tag:blogger.com,1999:blog-5444812750097572762024-03-05T23:18:18.895-06:00BEANS BLOGJason Beans, Founder and CEO of Rising Medical Solutions, writes about the little things that spark: Business Success, Happy Employees and Customers, and Financially Fit Healthcare.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.comBlogger129125tag:blogger.com,1999:blog-544481275009757276.post-15003579205691705802015-09-22T13:57:00.000-05:002015-09-23T08:07:50.140-05:00"Drive-By Doctoring" a Reason for Value-Based Purchasing<span style="color: #6a6a6a; font-family: "Georgia","serif"; font-size: 10.5pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Here
is my latest Risk & Insurance article that blog readers may find
interesting. In it, I share some thoughts on dishonest practices in healthcare, and how value-based purchasing can eliminate them: <a href="http://www.riskandinsurance.com/drive-by-doctoring-a-reason-for-value-based-purchasing/" target="_blank"><span style="color: #6fa8dc;">"Drive-By Doctoring" a Reason for Value-Based Purchasing</span></a></span><br />
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<a href="http://www.riskandinsurance.com/drive-by-doctoring-a-reason-for-value-based-purchasing/" target="_blank"><span style="color: #56b0d6;">Read more at Risk & Insurance »</span></a>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-27215720250449798642015-07-22T14:35:00.000-05:002015-07-22T14:40:06.897-05:00When Someone Needs to be Right — What is the Other Side?That is correct. The other side of the coin is that someone else has to be wrong.<br />
<br />
Probably the most common and damaging threat to a healthy relationship is the need to be right. This represents the Ego, one of the three “Evil E's”– <a href="http://www.beans-blog.com/2011/08/evil-es-ego-defined.html" target="_blank">Ego</a>, <a href="http://www.beans-blog.com/2011/08/evil-es-envy-defined.html" target="_blank">Envy</a>, and <a href="http://www.beans-blog.com/2011/09/evil-es-entitlement-defined.html" target="_blank">Entitlement</a> – that I’ve written about previously. When someone always needs to be right, by definition, there is someone that always needs to be wrong. This may not seem to be of any great importance, until you realize that the person that is "wrong" also has their self-esteem damaged in many instances. The need to be right does far more than provoke arguments. The need to be right eats away at loyalty, trust, intimacy and eventually destroys relationships and teams.<br />
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<a name='more'></a>Most divorces result from small insults to the ego that build up over time. Indeed, most fights between strangers result from the very same thing. It is the small blows to our self-esteem, the indignities, and the little insults to our vanity, that cause a lot of the pain in the world.<br />
<br />
To me, the most annoying people to be around are the "know-it-alls." It is sad at times, because the "know-it-alls" often have decent knowledge on many subjects, but no one wants to listen to someone preach at them on every topic. I can’t help but think that they could just sit in a room with a mirror and they would get the same social interaction.<br />
<br />
So what does this mean?<br />
<br />
Fight the need to be "right." It is unimportant. Focus on the outcome that you want to achieve. Listen to other people as much as you speak. You may find there are things you had not thought of before. Changing someone's opinion does not happen like a car slamming into a wall. It happens like a car taking a gentle turn in a new direction.<br />
<br />
“Those who never retract their opinions love themselves more than they love truth.” <br />
― <a href="http://www.goodreads.com/author/show/313376.Joseph_Joubert" target="_blank">Joseph Joubert</a><br />
<br />
“It's as simple as this. When people don't unload their opinions and feel like they've been listened to, they won't really get on board.” <br />
― <a href="http://www.goodreads.com/author/show/11503.Patrick_Lencioni" target="_blank">Patrick Lencioni</a>, <a href="http://www.goodreads.com/work/quotes/22516-the-five-dysfunctions-of-a-team" target="_blank">The Five Dysfunctions of a Team: A Leadership Fable</a>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-4313575076300072812015-07-15T10:41:00.002-05:002015-07-16T14:47:43.651-05:00Highest Charging Hospitals...and We Can HelpOf the <a href="http://www.npr.org/sections/health-shots/2015/06/09/412964072/highest-charging-u-s-hospitals-are-for-profit-and-concentrated-in-florida" target="_blank">50 U.S. hospitals</a> with the highest charges, 20 operate in Florida (40%) and half are owned by a single, for-profit hospital system, according to <a href="http://content.healthaffairs.org/content/34/6/922.abstract" target="_blank">a study</a> published in the journal Health Affairs.<br />
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<a name='more'></a>A few interesting facts:<br />
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• The top 50 highest charging hospitals have average charges at 10 times what Medicare allows.<br />
• The average hospital charges 3.4 times what Medicare allows.<br />
• “For-profit” hospitals dominate the highest charging hospital list (49 out of 50).<br />
<br />
We have observed the trend in rising Florida costs, and found significant hospital price increases in markets where consolidation has occurred.<br />
<br />
Programs like Rising’s <a href="http://www.risingms.com/landing/Pages/Surgical-Cost-Containment.aspx" target="_blank">Surgical Care Program</a> (SCP) were created to address the hospital cost issue, particularly in Florida – our strongest state for SCP coverage.<br />
<br />
The whole goal of SCP is to eliminate the incentive for providers to charge more. All-inclusive, fair rates are negotiated upfront for surgical procedures, so providers’ “standard” charges are removed from the equation. Hospitals seem to be currently unable or unwilling to accept this model, so the program focuses on those procedures that can be performed in an ambulatory surgery center setting. In Florida, Rising provides SCP services in every major market—it will not solve every situation, but it can be a major factor in controlling skyrocketing hospital costs.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-40275114570776107442015-07-07T14:50:00.000-05:002015-07-07T14:54:02.630-05:00Study Reveals Benefits of a Working MomA recent <a href="http://qz.com/434056/working-moms-have-more-successful-daughters-and-more-caring-sons-harvard-business-school-study-says/?utm_source=atlanticFB" target="_blank">study by Harvard</a> has shown that daughters of mothers who work outside the home have very distinct career advantages later in life. In addition, their adult sons are more involved in household responsibilities and spend more time caring for family members.<br />
