Category Archives: Health Administration

Medical Travel/Health Care Thought Leader Seeks Opportunities

 

Medical Travel/HealthCare Thought Leader and Blogger, seeks opportunities to speak, write, and collaborate on projects to bring about greater participation of patients to global medical travel facilities.

NOTE: DUE TO SEVERE FINANCIAL AND PERSONAL DISTRESS, I AM SEEKING IMMEDIATE OPPORTUNITIES IN MEDICAL TRAVEL. PLEASE RESPOND IF YOU CAN OFFER ASSISTANCE, AS THIS IS A MATTER OF LIFE AND DEATH.

BE ADVISED : I am not a physician, nor do I have patients or clients to refer to you. I am seeking persons already engaged in medical travel who want to expand into a new market. I offer my services in an administrative or managerial capacity.

Experience:

Over six years experience creating, maintaining, and analyzing current issues in Medical Travel, Health Care, and other topics.

Over six years research into the Medical Travel industry.

Promoted the implementation of medical travel into Workers’ Compensation insurance industry.

Analyzed the cost of healthcare and the options of alternative treatments abroad.

Presented White Paper to Medical Travel conference in Mexico in Nov. 2014.

Extensive experience in Insurance and Claims Management, especially in medical-related claims (Workers’ Compensation).

Strong administrative and financial skills.

Education:

Master’s in Health Administration, 2011

Interested in working remotely, willing to travel, willing to write and speak at conferences, has valid US passport.

Resume can be found here.

Blog: richardkrasner.wordpress.com

Phone number: +1 561-603-1685 (mobile)

 

Obamacare: The Last Stage of Neoliberal Health Reform

In my recent review of the Introduction to Health Care under the Knife, the term “neoliberalism” was discussed as one of the themes the authors explored in diagnosing the root causes of the failure of the American health care system.

For review, the term neoliberalism refers to a modern politico-economic theory favoring free trade, privatization, minimal government intervention in business, reduced public expenditure on social services, etc. (Source: Collins English Dictionary – Complete and Unabridged, 12th Edition 2014)

As defined in Wikipedia, and as I wrote in my review, neoliberalism refers primarily to the 20th-century resurgence of 19th-century ideas associated with laissez-faire economic liberalism. Those ideas include economic liberalization policies such as privatization, austerity, deregulation, free trade and reductions in government spending in order to increase the role of the private sector in the economy and society. These market-based ideas and the policies they inspired constitute a paradigm shift away from the post-war Keynesian consensus which lasted from 1945 to 1980.

This recrudescence or resurgence gained momentum with the election of Ronald Reagan to the presidency, and with the Republican takeover of the House of Representatives in the 1994 midterm election, which made Newt Gingrich Speaker of the House, and implemented the Contract with America. (I’ve called it the Contract on America, for obvious reasons)

Yet, the full impact of neoliberalism was not felt until the rise of the TEA Party in the run-up to the passage of the Affordable Care Act, or Obamacare, and that led to the Freedom Caucus in the House that has tried unsuccessfully multiple times to repeal and replace Obamacare with basically nothing.

Economist Said E. Dawlabani, in his book, MEMEnomics, describes the period from 1932 to 1980, which includes the post-war Keynesian consensus, as the second MEMEnomic cycle, or “Patriotic Prosperity” MEME. The current period, from 1980 to the present, represents the third MEMEnomic cycle, or the “Only Money Matters” MEME.

It is in this period that the American health care system underwent a radical transformation from what some used to call a “calling profession” to a full-fledged capitalist enterprise no different from any other industry. This recrudescence of 19th century economic policies did not spring forth in 1980 fully formed, but rather had existed sub-rosa in the consciousness of many American conservatives.

In the early 1970’s, Richard Nixon’s administration came up with the concept of the Managed Care Organizations, or MCOs, as the first real attempt to apply neoliberalism to health care. As we shall see, this would not be the first time that neoliberal ideas would be implemented into health care reform.

In Chapter Seven, of their book, Health Care under the Knife, authors Howard Waitzkin and Ida Hellander, discuss the origins of Obamacare and the beginnings of neoliberal health care reform. They point to the year 1994 as a significant one for reform worldwide, as Colombia enacted a national program of “managed competition” that was mandated and partially funded by the World Bank. This reform replaced their prior health system and was based mostly on public hospitals and clinics.

