R&R Insurance Blog

Safely caring for others is a full-time commitment. R&R Insurance Services always recognizes the expertise and commitment of our health care customers and their employees, especially during Patient Safety Awareness Week – March 3-9, 2013.

Here are some ways to promote patient safety in your organization:

• Patient Safety Get Involved: available from Department of Veterans Affairs
• Medication Errors - Tips to Help Prevent Them: available from American Academy of Family Physicians
• Hand Hygiene Project: available Joint Commission Center for Transforming Health Care
• Fall Prevention: available National Council on Aging
• Video: Keeping Patients Safe From Falls

Information on Health Care Workers and Patient Safety

For any help with understanding Patient Transfer Safety, or the implementation of proven wellness and work comp techniques, please contact me, Maureen Joy, OTR, knowledgebroker, Occupational Therapist and Health Care Specialist at R&R Insurance Services.

A mandate of electronic on-board recorders (EOBR) seems closer than ever. Many carriers are staying ahead of the curve by installing EOBRs today. Not only are they seeing operational efficiencies and improved fuel management, there are compliance benefits:

1. Increase log accuracy
   - Typically a comparison of GPS to driver’s log needs to be completed. With an EOBR there is no need for the audit because it automatically ties vehicle movement to driving time
2. Form & manner violations are virtually eliminated
   - EOBRs prompt the driver to enter data or it is filled automatically – thus eliminated math errors when calculating total hours for the day or leaving fields blank (among the top four violations in the CSA Fatigued Driving BASIC)
3. EOBRs are present and current
   - Drivers with paper logs struggle to keep their logs up-to-date and keep them present if/when requested by an authorized party
4. Real time duty status helps reduce violations
   - Dispatchers and drivers can monitor drivers’ hours-of-service real time thus avoiding situations where drivers may be forced to drive when they are out of hours

Contact me to discuss how your company can increase efficiencies with the use of EOBRs and as important, how EOBRs can keep you compliant, reduce fines, and affect your premiums.

I though that this was only something that insurance companies did? Et tu, CMS? What makes anyone think that health care reform is going to deliver a better, more affordable health care reality? You don't have to "wait and see" for the federal government to build the house when the foundation they have been laying is already cracking! I am comforted to learn, though, that the government is doing everything it can "to avoid running out of money." Welcome to the risk business! That's why the states have insurance regulators! Who's regulating you?

Link to full article to Obama Administration Cuts Benefits to Those in High Risk

Medications have side-effects; so do health care laws. Is California's scramble to find a solution to the overwhelming provider access issue a sign of things to come? California may be different in many respects and the same could be said of any of the other 49 states, but on this issue, they do not stand alone. Their "solution", however, may create some new side-effects of its own.

The LA Times article cites the following:

Problem: There aren't enough doctors to treat a crush of newly insured patients.

California Lawmakers' Solution: Fill the gap by redefining who can provide healthcare. They are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure. Read more...

I found a great article about disaster planning for physician practices, and an even better comment at the bottom of the article I felt worth sharing. It's from Bear Rock Electric located in Maryland. They sum up some concerns that practice managers should think about in a nice, concise way. I am also including a link to the whole article from MDNews.com about power outages and it's affect on practice management: Small practices and clinics have to prepare, too. This really applies to all health care facilities - not just small physician practices. Assisted Living, Nursing homes, Urgent Care Centers, CBRF.

Here's the comment from Bear Rock Electric:

Bear Rock Electric services the Maryland community for emergency preparedness and power outages and we thank you for such an insightful article. Medical processionals do face very unique situations during storms and power outages and we couldn't agree more that a plan should be in place. Not only do they have the same problems as anyone else, but they also face the tremendous disruptions caused by hours or even days of long nuisance outages.

We ask them to think about the following questions:
•What if you're in the middle of an office procedure?
•What happens to the day's schedule and the rest of the week?
•What about your refrigerated supplies?
•Where will your patients go? Does the ER have your specialty or dental facilities?

Standby power solves all these problems and if they own their building, it also protects that building from a devastating mold infection that could render it uninhabitable or require expensive remediation. It only takes 72 hours for black mold to get started behind sheet rock.

Interesting poll results from a recent MD News.com physician poll.

Q: Would knowing the cost of a diagnostic test to the insurance company and the patient affect your opinion about the need for the test?

40 % Yes. I would try to select the least expensive testing available without compromising patient care.

33 % Maybe. I would at least weigh the pros and cons associated with more expensive diagnostic methods.

27 % No. Pricing has absolutely no place in the practice of medicine. My role is to diagnose patients regardless of costs.

Obviously, there is still a long journey ahead when it comes to physician networks, partnering with care givers that provide health care for your employee base, and educating the impact not only to employers and their employees - looks like there is more need for education on the provider side as well.