<br />
<a name='more'></a>There was a very large sample size, and the findings appear to be statistically valid:<br />
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• The daughters of working mothers are more likely to be employed than those of non-working mothers (4.5% more).<br />
• The working daughters of working mothers are more likely to be in supervisory roles vs. the working daughters of non-working mothers (33% vs. 25%).<br />
• The daughters of working mothers earn more than the daughters of non-working mothers ($5,200 per year higher).<br />
<br />
Over the years, I have worked with many mothers, some of whom have expressed concern or even guilt about having a career. I grew up with a working mother. She had several part time jobs going at any given time (as many as 4 as I recall) and was often out of the house. For me, I believe that seeing both of my parents work was a big factor in my work ethic and the successes I’ve had. I'm sure I missed some things that stay at home mothers offer, but here is the main point...working moms - you are setting a great example for your kids and this will only help them later in life. Do not beat yourself up.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-32168813908105086782015-06-30T13:45:00.002-05:002015-06-30T16:11:21.014-05:00Erosion of the California Work Comp Reforms & MPNRecently, we were researching the likely impact of an MPN (<a href="http://www.dir.ca.gov/dwc/mpn/dwc_mpn_main.html" target="_blank" title="Erosion of the California Work Comp Reforms & MPN"><span style="color: #56b0d6;">Medical Provider Network</span></a>) implementation for a client in California. The data can vary dramatically depending upon the client and region of the state.<br />
<br />
The California Workers' Compensation Institute (CWCI) issued a Research Report in early June regarding the impact of physician networks in California Workers' Comp. In the report, one thing jumped out even more than the MPN data. The recent reforms California has made are not working. The workers’ compensation system is eroding badly.<br />
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<a name='more'></a>First, though, a look at the MPN data. In almost every instance, network providers had better results than non-network providers:<br />
<br />
• Lower attorney involvement (17.4% for network versus 32.9% for non-network providers)<br />
• Faster claims closure rates<br />
• Average risk-adjusted medical payments were 16% less for network claims versus non-network claims 24 months post injury<br />
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The only area that was better for non-network providers was, surprisingly, opioid prescriptions (54.5% in network versus 30.4% out of network). Overall, it sounds good for the MPN (although the opioid data scares me).<br />
<br />
However, in almost all situations, the results of the period prior to the MPN were better than those during the MPN period:<br />
<br />
• Attorney involvement in indemnity claims went from 38.1% to 44.6%<br />
• Indemnity claim closure rates at 12 months decreased from 72.7% to 61.2% during the MPN period<br />
• The percentage of in-network claims with at least one opioid prescription went from 39.1% to 54.5% during the MPN period<br />
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What I can glean from the data is that while the MPN produces somewhat better results in the current California environment, the overall changes in the California workers’ compensation environment since 2009 are all negatively impacting results—far more than the MPN is improving them. This is not a trend anyone wants to see continue in the largest workers' compensation market.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-41924719100392245592015-06-03T10:16:00.003-05:002015-06-30T13:51:36.751-05:00ER Visits Rise Under the ACA<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;">One of the main selling points of the Affordable Care Act (ACA) was the contention that it would reduce the number of people going to the emergency room (ER) for non-emergency services. When a patient does not have health insurance, these costs are often subsidized by taxpayers. And even when there is insurance coverage, an ER visit is much more expensive (by 5-10 times) than a doctor’s office or walk-in clinic visit.</span></span><br />
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;"><br /></span></span>
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;">After the ACA’s first two years, it appears that the law has had the opposite impact on patient behavior—and ER visits are increasing. A lot.</span></span><br />
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<a name='more'></a><span style="color: #6a6a6a; font-family: Georgia, Utopia, 'Palatino Linotype', Palatino, serif; font-size: 14px; line-height: 19.6px;"><br /></span>
<span style="color: #6a6a6a; font-family: Georgia, Utopia, 'Palatino Linotype', Palatino, serif; font-size: 14px; line-height: 19.6px;">The root cause is theorized to be the lack of medical providers, combined with an increase in Medicaid and insured people. We already have a shortage of doctors, which is projected to be </span><a href="http://www.healthcarefinancenews.com/news/doctor-shortage-hit-90000-2025-report-says?mkt_tok=3RkMMJWWfF9wsRoiv63OZKXonjHpfsX56OwvWqC3lMI%2F0ER3fOvrPUfGjI4FS8pmI%2BSLDwEYGJlv6SgFQ7LHMbpszbgPUhM%3D" style="font-family: Georgia, Utopia, "Palatino Linotype", Palatino, serif; font-size: 14px; line-height: 19.6px;" target="_blank">46,000 to 90,000 by 2025</a><span style="color: #6a6a6a; font-family: Georgia, Utopia, 'Palatino Linotype', Palatino, serif; font-size: 14px; line-height: 19.6px;">. Many doctors will not accept Medicaid patients. The result is patients who now have coverage, but no doctor, so patients feel comfortable going to the ER for smaller issues.</span><br />
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;"><br /></span></span>
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;">According to a <a href="http://www.wsj.com/articles/u-s-emergency-room-visits-keep-climbing-1430712061" target="_blank">Wall Street Journal article</a> on a survey of 2,098 emergency-room doctors conducted by the American College of Emergency Physicians (ACEP):</span></span><br />
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;"><br /></span></span>