1994 was also the year when then First Lady, Hillary Clinton spearheaded a proposal like the one Colombia enacted that was designed by the insurance industry. I am sure you all remember the Harry and Sally commercials that ran on television that sank her proposal before it ever saw the light of day?

What ultimately became Obamacare was the plan implemented in 2006 in Massachusetts by Mitt Romney, but that was later disavowed when he ran for President in 2012. Waitzkin and Hellander write that even though these programs were framed to improve access for the poor and underserved, these initiatives facilitated the efforts of for-profit insurance companies providing “managed care.”

Insurance companies, they also said, profited by denying or delaying necessary care through strategies such as utilization review and preauthorization requirements; cost-sharing such as co-payments, deductibles, co-insurance, and pharmacy tiers; limiting access to only certain physicians; and frequent redesign of benefits.

These proposals, the authors state, fostered neoliberalism. They promoted competing for-profit private insurance corporations, programs and institutions based in the public sector were cut back, and possibly privatized. Government budgets for public-sector health care were cut, private corporations gained access to public trust funds, and public hospitals and clinics entered competition with private institutions, with budgets determined by demand rather than supply. Finally, prior global budgets for safety-net institutions were not guaranteed, and insurance executives made operational decisions about services, superseding the authority of physicians and other clinicians.

The roots of neoliberal health reform emerged from the Cold War military policy, and the authors cite economist Alain Enthoven providing much of the intellectual framework for those efforts. Enthoven was the Assistant Secretary of Defense under Robert S. McNamara during both the Kennedy and Johnson administrations. While he was at the Pentagon, between 1961 and 1969, he led a group of analysts who developed the “planning-programming-budgeting-system” (PPBS) and cost-benefit analysis, that intended to promote more cost-effective spending decisions for military expenditures. Enthoven became the principal architect, the authors indicate, of “managed competition”, which became the prevailing model for the Clinton, Romney, and Obama health care reforms, as well as the neoliberal reforms around the world.

The following table highlights the complementary themes in the military PPBS and managed competition in health care.

_____________________________________

Sources: See note 11, page 273.

Enthoven continued to campaign for his idea throughout the 1970s and 1980s and collaborated with managed care and insurance executives to refine the proposal after being rejected by the Carter administration. The group that met in Jackson Hole, Wyoming, which included Enthoven and Paul Ellwood, was funded by the five largest insurance corporations, as well as the 1992 Clinton presidential campaign, and wife Hillary’s Health Security Act.

The authors state that Barack Obama, while a state legislator in Illinois, favored a single payer approach, but changed his position as a presidential candidate. In 2008, he received the largest financial contributions in history from the insurance industry, that was three times more the contributions of his rival, John McCain.

The neoliberal health agenda, the authors write, including Obamacare, emerged as one component of a worldwide agenda developed by the World Bank, the International Monetary Fund, and other international financial institutions. The agenda to promote market-driven health care, facilitated access to public-sector health and social security trust funds by multinational corporations, according to Waitzkin and Hellander. The various attempts in the US by the Republican Party to privatize Social Security is an example of this agenda.

An underlying ideology claimed that corporate executives could achieve superior quality and efficiency by “managing” medical services in the marketplace, but without any evidence to support it, the authors contend. Health reform proposals from different countries have resembled one another closely and conform to a cookie-cutter template. Table 2 describes the six features of nearly all neoliberal reform initiatives.

_______________________________

† Sources: patients, employers, public sector trust (“solidarity”) funds (the latter being “contributory” for employed workers, and “subsidized” for low income and unemployed).
‡ Sources: patients, public sector trust funds – Medicaid, Medicare.

The six features of neoliberal health reform are as follows:

  1. Organizations of providers – large, privately controlled organizations of health care providers, operate under direct control or strong influence of private insurance corporations, in collaboration with hospitals and health systems, may employ health care providers directly, or may contract with providers in a preferred network. In Obamacare, they are called Accountable Care Organizations (ACOs), supported only in Medicare, but Obamacare accelerated organizational consolidation in anticipation of broader implementation.

In this model, for-profit managed care organizations (MCOs) offer health plans competitively. In reality, competition is restrained by the small number of organizations large enough to meet the new laws’ financial and infrastructure requirements, as well as by the consolidation in the private insurance industry. They contract with or employ large numbers of health practitioners. Instead, physicians and hospitals are absorbed into MCOs.