For any help with understanding health care consumerism, lowering health care costs through the implementation of proven wellness and work comp techniques, please contact me, Riley Enright, knowledgebroker and health benefits specialist at R&R Insurance Services.

With the recent downturn in the economy, business focus has turned from safety to more “important” financial objectives. The truth of the matter is that poor safety initiatives could end up being the most costly part of the year for an organization. The associated costs of an ineffective and poor safety program, such as claims cost, insurance increases, loss of production, damaged equipment, potential loss of business, and market impact make it all the more important for organizations to invest in the value of safety. It is an investment in the most valuable assets you have: your people and your reputation.

A proactive approach to safety can result in a 52% reduction in incident rates over a several year period. Some ways to increase safety include identifying risky driving behaviors, defensive driver training, reinforcing driving skills, and an injury & illness prevention program for employees.

The first step to implementing a plan is to identify the correct partners. Education, equipment manufacturing and technology partners can provide resources to identify cause of incidents, educate skills, and develop processes to avoid incidents. Commitment starts with personal ownership, commitment by each employee, and reinforcement by managers.

As a R&R knowledge broker, I welcome the opportunity to discuss ways to work together in building a cost effective safety plan or enhance your current processes. Contact me to get started!

In January I attended the Economic Trends Seminar presented by the Biz Times. Speakers included Mike Knetter, PhD - President of UW Foundation, Gerry Frye - President The Benefit Services Group, Peter Gottsacker - President of Wixon, Larry Borgard - President & CEO Integrys Energy Group, and Jeff Yabuki - President & CEO Fiserv. Each gentleman spoke to his specific industry, where it was last year, and predictions for 2013. There was a lot of information shared - too much to put in to one article!

Following are my notes and predictions made by the presenters:

• Stock Market will be up 10%
• Real GDP will grow by 2.2%
• Unemployment will be 7.8%
• Inflation will be 2%
• Healthcare costs will increase
• Commodity costs will increase
• Food Stocks will underperform the market
• The Carbon tax is real
• In the future more alternative natural gas vehicles will be sold than alternative electric vehicles
• The economy will exit 2013 stronger than it was in 2012

Please contact me if you have questions on any of my observations. Have a successful and purposeful 2013!

Not long ago, I can recall when it seemed like only the larger, national, insurance carriers specializing in trucking insurance would take into consideration SafeStat Scores in underwriting a trucking Risk. This included carriers like Great West, Northland, Lancer, Sentry, Carolina Casualty, Continental Western, etc. At the same time very few, if any of the underwriters working for the smaller regional carriers, at least in the Upper Midwest, knew where to look for this information let alone how to interpret it. When I speak of smaller regional carriers, I’m talking about companies like Acuity, Integrity, Secura, General Casualty, etc. From my standpoint as a trucking insurance agent, this was a good thing, the less they knew, the easier it was for me to place a piece business with them especially business that was marginal from a SafeStat standpoint but that may have had good loss experience. Well, those days are over thanks to the Central Analysis Bureau.

Now, every insurance carrier we access specializing in trucking insurance subscribes to what is termed a "CAB Submission Report" from the Central Analysis Bureau. To put it in a nutshell, this is a report available by subscription. They gather their information from all of the various FMCSA websites including SAFER, SMS, and Licensing and Insurance websites. They take that information and put it in a nice easy to read report focusing on key points for underwriting review. Even the novice trucking underwriter will pick up on problem areas. In addition to pointing out all of the relevant information, the underwriters can sign up for alerts and be made aware if there are any serious violations or changes in scores within a particular category of SMS scores. For the first time in my career, I have actually had companies cancel policies, not because of loss problems, but strictly because of a conditional ratings and SMS scores.

1. How are the underwriters using this information? I asked some of my underwriters this same question and here are some of my responses:
   - As an initial screen of eligibility
   - To verify radius of operation and type of operation whether contract carrier, common, or broker
   - Type of commodities hauled
   - Prior insurance carrier information (do you shift your insurance frequently?) - also number of cancellations, etc
   - CSA rating
   - Out of Service - how often and why
   - Number of trucks and total mileage - is this trending up, down, or stable
   - Any hazmat indications and who are they shipping for? They will be looking for travel in higher population density areas.
2. Pricing, higher CSA scores translate into higher rates; lower CSA scores translate into more favorable rates.
3. Underwriters will use this report to see if there are any other operations that had authority at the same address. They're checking to see if there were any chameleon carriers operating under a different name. They will check the vehicles listed on the inspection reports with those submitted on the equipment list.

Insurance underwriters are now using this as one of the tools in their tool box. Some companies are even imposing specific scoring criteria. It’s more important now more than ever to be constantly trying to improve these scores. As Will Rogers said, “even if you’re on the right track, you’ll get run over if you just sit there.” In these economic times, it’s more important than ever to partner with people who can dramatically affect your bottom line. This is done through knowledge, resources, and ingenuity. Contact me to discuss how we can work together to lower your risk and save you money.