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;"><i>Many doctors don’t accept Medicaid patients because the state-federal coverage provides lower reimbursement rates than many private health-insurance plans. The waits for primary and specialty care by participating doctors appear to be leaving some Medicaid patients with the ER as the only option, according to ACEP.</i></span></span><br />
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;"><br /></span></span>
<span style="color: #6a6a6a; font-family: Georgia, Utopia, Palatino Linotype, Palatino, serif;"><span style="font-size: 14px; line-height: 19.6px;">This unexpected trend provides our industry with another metric to focus on going forward—reduced ER visits. It will be a good future indicator of the effectiveness of initiatives such as early intervention, case management and providers panels, as well as direction of care. These are the tools that will help us to avoid the unintended consequences of the ACA.</span></span>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-83147361732126273232015-05-27T15:06:00.000-05:002015-05-27T15:10:14.518-05:00The Joy of Hitting the NumbersI just started ANOTHER weight loss regimen.<br />
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It is tough for me. My lifestyle is inconsistent. I eat out and entertain A LOT. Last week, I had dinners planned for six nights in a row, not to mention business lunches. It takes a toll on the body. Still, I go up and down, and I need to figure out a way to maintain the same weight. I have young kids. I want to be around to know my grandchildren.<br />
<br />
<a name='more'></a>I jumped on the scale today and found that I dropped a good amount of weight yesterday. I have felt great all day. I'm motivated not to eat too much, and I’m dying to find the time to work out tonight after dinner.<br />
<br />
Last weigh-in, I realized my weight had gone up. I was discouraged and drained for a while afterwards. I had no drive to work out or eat less.<br />
<br />
It dawned on me how motivating success is. Hitting your goals and targets is self-fulfilling. You want to hit them again and again, and are excited when you do. Failure has the opposite effect. It is draining and demotivating. Failure begets more failure.<br />
<br />
The key is, simply put, to START. The most successful people I know make it a part of their DNA to hit their metrics and goals. If they have a deadline, they make it—no excuses. Over time, they crave and expect that success, and achieving it becomes easier and easier. And they exude the energy and confidence that only comes with success.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-4531802085914228252015-05-20T10:32:00.003-05:002015-05-20T10:34:34.647-05:00If You Can't Beat Them, Buy Them: Why Some Drug Costs Are Going UpI have done some analysis on pharmacy costs for clients recently. During that time, I noticed an increase in the cost per prescription for some drugs. Our pharmacy partners have shown the same trend in their data. This upsurge made no sense to me.<br />
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<a name='more'></a>Many drugs are coming off of patent, meaning generics of those drugs can now be manufactured. Historically, this has always driven down costs and “generics” was synonymous with “cheaper.”<br />
<br />
A <a href="http://www.wsj.com/articles/pharmaceutical-companies-buy-rivals-drugs-then-jack-up-the-prices-1430096431" target="_blank">Wall Street Journal article</a> may give us a clue as to why this is happening. It turns out the pharmaceutical companies are buying smaller companies or their rivals, and jacking up their prices. Since 2008, branded drug prices have increased 127%, versus an 11% increase in the Consumer Price Index (CPI).<br />
<br />
This is very similar to what is occurring in the hospital world. Hospitals are buying competing hospitals, medical groups and ambulatory surgery centers, and once they have established a virtual regional monopoly, they raise all the prices.<br />
<br />
If you can't beat them, buy them.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com1tag:blogger.com,1999:blog-544481275009757276.post-10764640479743786702015-05-14T13:40:00.003-05:002015-05-14T14:09:40.198-05:00When Yelp Reviews are Better than Hospital Rating Systems<span style="color: #6a6a6a; font-family: "Georgia","serif"; font-size: 10.5pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Here
is my latest Risk & Insurance article that blog readers may find
interesting. In it, I share some thoughts on the problems with Hospital Rating Systems and how employers and payers can get to meaningful provider quality measures: <a href="http://www.riskandinsurance.com/when-yelp-reviews-are-better-than-hospital-rating-systems/" target="_blank">When Yelp Reviews are Better than Hospital Rating Systems</a></span><br />
<br />
<span style="color: #56b0d6;"><a href="http://www.riskandinsurance.com/when-yelp-reviews-are-better-than-hospital-rating-systems/" target="_blank"><span style="color: #56b0d6;">Read more at Risk & Insurance »</span></a></span> Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com1tag:blogger.com,1999:blog-544481275009757276.post-16672810579533306162015-04-28T08:09:00.001-05:002015-04-28T10:40:16.017-05:00A Few More Observations on the ProPublica/NPR DebateLast week, I <a href="http://www.riskandinsurance.com/workers-comp-like-a-nasty-divorce/" target="_blank">shared my thoughts</a> on the hot debate ignited by the recent ProPublica/NPR series, “The Demolition of Workers’ Compensation.” While I focused on “big-picture” questions that we must ask ourselves as we examine the points raised, I did want to follow up with some additional commentary. The authors took on some important issues in their articles, but I must take issue with a number of the assumptions and conclusions they made in the process.<br />
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<a name='more'></a><strong>Fuzzy Math</strong><br />
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Let’s start with a macro-level analysis of the numbers. The article’s statistics do seem to support the “decimation” of the workers’ comp system. However, the basis for many of their assumptions was faulty math. For instance, in most cases, they use total paid wages as a denominator to indicate that the employees’ share of the benefits is declining, which is problematic for a number of reasons. Through improved technology and training, and the fact that many high-risk jobs have gone overseas, the number of work comp incidents per employee is dropping each year. An office job will have far less injuries than a manufacturing job, for example. The workplace is becoming safer.<br />