  1. Organizations of purchasers – large organizations purchasing or facilitating the purchase of private health insurance, usually through MCOs. Under Obamacare, the federal and state health insurance “exchanges”—later renamed “marketplaces” to reflect reality of private, government-subsidized corporations—fulfill a similar role.
  2. Constriction of public hospitals and safety net providers – public hospitals at the state, county, or municipal levels compete for patients covered under public programs like Medicaid or Medicare with private, for-profit hospitals participating as subsidiaries or contractors of insurance companies or MCOs. With less public-sector funding, public hospitals reduce services and programs, and many eventually close. Under Obamacare, multiple public hospitals have closed or have remained on the brink of closure. Note: This is a subject I have written about in prior posts about Medicaid expansion.
  3. Tiered benefits packages – defined in hierarchical terms, minimum package of benefits viewed as essential, individuals and employers can buy additional coverage, poor and near poor in Medicaid eligible for benefits that used to be free of cost-sharing, but since Obamacare passed, states have imposed premiums and co-payments. Under Obamacare, various metal names—bronze, silver, gold, platinum, identify tiers of coverage, where bronze represents the lowest tier and platinum the highest.
  4. Complex multi-payer and multi-payment financing – financial flows under neoliberal health policies are complex (see Chart 7.1). There are four sources of these various financial flows.
    1. Outflow of payments – each insured person considered a “head” for whom a “capitation” must be paid to an insurance company or MCO.
    2. Inflow of funds – funds for capitation payments come from several sources. Premiums paid by workers and their families, contributions from employers is a second source. Public-sector trust funds are a third source, co-payments and deductibles constitute a fourth source, and taxes are a fifth source.
  5. Changes in the tax code – neoliberal reforms usually lead to higher taxes because they increase administrative costs and profits, Obamacare reduces tax deductions and imposes a tax for so-called Cadillac insurance plans. In addition, it calls for penalties for those who do not purchase mandatory coverage, administered by the IRS. I was unable to get on the ACA because I had not filed a return in several years due to long-term unemployment because of the financial collapse of 2007/2008, and the subsequent jobless recovery.

Chart 7.1 Financial Flows under Neoliberal Health Reform

_______________________________

*Purchase of insurance policies for employers and patients mediated by large organizations of health care purchasers.

What is the outlook for single payer in the US, the authors ask?

They cite national polls that show that about two-thirds of people in the US favor single payer. See Joe Paduda’s post here.

If the US were to adopt single payer, the PNHP proposal would provide coverage for all needed services universally, including medications and long-term care, no out-of-pocket premiums, co-payments, or deductibles; costs would be controlled by “monopsony” financing from a single, public source, would not permit competing private insurance and would eliminate multiple tiers of care for different income groups; practitioners and clinics would be paid predetermined fees for services without and need for costly billing procedures; hospitals would negotiate an annual global budget for all operating costs, for-profit, investor-owned facilities would be prohibited from participating; most nonprofit hospitals would remain privately owned, capital purchases and expansion would be budgeted separately, based on regional health-planning goals.

Funding sources would include, they add, would include current federal spending for Medicare and Medicaid, a payroll tax on private businesses less than what businesses currently pay for coverage, an income tax on households, with a surtax on high incomes and capital gains, a small tax of stock transactions, while state and local taxes for health care would be eliminated.

From the viewpoint of corporations, the insurance and financial sectors would lose a major source of capital accumulation, other large and small businesses would experience a stabilization or reduction in health care costs. Years ago, when I first considered single payer, I realized that if employers no longer had to pay for health care for their employees, they could use those funds to employ more workers and thus limit the impact of recessions and jobless recoveries.

So how do we move to single payer and beyond?

According to the authors, and to this reporter, the coming failure of Obamacare will become a moment of transition in the US, where neoliberalism has come home to roost. This transition is not just limited to health care. The theory of Spiral Dynamics, of which I have written about in the past, predicts that at the final stage of the first tier, or Existence tier, the US currently occupies, there will be a leap to the next stage or tier, that being the Being tier, where all the previous value systems have been transcended and included into the value systems of the Being tier.

We will need to address, the authors contend, with the shifting social class position of health professionals and to the increasingly oligopolistic and financialized character of the health insurance industry. The transition beyond Obamacare, they point out, will need to address also the consolidation of large health systems. Obamacare has increased the flow of capitated public and private funds into the insurance industry and extended the overall financialization of the global economy.

The authors conclude the chapter by declaring that as neoliberalism draws to a close, and as Obamacare fails, a much more fundamental transformation needs to reshape not just health care, but also the capitalist state and society.

