumb and blind to the truth. It doesn’t have to be that way. It can be better.

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

Medical Tourism in the Dominican Republic: Play Ball!

I am usually reluctant to post anything from the Medical Tourism Association, as they copyrighted my white paper without my written permission, but the picture of Bartolo Colon of the New York Mets (First place in the National League East and the pitcher with the best record in the league) made me do otherwise.

As I did with the last two countries, Costa Rica and Colombia, here is the link to the article in Medical Tourism Magazine:

http://www.medicaltourismmag.com/news/2015/05/medical-tourism-training-dominican-republic-ready-to-play-ball/

Baseball players are susceptible to many kinds of injuries that require surgery, especially orthopedic surgery. It’s only the second month of the season, and the Mets have several players on the Disabled List, from David Wright to Vic Black, Jerry Blevins, Josh Edgin, Dillon Gee, Jenrry Mejia, Rafael Montero, Bobby Parnell, Cesar Puello, Zack Wheeler, and Travis D’Arnaud.

Most of these are either shoulder (Tommy John surgery), elbow, back, or other injuries, and might share some commonalities with workers’ comp injuries.

If Major League Baseball is going abroad for surgery, shouldn’t you?

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I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

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Los inmigrantes latinos sufren lesiones más Construcción

Trabajadores latinos e inmigrantes frente a los riesgos mortales desproporcionados en la construcción, según un informe publicado ayer por el Comité de Nueva York para la Seguridad y Salud Ocupacional (NYCOSH), e informaron hoy en Immigrants.com Trabajo.

El informe, “El Precio de la Vida: 2015 Informe sobre la construcción muertes en Nueva York”, dijo que los latinos constituyen el 25% de los trabajadores de la construcción del estado de NY, pero representa el 38% de las víctimas mortales de la construcción en Nueva York en 2012.

A nivel nacional, las muertes de construcción latinos aumentaron de 182 en 2010 a 233 en 2013, según el informe.

Algunos de los otros resultados reportados por los inmigrantes que trabajan son las siguientes:

• Un estudio de los registros médicos de 7.000 estadounidenses trabajadores de la construcción Latino encontró que eran 30% más propensos que los blancos no latinos trabajadores que se lesionan en el trabajo. Varios estudios han demostrado que la falta de formación es una de las razones por las tasas de lesiones más elevadas de trabajadores de la construcción hispanos.
• Además, muchos trabajadores de la construcción de Nueva York son los no ciudadanos, de acuerdo con la Encuesta de la Comunidad Americana del Censo de Estados Unidos, incluyendo 40% de los 124.240 trabajadores de la construcción de Nueva York, el 36% de los 7.710 instaladores de paneles de yeso, 28% de los 10.405 techadores y el 25% de los 88.475 carpinteros. Ellos, también, tienen menos probabilidades de recibir formación en seguridad.
• Las personas de los trabajadores de color y de la construcción inmigrantes tienen más probabilidades de trabajar fuera de los libros, para ser clasificado erróneamente como contratistas independientes, para trabajar como jornaleros, o tener conocimientos limitados de Inglés que no suele incluir términos técnicos, y por lo tanto es menos probable que recibir capacitación en seguridad.
• El 80% de los trabajadores inmigrantes en la construcción son latinos. Un Centro para la Democracia Popular informe hallazgo mostró que el 60% de la caída de la construcción de Nueva York muertes OSHA investigó 2003-2011 eran latinos y o inmigrante. Además, los contratistas no sindicalizados tienen menos probabilidades de proporcionar condiciones de trabajo seguras, entrenamiento OSHA y equipos de seguridad.
• Los trabajadores indocumentados son menos propensos a negarse a trabajar en condiciones peligrosas o de hablar a favor de mejores condiciones de salud y seguridad por temor a ser despedidos o deportados. En profundidad es la información sobre todos los casos difíciles de conseguir, ya que muchas muertes se anuncian antes de los nombres de ser liberado, y no hay seguimiento de los informes de los medios de comunicación.

Esta no es la primera vez que hablé de la difícil situación de los trabajadores latinos en ciertas industrias de alto riesgo, que incluyen la construcción. Mi post, una alternativa a cirugías de alto costo para los reclamos de compensación laboral en virtud de los programas de recapitulación, discute este tema con más detalle, y señala al lector a los artículos anteriores he escrito, y para artículos de Joe Paduda y Peter Rousmaniere, que escribió hoy pieza.

La gente sigue preguntándome donde la propuesta de valor es para el empleador y el empleado en tener la cirugía realizada en un país distinto de los EE.UU., y especialmente en el país de origen del trabajador lesionado, por lo que no existen barreras idiomáticas o culturales.

Bueno, esa es una propuesta de valor, ya que al ser capaz de entender el proceso de reclamaciones y el procedimiento quirúrgico en el lenguaje de la propia proporciona la confianza de que el paciente está recibiendo la mejor atención médica posible. No siempre tiene que ser un valor en dinero de por qué la cirugía en el extranjero es mejor que recibir en un hospital de Estados Unidos donde la lengua y la cultura son impedimentos.

La segunda propuesta de valor de tener el paciente ir al extranjero, especialmente a un trabajador latino, es que los amigos y familiares que siguen en el país de origen pueden visitar al paciente y hacerle sentir mejor acerca de su ser sin trabajo temporalmente.

Estas son las propuestas de valor intangible que no se puede poner un precio, pero que pueden dar lugar a una recuperación más rápida y un empleado más feliz cuando lo hace volver al trabajo. Eso por sí solo vale la pena la inversión.

Pero como para el empleador, si el costo de la cirugía y la factura total del hospital es miles de dólares menos en un centro médico del turismo extranjero de lo que pagarían en un hospital local, entonces el valor para el empleador es que él está ahorrando un mucho dinero, especialmente si la mayor parte de su fuerza de trabajo es latina.

He hablado con varias personas acerca de esta idea, y, sin embargo, algunos de ellos no ven el valor en el ahorro de dinero en cirugías costosas. Sólo puedo suponer que les gusta pagar por la nariz para la cirugía en una rodilla, cadera, hombro o muñeca.

O tal vez, sienten que está bien para un trabajador para ir al extranjero en virtud de salud de grupo (como una compañía en Carolina del Norte ha hecho), pero no en un borrador de los trabajadores. ¿Eso no golpear de sesgo de clase?

He escrito mucho sobre el alto costo de sistema de compensación de nuestros trabajadores, sus fracasos y deficiencias, pero sin embargo, nadie está dispuesto a admitir a sí mismos, y mucho menos este escritor, que tal alternativa es realista.

Para ser justos, he tenido algunas conversaciones con algunas personas que lo consiguen, pero por desgracia, no hay segundo partido dispuesto a explorar esto. A medida que la fuerza de trabajo se vuelve más latino, y como un borrador de trabajo está bajo asalto en muchos frentes, puede haber algunos empleadores, intermediarios, transportistas por ahí que lo escuche.

Mientras tanto, voy a seguir escribiendo, a pesar de que me estoy haciendo nada para hacerlo. Prefiero ser ganar honorarios de consultoría o incluso un cheque de pago, pero hasta entonces, voy a seguir creyendo que el turismo médico no es sólo para la gente blanca con grandes bolsillos de seguros y profundos, o para grandes empresas con planes de salud de grupo, o para aquellos la búsqueda de la cirugía estética o plástica, etc., pero para todas las personas, ricos y pobres.