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So let’s say that 2 people out of every 100 were hurt before a safety improvement was made, and afterwards it dropped to 1 per hundred. With the exact same benefits, using their logic, the injured worker just had their benefits cut in half. This is obviously not true. The proper denominator is the number of injured workers, not total paid wages. With a state-specific system, there will obviously be anomalies and outliers among 50 different states, but on the macro-level we have seen wage benefits increase at around the rate of inflation for the last decade. This, to me, seems fair.<br />
<br />
<strong>The Profitability Puzzle</strong><br />
<strong></strong><br />
The article also cites the profitability of workers’ comp and how employers are lobbying to make more money through reforms. Yet according to the very studies they cite, employer costs increased 6.9% between 2011 and 2012, but the number of covered employees only increased 1.6%. That is a 5.2% cost increase per employee. That is much higher than the Consumer Price Index for 2012, and doesn’t correspond with a profit-taking climate.<br />
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A critical situation that the articles did raise, and that we as a society must address, is the shift of workers’ compensation liability to the taxpayer through Social Security Disability and Medicare/Medicaid. Perceived profits in the workers’ comp arena aside, this shift of liability to already heavily burdened programs is a critical issue. Candidly, Social Security and Medicare were designed as a program for the elderly. The expansion beyond the original scope into disability insurance is one of the primary reasons (that, and the fact that there was no adjustment for increased life expectancy) these programs will not be sustainable long term.<br />
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<strong>The Workers’ Comp Social Contract</strong><br />
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Workers’ compensation is a social contract to provide benefits to those hurt at work, regardless of fault. In the industrial revolution, someone injured at work could be promptly discarded. Unable to work, they often became beggars or homeless. This resulted in a backlash of lawsuits and strikes, putting companies and all jobs at risk. By covering medical care for those hurt at work, and providing some income, the deal was employees’ healthcare and basic income would be covered and unnecessary friction costs (e.g. legal fees) would be reduced in order to pay for these benefits. Frankly, it was designed for catastrophic injuries, and has expanded to encompass any bump, bruise or paper cut, but that is a different story. How has it worked? OSHA recently reported on the earning power of people in the 10 years after a workers’ compensation injury, finding that the average person makes 85% of their pre-injury wages. This is certainly not ideal, and obviously hard on many people, but candidly it is pretty amazing. From no earning power historically, to 85% over 10 years, is an impressive impact from our system. To a major extent, it is obviously working.<br />
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But as the ProPublica article points out, there are gaps in the impact on employees. Objective severe injuries (those medically visible) likely do not receive enough benefits and subjective (patient word only) ones are draining too much of the money available. An employee making high wages will never be able to sustain the same lifestyle, while some employees can make the same or even more by staying on workers’ compensation. States need to find ways to improve their systems to not only ensure that benefits are being fairly distributed to the most severely injured, but also make sure there is a safety net WITH a strong incentive to come back to work. People should not make as much not working as working. These are needed updates to the terms of this social contract.<br />
<br />
In our country, we have an expectation of fair play. So when something seems inequitable or one-sided, in written contracts or even in social contracts, it offends our sensibilities. One point where the ProPublica authors and I agree is that the CA IMR rules, where the reviewing provider can remain anonymous, is pretty un-American. Much like red light speed cameras, it is easier for the regulatory body, but that does not make it right. We have a right to face our accusers in the United States.<br />
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As I’ve said before, there are no easy answers. But we must not take short-cuts in defining the problems that we face, nor make blanket condemnations of state legislatures, insurers, or employers in a rush to judgment. The challenges facing the workers’ compensation industry today are very real, and frankly deserve nothing less than a measured, thoughtful analysis as to how to make it better overall for society.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com1tag:blogger.com,1999:blog-544481275009757276.post-85441025186425087642015-04-21T09:56:00.000-05:002015-04-21T15:06:32.166-05:00Workers' Comp: Like a Nasty Divorce<span style="color: #6a6a6a; font-family: "Georgia","serif"; font-size: 10.5pt; mso-ansi-language: EN-US; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Here is my latest Risk & Insurance article that blog readers may find interesting. In it, I share some views on the ProPublica/NPR series on "The Demolition of Workers' Comp" and the ensuing industry debate: <a href="http://www.riskandinsurance.com/workers-comp-like-a-nasty-divorce/"><span style="color: #56b0d6;">Workers’
Comp: Like a Nasty Divorce</span></a></span><br />
<br />
<span style="color: #56b0d6;"><a href="http://www.riskandinsurance.com/workers-comp-like-a-nasty-divorce/" target="_blank">Read more at Risk & Insurance »</a></span> Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-64513880917335266832015-03-10T15:13:00.000-05:002015-03-10T15:17:47.508-05:00Whether You Believe You Can or You Can't — You Are RightThe other day on the drive home, Mike Ditka was being interviewed on the radio. He had some good quotes. Commenting on teams or players, he quoted Henry Ford and said, “If you believe you can do something or you can’t do something, you are right.” <br />
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<a name='more'></a>Such a simple statement, and yet so profound.