To sum it all up, all the attempts cure the ills of health care by treating the symptoms and not the cause of the disease will not only fail, but is only making the disease worse, and the patient getting sicker. We need radical intervention before the patient succumbs to the greed and avarice of Wall Street, big business, and those whose stake in the status quo is to blame for the condition the patient is in in the first place.

Therefore, Obamacare is the last stage of neoliberal health care reform.

Follow-up to My Open Letter to the Medical Travel Industry

Just over four months ago, I published an open letter to the medical travel industry.

To date, I have had no response to my letter of December 14th, nor have I been invited to attend any of the conferences that have been held since, or will be held in the future, and I just learned of one at the end of this month in Washington, DC.

By that time, I will have been writing this blog for five and a half years, and still on a daily basis, my posts get at best, less than fifty views, and on most occasions, not even twenty.

I have posted them to LinkedIn, Twitter, and have re-posted them several times, and yet, each time, I get a few clicks added to the ones previously received.

I am putting my heart and soul in this and not receiving any compensation, although I should. So would it hurt if the industry paid a little more attention to my writing and to me, in lieu of actual remuneration?

As a friend we all know once said to me, “What am I? Chopped Liver?”

I am not doing this to stroke my ego, nor am I doing it because I have nothing better to do. I am doing it because I care. I am in the process of reading a fascinating book on the real reasons health care in the U.S. and elsewhere is undergoing major changes that have affected the delivery of health care, it’s cost, quality, efficiency, and its efficacy.

The least any of you could do is acknowledge my efforts and pay me some courtesy. Is that too much to ask?

I’ve met some of you in the past seven years since I began this journey, but I’d like to meet more of you. And I am sure you would like to meet me. I am funny and am a great person to know.

What say you?

Thank you very much.

Richard

 

Regulation Strangulation

The American Hospital Association (AHA) released a report that stated that there is too much regulation that is impacting patient care.

The report, Regulatory Overload Assessing the Regulatory Burden on Health Systems, Hospitals, and Post-acute Care Providers, concludes with the following assessment:

Health systems, hospitals and PAC providers are besieged by federal regulatory requirements promulgated by CMS, OIG, OCR and ONC, many of which are duplicative and cumbersome and do not improve patient care. In addition to the regulatory burden put forth by those agencies, health systems, hospitals and PAC providers are subject to regulation by additional federal agencies, such as the Department of Labor, the Drug Enforcement Administration, the Food and Drug Administration and by state licensing and regulatory agencies. They also operate under stringent contract requirements imposed by payers, such as Medicare Advantage, Medicaid Managed Care plans and commercial payers, which also require reporting data in different ways through different systems. States and payers contribute to burden through, for example, documentation, quality reporting and billing procedures layered on top of the federal requirements.
Regulatory reform aimed at reducing administrative burden must not approach the regulatory environment in a vacuum — evaluating the impact of a single regulation or requirements of a single program — but instead must look at the larger picture of the regulatory framework and identify where requirements can be streamlined or eliminated to release resources to be allocated to patient care.
In a previous post, Models, Models, Have We Got Models!, I said that from the beginning of my foray into the health administration world, I noticed that there were too many models, programs, and schemes dedicated to lowering costs and improving quality of care, that only raised the cost of health care and did not improve quality of care.
This is what I said then about all the models, programs, and rules promulgated by CMS over decades that have not made things better:
The answer was simple. Too many models, programs, rules, and so on that only gum up the works and make real reform not only impossible, but even more remote a possibility as more of these inane models are added to what is already a broken system.
So it seems that I was right even then, and now the AHA has proved it so. Why not scrap these models, programs, and rules and institute real reform…Medicare for All and be done with it?

Health Care Writer 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

Objective

Independent writer/blogger with over four years blogging experience with issues in Health Care and Workers’ Compensation, seeks correspondent, journalist, contributor position in Health Care, Health Care Policy, International Health Care, or Public Health.

Education

MHA, Health Administration, Florida Atlantic University, 2011

Relevant Courses:

Intro. to US Health Care Systems
Org. Behavior in Healthcare
Health Care Mgmt. (elective) Topic: Healthcare Quality
Health Law
Health Policy
Healthcare Finance
Healthcare Internship
Planning & Mktg. in Healthcare
The 2010 Patient Protection & Affordable Care Act (elective)
Res. Methods for Healthcare Mgmt.

