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Determining Future Medical Exposure – Life Care Plans + Cost Projections

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Determining Future Medical Exposure Presentation

Determining future medical exposure was the next presentation.  Presenters – Alisa Cornetto and Carmen Bullard, Concierge Medical and Risk Consultants

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Hire someone certified due to Daubert  rules and also that have proper credentials

Review CV’s of life care planners and other consultants

Definition of Chronic Pain – daily pain that has lasted six months to on year after the original pain incident

15% – 20% of the population has chronic pain

Cost of Chronic pain (annually):

  • 2003 – $25 billion
  • Present – exceeds $40 billion

Pain:

  • 25% of all sick days = $50 million
  • 80% of all physician visits

Definition of A Life Care Plan:

A life care plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis and research which provides an organized concise plan for current and future needs with associated costs, for individuals who have experienced catastrophic injury or have chronic care needs

Goals

  • Provide health education to the interested parties, when appropriate.
  • Develop accurate and timely costs information

Functions

Collect data that is systematic, comprehensive, and accurate

Research

  • Use reliable sources
  • Sources that are readily available to the client

Considers 

  • Duration of care
  • Replacement frequency
  • Appropriate use by client
  • Care is reasonably available

MSA Analyis and Life Care Plan are two very different things

 Life Care Plan needs to be collaborative

Medical Cost Projections are not the same as Life Care Plan

No governing body for Medical Cost Projections

Goal is the patient

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Table of Contents

James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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