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<br />
People accomplish amazing things every day. Those people believe they can do it. Others make excuses, and explain all the tough reasons why they are unable to accomplish something. Guess what? They do not accomplish those things. They were right.
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<br />
I get triggered when I hear the reasons why something “cannot” be done. Stop thinking about "why your team cannot do something,” and change it to "we will accomplish this, we just need to figure out how." It is amazing how a simple change in attitude can have a tremendous impact on outcomes in both your work and life.
Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-48337313670725573392015-03-04T13:49:00.000-06:002015-03-05T17:33:05.489-06:00Leadership Navigation: Resourcefulness vs. ProcessI recently went on a long boat ride to the middle of nowhere. The ship was very well run. Because of the tight space, everything had a clear place. Everyone knew their jobs well. Whether pulling into port or fishing, the crew all knew what had to be done to run the process. They fixed broken items. They cleaned, maintained, and kept the ship organized. They prevented and prepared for any future potential issues.<br />
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<a name='more'></a>When the boat was running in clear skies and calm waters, it was interesting to watch. Observing the captain, it was amazing how often he appeared to be doing close to nothing. The boat was on autopilot for long periods of time while he just sat there. The process and systems were so solid, he did not need to do much. Over-steering would have just made the ride rougher and less efficient.<br />
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When things got rough, it was a different story. When a storm blew in, or the waves were huge, or we hit dangerous waters with rocks and reefs to watch out for, he had to jump in and ensure that everyone was protected. There were rough nights where he and the crew did not sleep, in order to keep the boat and passengers safe.<br />
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This struck me as a good analogy for what a leader should be.<br />
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When someone is new to a job, or a company takes on new business, there can be periods of intense work. Leaders need to make sure everyone gets through it. However, that should not be the normal state. The goal of a leader should be to set up the process and empower their team so people do not need to work 18-hour days, nor live in a state of “fight or flight.” People will burn out if that state goes on too long. There is always the need for preparation, improvement, and maintenance, and the goal should be smooth sailing most of the time.<br />
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Of course there will occasionally be tough times. As a leader, I want to know that my team is WILLING to do whatever it takes to keep our clients happy and the company running smoothly in these times. I want to know that the long days and "do anything to succeed" drive are in someone, but they should strive to not have to use that drive frequently. Our goal should be to get through the tough times, and keep improving our systems so those tough times happen less and less often.<br />
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Process and resourcefulness. A leadership needs to navigate both.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-1594399305030366402015-02-26T15:08:00.000-06:002015-03-04T15:17:30.811-06:00Attitude—It Affects Surgery OutcomesA recent Mayo <a href="http://www.outpatientsurgery.net/surgical-facility-administration/patient-management/sad-truth-longer-faces-have-longer-recoveries--e-12-09-14" target="_blank">study</a> reinforces what we have always believed. A person's attitude and happiness really affect how quickly they recover.<br />
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<a name='more'></a><em>“The study, which looked at 431 colon cancer surgery patients, found that the 13% of patients who had quality-of-life scores below 50 on a 100-point scale were almost 3 times as likely to have serious post-surgery complications as those with scores of 50 or above. In turn, those with complications were hospitalized an average of 3.5 days longer than the others.”</em><br />
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Given that each day in a hospital ICU will cost thousands of dollars, the financial impact is dramatic.<br />
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Many in the industry include social risk factor scoring in claims risk assessment, but it would be compelling if quality of life score data was incorporated as well. The quote, "we can now measure quality of life like blood pressure" jumped off the page for me.<br />
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So in the context of our industry, this is great information and a great opportunity, but it is just as important to apply this to life. Attitude impacts everything in life, including health. Work on improving your own happiness and quality of life score. There is no limit on happiness.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-77491023820610486042015-02-09T12:23:00.001-06:002015-03-04T15:18:41.961-06:00Life Lessons from an Australian ComedianThis <a href="http://www.timminchin.com/2013/09/25/occasional-address/" target="_blank">Commencement Address</a> was delivered at a school in Australia by a graduate of the school who is now a well-known comedian. I want to watch this with my kids at a later point in life when they can understand some of the nuances. For now, I share some of these lessons with you.<br />
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<a name='more'></a><br />
<strong>Lessons from Tim Minchin’s Speech:</strong><br />
<ol>
<li>You do NOT have to have a giant DREAM. Instead, have passionate dedication to short-term goals. If you focus too far ahead, you won't see the shiny thing out of the side of your eye.</li>
<li>Do NOT seek happiness. If you think about it too much, it goes away. Keep busy and aim to make someone else happy.</li>
<li>It's ALL luck. You are lucky to be here, to have your background, your DNA, etc. Don't take yourself too seriously.</li>
<li>Exercise. Take care of your body. We are living longer. You are going to need it.</li>
<li>Be HARD on YOUR OWN opinions and beliefs. Be intellectually rigorous. </li>
<li>Be an AMAZING TEACHER in all aspect of your life. Share your ideas, rejoice in what you love, and SPRAY IT.</li>
<li>Define yourself by what you LOVE, and not what you dislike.</li>
<li>RESPECT people with less power than you.</li>
<li>DON'T RUSH. Don't PANIC. You do not need to know what you are going to do with your life yet.</li>
