Life & Health

One scenario is that when CMS/Medicare learns (and they will) it has been paying for work comp-related medical care, it will seek repayment from the claimant. The claimant, having spent the work comp settlement, will be unable to pay. Ultimately, it will be the employer and/or insurance carrier that will be held accountable.

Protecting people from financial responsibility for healthcare exposes them to risks by encouraging them to remain uninvolved in care decisions. Payment decisions cannot be separated from care decisions because true ownership requires control of both. It's critical that employers understand how plan design can encourage employees to be rationally informed.

Employers invest billions of dollars in health improvement and health management to try to control costs, yet many overlook an even larger opportunity to reduce benefit costs by aligning incentives with their business practices in ways that do not require additional investments. Ignoring such obvious opportunities leaves huge potential for business performance unrealized. We are pleased to include a video interview with Ms. Lynch with this article through a special media partnership with WRIN.tv.

One of the most blatant payer offenses today is an entire range of products with names like Mini-Meds, Discount Health Cards and Fixed Benefit Indemnity plans. In theory, the idea has always been to provide some healthcare coverage, however limited, to those who couldn't afford either a high-deductible health plan — or catastrophic only coverage. In most cases, especially the discount health cards, the benefits are either a small fraction of anything that could be considered useful — or simply non-existent.

Medicare has introduced some useful and very helpful tools to improve our health care system. Hopefully this will provide an improved foundation to make even more improvements to our health care system.

People now realize they need better information about which doctors to choose, information based on objective data, not vast lists of doctors' names and locations.

Data monitoring means applying technology and analytics to gain real-time intelligence and decision support in claims management. Moreover, data monitoring is the way to link analytics to operations, thereby making them actionable.

Sometime over the last few years, the baby boomers started to retire. This has created a complex double-edged sword for professionals. While these people are typically in need of legal and financial help, they are also more likely to suffer from some type of dementia. This problem is compounded by the fact that people typically wait until later in their life to perform complex transactions.