Papers:

EnergySmart Hospitals: A Comparative Review
Banning Soda under the SNAP Program: A Policy Review
Legal Barriers to Implementing Int’l Providers into Medical Provider Networks for WC
PPACA: The End of Workers’ Compensation?
Medical Management Internship Paper

M.A., History, New York University, 1981
Concentration: American History

B.A., Liberal Arts, SUNY Brockport, Brockport, NY, 1979
Concentrations: Political Science, History, Sociology/Afro-American Studies

Professional Experience

Editor-in-Chief/Content Writer, Transforming Workers’ Compensation blog, Boynton Beach, FL                  2012 – Present
Published over 300 articles covering current issues in Workers’ Compensation, Healthcare,
and to promote the implementation of medical travel into Workers’ Compensation.

Risk Management Consulting Services, Boynton Beach, FL                                                                                  2002 – 2010
Multiple consulting projects:
Strategic Outsourcing, Inc., Charlotte, NC
Environamics, Inc., Charlotte, NC
Fredrick C. Smith Clinic, Marion, OH
Bonitz, Inc., Charlotte, NC

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

Consultant                                                                                                                               1995 – 2001
Various assignments, Dallas, TX
Data Analyst, Stirling Cooke, Dallas, TX
BPO Compliance Analyst, PMSC, Sarasota, FL
Data Services Consultant, NCCI, Inc., Boca Raton, FL
Underwriting Data Analyst, Allstate, Boca Raton, FL

A Simple Friday Morning Health Care Philippic – (With Apologies to Simon & Garfunkle)

Health Affairs blog today posted an article about the new rules CMS released on Wednesday that would establish key parameters for the new Quality Payment Program, a framework that includes the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). These policies were established by the latest, permanent ‘doc fix,’ the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

My writing this morning is not about the proposed rule, the Quality Payment Program, the Merit-based Incentive Payment System (MIPS), or the Alternative Payment Models (APM’s).

But rather, it is about something I first encountered during my first MHA class on Health Care Quality. Reading the assigned readings in the one textbook we were given, I noticed that throughout the last several decades, CMS has released and created many rules, programs, models, and whatnot, that made my head spin. No doubt that is what the good folks at CMS intended, because these rules, programs, models, schemes and “solutions” have only seemed to make the American health care system more complex, confusing, bureaucratic, wasteful, idiotic, and expensive.

When supporters of the current challenger in the Democratic Party presidential primaries say that their candidate will give them free health care, do they really understand and realize how much of a house of cards the entire system is, and one that will collapse if given enough time?

How so, you ask? Well, if you know of any other human-devised system that is so top-heavy, so convoluted, and so complex that the sheer weight of its rules, regulations, laws, programs and models will cause it to collapse, let me know, because the US health care system is the only one I see.

What those who advocate Medicare for All don’t realize (I am one too, but I realize what is at stake), is that even with all of this complexity, people are profiting from the ever continuing releasing of proposed rules, programs and models, and that to simply do away with them is equally as bad as letting it collapse, but at least when it does collapse, we can start all over again and provide the single payer system they want.

Yet, if we scrape it now, those who just got health coverage will lose it, those who never had it will never be able to afford it, and the entities that profit from it will work day and night to prevent the scraping of their “golden goose”.

I don’t have all the answers, but I know this, too many rules, programs, incentives, models, schemes, etc, etc, and so forth, only makes things worse, not better. I don’t remember learning about other nations’ health care systems being so top-heavy and so complex, and maybe, in the final analysis, is why their systems work, and ours does not.

When an American citizen goes abroad and needs medical care in a country such as France (I read one person’s account of what they experienced), the bill they received after treatment was only a few dollars, not hundreds or thousands. Why is that? Maybe because they don’t have a CMS screwing it up.

Maybe it’s because their doctors don’t wave expensive watches in the faces of their patients, or describe their recent safaris where they shot some endangered species in Africa because they were wealthy and believe they have the right to do so, as a Midwestern dentist did last year to a prized lion.

I also remember that during the run-up to the enactment of the ACA, many senior citizens demanded that the government keep its hands off of their Medicaid, and that they did not want some government bureaucrat to make health care decisions for them and their families. Who do they think makes these decisions in health insurance companies? Do they know any corporate “bureaucrats”, or do they think that because they work for a private company, that they are not part of a bureaucracy?

I’ll end this philippic here, but it makes me wonder why we haven’t gotten wise to the fact that too many cooks, too many rules, etc., only make things worse, not better. We need to wake up and join the rest of the industrialized world.