</ol>
Finally, leave it to humans to think that life has a purpose. There is one sensible thing to do with this empty existence: <strong>FILL IT</strong>. LEARN as much as you can about as much as you can. Take PRIDE in whatever you are doing. SHARE ideas. BE enthusiastic, "It's an incredibly exciting, wonderfully meaningless life of yours."<br />
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The summary loses a lot of the finer points of his message, so enjoy his <a href="http://www.timminchin.com/2013/09/25/occasional-address/" target="_blank">speech</a> sometime.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-61886982385820040292015-02-05T13:13:00.001-06:002015-02-05T13:25:31.573-06:00WAIT — "Why Am I Talking"I was at my daughter's school and there was speaker on child psychology. The emphasis was on the damage done to kids by over-parenting and over-managing their lives. It was very interesting. They asked adults about their favorite childhood memory. Only 20% named something involving a parent. It was usually about when they accomplished something new, took a risk, or were with friends being spontaneous. The moments when they were able to risk and grow were their top moments.<br />
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<a name='more'></a>Then they asked the least favorite time in childhood. The number one worst memory was the ride home after a sporting event—a parent telling them what they could do better, or what they missed. The parent was trying to help, but the child could sense the disappointment in every word.<br />
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One of my executive coaches found that the most disheartening thing I did to co-workers was when they showed me something new, I immediately went to feedback and ideas for improvement. Just like a parent after a game, trying to help, it was perceived as judgment. That is one reason that employee acknowledgement programs are so important to me, to Rising’s culture, and to corporate cultures in general —so we don’t forget to celebrate employees’ accomplishments and improvements in the moment.<br />
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It is interesting that as adults, two of the factors that most determine job satisfaction are Mastery (or Perceived Progress) and Autonomy (or Perceived Control).<br />
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Our motivations, and what drives us, do not change much over time.<br />
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An acronym referenced in the lecture as a tool to control the urge to over-parent, over-manage, etc., was WAIT, or “Why Am I Talking?” Let the child talk, and work through ideas and issues on their own, and only provide feedback when asked. It is a simple and profound takeaway for those of us with children, and at times, in business and life.<br />
<br />Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-2246856008097875912014-09-17T14:26:00.000-05:002014-09-17T14:35:50.055-05:00Workers' Comp - Feeding the Heroin Dragon<I'm now writing some articles for Risk & Insurance magazine that readers
of my blog may find of interest. Periodically, I will post links to them
here: <a href="http://www.riskandinsurance.com/workers-comp-feeding-heroin-dragon/" target="_blank">Workers' Comp - Feeding the Heroin Dragon</a>.><br />
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<a href="http://www.riskandinsurance.com/workers-comp-feeding-heroin-dragon/" target="_blank">Read more at Risk & Insurance »</a>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-32792555483697332582014-08-29T14:02:00.000-05:002014-08-29T14:02:24.232-05:00ALS Association, Don’t Waste this OpportunityI have a different perspective on charitable organizations than most. My first job at 13 years old was cold calling for charities. I would sit in a smoke-filled room dialing lists (phone book, past donors) for hours. I hadn’t hit puberty yet so most prospects would call me ma'am. I got more donations when they thought I was a female, so I ran with it. The owner of my company drove a new Ferrari. His 19-year-old son, who ran my office, also drove a Ferrari (one of his dad's old ones). They would ask the police or a charity in the town if they could raise money for them (say $10,000) and if they raised $40,000, they kept the difference. I started to see how easy it was to use people's good nature to raise money for purely selfish reasons and I developed a healthy distrust of charitable organizations.<br />
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<a name='more'></a>My mother was a college professor. I would listen to her colleagues talk about how they had a "research grant" and then they used this time off from teaching to take another job, write a book, etc. instead of conducting said “research.” So I also developed a cynical view of the ability to waste money on "research."<br />
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The Amyotrophic Lateral Sclerosis (ALS) Association now finds itself at a crossroads, with unprecedented donations and the influx of funds to make real headway with a fatal disease that is still largely a mystery.<br />
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ALS is more commonly known as Lou Gehrig's Disease. It is a horrible disease that slowly kills the body’s ability to use muscles. First the conscious muscle use goes (walking, lifting), then the sub-conscious (breathing, swallowing) and, finally, the eyes tend to go last. Imagine, your mind is fully sharp, but your body no longer listens or responds. It is like living in reverse of what you did as a baby. Nobody should have to endure this disease if we can solve it.<br />
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<a href="https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=lou%20gehrig%20speech" target="_blank">Lou Gehrig announced</a> his diagnosis July 4, 1939. In the 75 years since, little attention has been paid to the disease, and little progress has been made. Sadly, even the root cause is not really known.<br />
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A very good friend of mine has been stricken by this terrible disease. I am blown away by how, in just this year of his diagnosis, it’s a cause that has for the first time come to the forefront of society's attention with the <a href="http://espn.go.com/boston/story/_/id/11366772/in-als-fight-pete-frates-message-loud-clear-ice-bucket-challenge" target="_blank">Ice Bucket Challenge</a>. It feels like fate.<br />
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The amount of money raised by this challenge has been staggering. At the time I am writing this, the total raised for the ALS Association has been about 80 million, vs. 2.5 million at the same time last year. That is a 32 fold increase. This is amazing.<br />
