Category Archives: Risk Management

A Personal Appeal

As you may have noticed, I have been re-posting several times articles about my interest In finding opportunities or remote/virtual positions.

To date, I have had no success. As I may have mentioned in my previous post, “Now It’s Personal“, I was diagnosed with End-Stage Renal Disease, and have been undergoing peritoneal dialysis at home.

The treatment is going well, but yesterday I began what will be a long, possibly three year process to get a transplant. As I am doing now, and will be doing in the future, I have been staying home to receive my dialysis supplies every two weeks, and going to the clinic for blood work and follow-up. In addition, I will have tests, and need to go down to Miami, so my schedule will not allow me to work full-time, or even part-time for twenty hours a week at some office.

To that end, I am interested in any work any of you can pass onto me that will utilize my skills and experience. No matter where you are in the world, as long as we can communicate online, I can do something constructive and valuable.

If you need my CV, I will gladly provide it upon request.

I would not do this here if the other postings had been successful, and time is running short.

 

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Insurance/Risk Management/Health Care Thought Leader Seeks Opportunities

Insurance/Risk Management (Workers’ Comp)/Health Care Thought Leader and Blogger seeks remote or virtual opportunities. Project work appreciated.

Experience:

Over fifteen years’ experience in Workers’ Compensation, Risk Management, and Property & Casualty Insurance.

WC, GL, P&C Claims Management, WC Statistical Reporting, Data Analysis, Management & Reporting.

Content Writer with five years experience creating and maintaining professional blog analyzing current issues in Workers’ Compensation and Healthcare.

Analyzed the cost of health care and the options of alternative treatments abroad.

Interested in working remotely, willing to travel.

Resume can be found here.

Blog: richardkrasner.wordpress.com

Dear Reader, con’t.

Last month, I told you that I was planning to shut down my blog because of my acceptance of a new position.

Unfortunately, some things were not meant to be, and while I was waiting until the new year to end the blog, I have decided to reverse course and keep it up and running, so those of you who have enjoyed my writing will have more to enjoy, I hope.

This still leaves me back where I was in October when I accepted the position, so if any of you have something in mind, let me know.

I am open to consulting with anyone. Resume furnished upon request.

Medical malpractice at Pilgrim’s Pride…the poultry company?

It sounds like malpractice to me. That’s what I’ve been thinking ever since learning how the injuries sustained by poultry workers are treated (and not treated) at the company nursing stations.

Source: Medical malpractice at Pilgrim’s Pride…the poultry company?

Self-Insured Employers Fail To Adopt Medical Travel

When I began my writing, one of the ways I saw medical travel could be implemented into workers’ comp was through employers who self-insure.

There are not that many companies who do self-insure for several reasons, one of which is the administrative costs and extra hoops they would have to go through just to get approval from state regulators to be self-insured. This is something most small employers will not do. More on what I think about this later.

Today, Irving Stackpole, President of Stackpole & Associates (a LinkedIn connection of mine), wrote an article in the International Medical Tourism Journal (IMTJ) about why US employers have failed to adopt medical travel benefits.

For the sake of transparency and honesty, I have never met Irving, but have had discussions with him a few times on LinkedIn in some of the groups we have in common. I have met his co-host of his radio show, Elizabeth Ziemba, when we both attended the 5th Medical Tourism and Wellness Business Summit in Reynosa, Mexico in November 2014.

In his article, Irving mentions that while some small employers such as HSM (who I have written about in earlier posts), Hannaford Supermarkets, the Casino and Hotel of the Blue Lake Rancheria Tribe in Northern California, and IDMI Systems have added medical travel to their health plans, he does not know of any large employers who have.

When I attended the 5th World Medical Tourism & Global Healthcare Congress in 2012, large employers such as Disney Institute, American Express, and Google sent representatives to speak at the Congress. If they attended, then surely their companies must be involved in some degree with medical travel? What did they discuss? Certainly not the weather (Hurricane Sandy was right outside the hotel).

But I digress, yet again.

According to Irving, six percent of firms offering fully-insured plans reported that they intend to self-insure because of the ACA. So, he is correct in that not many companies are self-insured.

However, Irving also states that it is estimated that the average self-funded plan covers between 300-400 employees, and that 59% of them in the US self-fund as part of their health plan.

