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Risk Management and Long Term Care

Risk Management and Long Term Care. David Friend November 9, 2002 CAS Annual Meeting Boston, MA. Challenges in the Long Term Care Industry. Reimbursement is controlled by Medicare/Medicaid Insurance Premium increases cannot be passed on to the customer

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Risk Management and Long Term Care

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  1. Risk Management and Long Term Care David Friend November 9, 2002 CAS Annual Meeting Boston, MA

  2. Challenges in the Long Term Care Industry • Reimbursement is controlled by Medicare/Medicaid • Insurance Premium increases cannot be passed on to the customer • Obtaining proper insurance for reasonable price • Runaway litigation cost • Proper staffing for Risk Management Department • Turnover effects quality of care

  3. Senior Management Support • Senior Management sets the tone for the Risk Management Goals and Objectives • Risk Manager is responsible to keep Senior Management Appraised • Corporate Statement on Loss Prevention • Meet with Senior Management monthly/quarterly whenever possible

  4. Department Structure( in the real world!) • The History of LTC’s is to have minimal staff for the Risk Management Department • Loss Prevention Director (2-3) • Claim Manager (1-2) • Risk Analyst

  5. Attacking the Problem • Focus must be on Prevention • Mitigate the Exposure • Become a Salesmen/Tell the story of the company. • Have Senior Management at the carrier road show! • Be creative: Self Insurance, Captives, swing plans etc.

  6. Will it get better? • Consolidated Lobby effort by the CEO’s • Tort Reform • Some states have cap’s on Punitive Damages • States are beginning to put limits on statue of limitations • It Just has to!

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