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The ALS Association appears to be <a href="http://www.charitynavigator.org/index.cfm?bay=search.summary&orgid=3296#.U_y6rU0g-70" target="_blank">reasonably well run</a> based on the percentage of money received that actually goes into programs. In 2013, 72.3% of the funds raised went to the programs they support. This has nothing to do with how effective they are at running their programs or the quality of the research, but it is a start.<br />
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When I did <a href="https://www.youtube.com/watch?v=XgBXi8wFDhM" target="_blank">my Ice Bucket Challenge</a>, I challenged the association and researchers to use these funds wisely. The association has NEVER seen money like this. The research teams and association cannot be equippedto deploy it all right away, and in some ways, that is good. This windfall cannot be counted on every year, so it needs to be spent effectively.<br />
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We need to use this opportunity to start making progress on fighting this disease. There should be no big increases in salaries or overhead for the association. The association needs to make sure the researchers being funded are making progress or, if not, stop wasting money on the bad research paths and move it towards more promising paths.<br />
<br />
Really, any disease has only a certain number of possible root causes – genetic, environmental, viral, bacterial, nutritional, or physical damage (or some combination).<br />
<br />
This disease needs passionate researchers to attack the search for answers head on – perhaps people who have lost someone to ALS or people who may have a family risk. We need researchers who are dedicated to finding a cure today, not tomorrow. It's a very worthy cause, but I don't want to see the fight to cure ALS become people's life-long careers. We do not need more experts at "knowing the most about nothing." Let's work on it, solve it, and move on to fight other diseases. Or, at the very least, let's use this money to find root cause(s) so we can attack something specific.<br />
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This is an opportunity to change lives for the better. Let's make the most of it!Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com1tag:blogger.com,1999:blog-544481275009757276.post-14675672079596986212014-08-27T10:34:00.000-05:002014-08-27T11:00:30.363-05:00Hospitals Are Not Getting Safer<I'm now writing some articles for Risk & Insurance magazine that readers of my blog may find of interest. Periodically, I will post links to them here:<br />
<a href="http://www.riskandinsurance.com/hospitals-getting-safer/" target="_blank"><span style="font-family: Georgia;">Hospitals Are Not Getting Safer</span></a><span style="color: #666666; font-family: Georgia;">.></span><br />
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<a href="http://www.riskandinsurance.com/hospitals-getting-safer/" target="_blank">Read more at Risk & Insurance »</a>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-36673728875804080892014-08-21T15:00:00.000-05:002015-01-28T15:08:35.928-06:00Smiles and Hugs MatterThis is the <a href="https://www.youtube.com/watch?v=y6He0FWoFj0" target="_blank"><span style="color: #56b0d6;">heartwarming story</span></a> of a young man who started his own restaurant. That, in and of itself, is a nice accomplishment. Tim is his name. However, what makes the story <em>truly</em> amazing and touching, though, is that Tim has Down’s syndrome.<br />
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<a name='more'></a>Watching the joy he brings to serving his customers is an inspiration.<br />
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He is not staying in business by serving amazing food. As he says it, "food is food." It is all about the hugs, smiles and joy he gives to those that visit Tim's Place.<br />
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It is sometimes hard to keep in mind that the "personal" touch and joy we can give to our friends, co-workers, and customers is every bit as important as our "food."<br />
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Now…hug them and make great food, and you have something truly special.Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com1tag:blogger.com,1999:blog-544481275009757276.post-213563774330515522014-05-01T11:14:00.005-05:002014-08-27T10:35:01.929-05:00Exciting Advance in Treatment of Paralysis<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">I am sure many of you saw this, but I recently <a href="http://www.usatoday.com/story/news/nation/2014/04/08/paraplegics-stimulation-paralysis/7420027/">read about</a> one of the most amazing medical advancements I have heard about in years.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">A group of researchers recently restored movement to the legs of paraplegics. There were four participants in the research study, and all four of them regained movement.</span><br />
<span style="color: #666666; font-family: Georgia, 'Times New Roman', serif;"></span><br />
<a name='more'></a>According to the article, "By coursing an electrical current through the four men's spines, the research team...appears to have 'dialed up' signals between the brain and legs that were believed to have been completely lost."<br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">Can you imagine the impact on quality of life for thousands of people? Not just on those suffering from paralysis, but their families as well? What about the other nervous system disorders like ALS?</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">This also has the potential to be a large money-saver for the healthcare industry. Lifetime care needs would be minimized if the patients can be self-sufficient again.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">I have not been this excited by a breakthrough in a long time. I cannot wait to watch this evolve.</span>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-8430322172710289342014-02-27T15:53:00.000-06:002014-02-27T15:53:03.810-06:00Your Internal Clock - Morning Person or Night Owl?<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><a href="http://www.brainpickings.org/index.php/2012/05/11/internal-time-till-roenneber/">This article</a> was great. It addresses people and their various requirements for sleep.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">Each of us requires a different amount of sleep. Each of us also has a different internal clock. Biologically, we are programmed to be morning people or night owls. The combination makes us who we are.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"></span><br />
