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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 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 • Obtaining proper insurance for reasonable price • Runaway litigation cost • Proper staffing for Risk Management Department • Turnover effects quality of care
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
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
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.
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!