And he goes on to say that many small companies are looking to self-fund to reduce their share of the cost burden, but that because small employers are not able to assume the same risk levels, stop loss rates are rising. This pressure, he adds will serve as a limitation on the expansion of self-funded health insurance into the smaller market.

Irving concludes that there are four reason why large self-insured companies would add an additional medical travel benefit to their insurance plans:

  • Current implementation of the ACA has distracted or absorbed attention of insurance markets, including self-insured companies. Many companies are wrestling with far issues of how many employees will be included/excluded, potential penalties, and avoiding fines under the ACA;
  • Self-insured plans are exempt from many of the more costly and burdensome requirements of the ACA as long as they don’t make significant changes, therefore they are careful about keeping their plans unchanged;
  • Reinsurance, or stop loss coverage may be limited for plans offering a medical travel benefit, and;
  • There is no history of outcomes , evidence or actuarial models to support the case among employers for a disruptive change such as international medical travel. Reports suggesting cost savings and quality outcomes are not yet supported by evidence.

One other factor Irving suggests as to why many employers have avoided medical travel is because many find it necessary to contract with a third party administrator (TPA) to collect premiums, manage membership enrollment, claims adjudication and payment. These TPA’s are sometimes referred to as providing “Administrative Services Only” contracts or “ASO” contracts, where they provide typical third party administration services, but assume no risk for claims payment.

Because of these contracts, Irving says that while economic logic suggests that self-funded employers should be interested in high quality, lower cost destinations, it is necessary to convince both the benefits manager and the TPA/ASO  of the value of being a destination provider, and the low risk associated with accessing international medical travel.

Okay, now it’s my turn.

“Impossible is just a big word thrown around by small men who find it easier to live in the world they’ve been given than to explore the power they have to change it. Impossible is not a fact. It’s an opinion. Impossible is not a declaration. It’s a dare. Impossible is potential. Impossible is temporary. Impossible is nothing.”

Muhammad Ali

While everything Irving wrote about appears to be factually true at the moment, and I cannot dispute what he says, the fact that employers have been unwilling to pursue medical travel is more complicated than the reasons he gives above.

True, the ACA has many things in it that may or may not seriously impact health care and the health insurance industry, but what he does not mention is that many of the things holding employers back pre-date the enactment of the ACA, and are more concerned with keeping health care the purview of those along the supply chain who profit the most from the system we have created, and not concerned with providing people either under health insurance or workers’ comp, with the best medical care possible, at the lowest cost, no matter where it comes from.

TPA’s and ASO’s and ERISA, and many other mechanisms such as stop loss insurance, and risk avoidance, etc., are mere barriers to the implementation of medical travel into both health care and workers’ comp.

Using my oft-time quoted analogy of going to the Moon, imagine if the baby steps we took to get there such as the Mercury, Gemini and early Apollo programs were not baby steps to the Moon, but actually barriers set up so that we are thwarted every step of the way to getting there or to go even further, such as landing humans on Mars. Don’t you think there would be people just like Irving who would say that it cannot happen?

That is why I quoted the late Muhammad Ali. For a poor black kid from Louisville, he sure had a better understanding of what can be than most folks who did not grow up like he did.

But this does not let the medical travel industry off the hook. I said so in my post, “Ensuring Patient Safety: Making Sure Medical Tourism Puts Its Money Where Its Mouth Is“.

But it is not just the industry itself that needs to come clean. Foreign governments and their travel ministries, the medical travel facilities, the providers, and the facilitators must present hard evidence that better quality and lower cost is possible, and so that when some of the dire predictions of the impact of the ACA are fully realized, or the US health care system collapses of its own weight (see my post, “Colorado “Single Payer” in Health Care Industry’s Sights“), medical travel as an alternative will become more acceptable to US employers, large and small, and not just for health care, but for workers’ comp as well.


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’ Comp Blog is now viewed all over the world in over 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.

Business Travel Risks During Olympics

Risk Management Monitor published an article here today about the business travel risks due to Zika during the Olympics this August in Brazil.

This information is important to all those medical tourism facilitators who travel to, or work with medical tourism destinations in Brazil, as well as other countries in South America.

Here are the areas of concern risk managers and business leaders need to think about:

  • The risk to employees
  • Duty of Care
  • If travel is necessary
  • Embracing Flexibility

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.