<a name='more'></a><span style="color: #666666; font-family: Georgia, Times New Roman, serif;">My wife and I loved this article for different reasons. She feels she needs eight hours of sleep no matter what. I am definitely wired to be a night owl. I feel smarter and more energized in the evening than in the morning. I have been explaining for years my inability to go to sleep early and how depressing it is to leave my almost euphoric state (where I am in the zone) at night.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">Turns out we are both right.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">The article talks a lot about social jet lag. It was interesting because it hit on what I feel at times. Society (work, commute, children, etc.) push me to an earlier and earlier start time (especially with a longer commute now), but my body is most awake and aware at night. According to the article, entrepreneurs and innovators tend to have later chronotypes which matches what I have seen in others.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">If you have a natural rhythm, work to live within it. Work with your teammates on schedule and family on preferred hours. You will be more effective and happy.</span>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-9068014400029372882014-02-19T12:59:00.000-06:002014-02-19T12:59:39.980-06:00Variability in Surgical Costs - Bill Goes Viral<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">This <a href="http://gma.yahoo.com/reddit-user-posts-55-000-hospital-bill-appendectomy-123853510.html">article</a> features a patient that posted their $55K appendectomy surgery bill online, and it makes some very interesting points.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">The University of California San Francisco researchers set out to find out how much an appendectomy cost in California. The price varied from $1,529 to $182,955. </span><br />
<span style="color: #666666; font-family: Georgia, 'Times New Roman', serif;"></span><br />
<a name='more'></a>The "recovery room" was over $7K for 2 hours. This room charge has always driven me nuts. For an inpatient stay, the patient already has a room they are paying to stay, sleep and "recover" in. That room rate does not get reduced when they are also charged for the "surgical room" to do the surgery, and then they throw in another room or two for "recovery" at massive hourly rates well beyond the cost.<br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">The hospitals cite issues caused by Medicare, Medicaid, and other government programs, stating "...a more straightforward pricing system is only possible when reimbursement from government-sponsored patients covers actual costs." They are flat out admitting they are cost-shifting to every other person who treats there to cover government plans. From what I've seen, many Medicare payments are well above what reasonable costs should be; however, there is likely some validity to this point as I'm sure some payments are unreasonable. </span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">Making pricing transparent (fair to all parties) is critical to the long-term survival of healthcare. Rising's <a href="http://www.risingms.com/Payers/WC/Pages/surgery-implant-cost-containment.aspx">surgical care program</a> resolves all of these issues, eliminating the variability, moving treatment out of the arbitrary hospital system, and paying providers a fair rate, quickly.</span>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0tag:blogger.com,1999:blog-544481275009757276.post-6968508472045474102014-02-13T13:55:00.000-06:002014-02-13T13:55:11.208-06:00Re-Injury Stats After Employees Return-to-Work<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">I found this <a href="http://www.workcompwire.com/2013/11/sarah-tayts-rtw-if-at-first-you-dont-succeed-try-try-and-try-again/?goback=.gde_1328307_member_5811146038093824000#%21">article</a> very interesting on Return-to-Work (RTW) in the workers' compensation environment. Most would agree that the goal is to get employees back to work at pre-injury status or maximum improvement (MMI). Easier said than done however, and there are varying levels of success.</span><br />
<span style="color: #666666; font-family: Georgia, 'Times New Roman', serif;"></span><br />
<a name='more'></a>The fact that <b style="color: #666666; font-family: Georgia, 'Times New Roman', serif;">one third of employees that return to work experience a re-injury within 6 months </b><span style="color: #666666; font-family: Georgia, 'Times New Roman', serif;">demonstrates the non-linear and difficult nature of getting someone back to work. It takes expertise, finesse, knowledge and persistence to achieve the best outcomes. The results and outcomes we see speak to the quality of our staff and great partnerships with our clients.</span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">This is a good read for anyone that wants a better feel for what's involved in case and claims management. </span><br />
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;"><br /></span>Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com4tag:blogger.com,1999:blog-544481275009757276.post-27127367183176877972014-02-05T13:38:00.002-06:002014-02-05T13:38:46.146-06:00The Doctor Shortage & Surgical Care<div class="ms-rtefontface-5">
<span style="color: #666666; font-family: Georgia, Times New Roman, serif;">There is
a looming crisis in access to care as noted in <a href="http://www.healthleadersmedia.com/print/PHY-298361/Alarming-Physician-Shortages-Lie-Ahead#!">this
article</a>. </span><span style="color: #666666; font-family: Georgia, Times New Roman, serif;">All of
the numbers point the same way. More people are getting coverage. More doctors
are retiring. Medicaid patients are already having trouble finding care.
Medicare and work comp are next. Accessing care is huge concern for many
of the payers I speak to. They know what is coming.</span></div>
<a name='more'></a><br />
<div class="ms-rtefontface-5">
<span style="color: #666666; font-family: Georgia, 'Times New Roman', serif;">Addressing
this issue is an ancillary benefit of Rising’s </span><a href="http://www.risingms.com/Payers/WC/Pages/surgery-implant-cost-containment.aspx" style="font-family: Georgia, "Times New Roman", serif;">surgical
care management</a><span style="color: #666666; font-family: Georgia, 'Times New Roman', serif;"> approach. By getting patients into good providers quickly,
there's a ton of value for all involved – patients, providers, and payers. This free market model has the potential to help providers get out of the insurance
mess, make more money, and stabalize business, while customers continue to get
access to quality care when they need it. It can start in workers' compensation
and auto, but I fully expect the model to move to even group health carriers or
private patients that need access to care.</span></div>
Jason Beanshttp://www.blogger.com/profile/14165525132518712173noreply@blogger.com0