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.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

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.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Blog is now viewed all over the world in 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

Insurers’ Have Zika on Radar

As a follow-up to my last post on the Zika virus and what the medical travel industry should be doing about it, I want to direct you to what Shelby Livingston wrote last week in Business Insurance.

She said that American health care insurers are closely monitoring the virus, educating their members, but have not yet figured out what it will cost payers.

A spokesperson for Aetna said, “We are in contact with the Centers for Disease Control, U.S. federal agencies, state and local health departments, health care providers and others so that we can provide timely, relevant and accurate information from the CDC to our members and customers. Additionally, we have distributed health information from the CDC to our disease management and case management teams to help support our members.

The statement also said, that it is premature to predict health care costs associated with the Zika virus.

Anthem posted a message on Twitter, Livingston reported, cautioning travelers to the Caribbean to heed the CDC’s warnings; UnitedHealth Group has published updates on its website, but did not respond to her requests for comment on how they are responding to the virus, or whether they are projecting costs associated with the virus.

As I noted in my post last week, this virus may have a chilling effect on your business and the health of your patients. It is advisable to monitor what the US insurers say and do going forward.

EMPLOYMENT WANTED

Very talented, detail-oriented, highly motivated, visionary thinker with extensive Risk Management, Property & Casualty Insurance, and Workers’ Compensation Claims experience, Risk Management Information Systems, Insurance Data Processing and Workers’ Compensation Statistical Reporting experience, possesses B.A. in Liberal Arts, an M.A.in History, and a Master’s in Health Administration degree (MHA), actively seeking a rewarding, and challenging position.

Willing to work hard, willing to learn, willing to teach, salary commensurate with experience, both professional experience and life experience.

Successful blogger with excellent written and verbal skills, strong financial and organizational skills, as well as  strong analytical and problem solving skills, .and can think outside the box.

Has strong knowledge of economic, social and political issues, as well as strong interest in global issues, including the growth and development of medical tourism.

Location is flexible, provided it is amendable, would consider non-US positions provided relocation is included. Strong English language proficiency, willing to learn others as well.

Will consider consulting opportunities. Contact me by email at: richard_krasner@hotmail.com or by phone, +1-561-738-0458, or cell, +1-561-603-1685. Resume/CV will be provided upon request, or can be viewed on blog or LinkedIn profile.

Health Care Policy 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
Blog: https://richardkrasner.wordpress.com
Skype: richard.krasner

Professional Profile

Master’s In Health Administration (MHA) graduate with extensive Insurance business experience and academic training in Political Science and other Social Sciences, looking to transition into Health Care Policy.

Skills

• Strong financial, organizational, written and presentation 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

Master’s in Health Administration, Florida Atlantic University, Boca Raton, FL, Dec. 2011
Courses:
Introduction to US Health Care Systems Organization Behavior in Healthcare
Health Care Mgmt. (elective) Topic: Healthcare Quality Health Law
Health Policy Healthcare Finance
Planning & Mktg. in Healthcare The 2010 Affordable Care Act (elective)
Research Methods for Healthcare Mgmt.

Papers:
EnergySmart Hospitals: A Comparative Review
Banning Soda under the SNAP Program: A Policy Review
Legal Barriers to Implementing Int’l Providers into Medical Provider Networks for WC
PPACA: The End of Workers’ Compensation?
Medical Management Internship Paper

M.A., History, New York University, New York, New York
Concentration: American History

B.A., Liberal Arts, SUNY Brockport, Brockport, NY
Concentrations: Political Science, History, Sociology/Afro-American Studies/Social Sciences/Humanities

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.

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 on November 12, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/implementing-internationalmedical-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 on November 15, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/healthcare/articles/implementing-internationalmedical-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 on November 28, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/workers-compensation/articles/implementinginternational-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 on December 4, 2012.
http://www.insurancethoughtleadership.com/index.php/risk-transfer/workers-compensation/articles/implementinginternational-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/implementinginternational-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-formexican-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-thehorizon-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-tourismand-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-revisitedadditional-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-workerscompensation-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-globalhealthcare-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-intoworkers-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-arethe-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-themerits-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-themerits-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-mouthis/

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-intoworkers-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-ispossible-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-isbeing-ripped-off/

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

Addendum

Publications

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/

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-toemployees/

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-decadefrom-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-observationsand-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-possibleeffects-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,
http://www.medicalsea.org/from-pariah-to-player-south-africas-journey-towards-becoming-a-medical-tourismdestination/

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