[December 10, 2012] |
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Financial Analytical Tools that Identify and Remediate Insurance Coverage Gaps Will Play a Critical Role in Helping Healthcare Reform's Accountable Care Organizations Succeed
BRIARCLIFF MANOR, N.Y. --(Business Wire)--
Since the Patient Protection and Affordable Care Act (PPACA) raised the
profile of Accountable Care Organizations (ACOs) in 2009, there has been
rapid expansion among healthcare providers, but few have addressed ACOs'
unique liability issues until now. USI Insurance Services ("USI") has
found that traditional insurance policies are not designed to address
the complexities inherent in ACOs, and this could result in devastating
coverage gaps from uncovered claims and significant litigation that
could exhaust policy limits. As a result, unique financial analytical
tools that can identify and remediate coverage gaps are quickly gaining
traction in the marketplace.
Rob Meyers, USI's senior vice president, property & casualty, said, "We
understand there is no 'one size fits all policy', which is why USI
created an enterprise risk management approach that places the issues
for ACOs front and center. This includes discussing a breadth of
relevant topics that other firms are not asking and evaluating each
requirement in the context of which analytical tool can yield the most
refined, accurate answer. Following this analysis and a rigorous
exposure assessment, we present a depth of solutions that address those
concerns and demonstrate how the solution translates into meaningful,
measureable results."
USI estimaes there are more than 300 ACOs in the U.S., and many more on
the drawing boards. Jeff Levy, vice president for the USI Southwest
region, said, "The insurance industry has begun evaluating potential
risk solutions for these healthcare organizations. However, for these
tools to work, they need to be able to correctly identify those new
exposures that may not be covered under a traditional insurance policy
and then obtain adequate limits of liability - all while keeping the
cost of coverage affordable. This is particularly crucial as most
providers are struggling with assuming the additional financial risks
associated with adopting the ACO model."
USI's ACO Shield is a suite of financial analytical tools supported by a
consultative process that guides a leadership team to better
understanding the exposures arising out of an ACO's structure, plan and
operation. The systematic approach that distinguishes ACO Shield is
designed to fit multiple permutations of this healthcare delivery model,
including ACOs organized around the Centers for Medicare and Medicaid
Services model of integrated care delivery, and many other private
sector models. In addition to creating greater transparency, this
solution fine-tunes insurance coverages to address liability needs in
management, employment, managed care and malpractice.
Phil Dyer, senior vice president of healthcare management services for
the USI Northwest region, said, "The concept of ACOs is gaining a great
deal of attention in the reshaping of American healthcare delivery, and
traditional, off-the-shelf insurance products are limited in their
ability to fully address these new risks. Whether an ACO relies on an
open or closed architecture, is hospital-centric or physician
group-centric, USI's ACO Shield offers a meaningful solution for
important risk issues impacting these healthcare organizations."
About USI Insurance Services
Founded in 1994, USI is a leading distributor of property and casualty
insurance, employee benefits and specialty products throughout the
United States. Headquartered in Briarcliff Manor, NY, the Company
operates out of nearly 100 offices in 26 states. As the third largest
privately-held insurance broker in the nation, USI combines its
client-centric culture at the local level with leading edge technical
resources on the national level. Visit USI at www.usi.biz
to learn more.

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