– by Dennis Passovoy –
In recent years there have been countless medical advances that have brought treatment to thousands of medical conditions. We now have much greater insight into the appropriate care and treatment of individuals with far greater reach and positive medical outcomes. As a society, we have become quite adept at treating a multitude of disease states, reducing both the cost associated with treatment and the ill effects on the individual. However, through all of these advances, the primary focus from a medical perspective has been to treat the patient after a medical event, and after the associated expenses have been incurred by the underlying health plan. Enter Medical Risk Management.
Medical Risk Management is the practice of identifying, assessing and prioritizing the medical risk in a group prior to a medical event taking place in the life of one of the members. Recent technological advances in data analytics coupled with 10+ years of clinical work in the field have enabled enormous strides in our ability to predict who the future high cost claimants will be with a high degree of accuracy. With the right data, the right tools and the right clinical resources, we have three times the industry standard capability to predict medical risk.
The greatest fallacy of health care is believing that skyrocketing costs are driven by how sick and old your workforce has become and that better access to medical care will reduce costs and improve quality. Actually, the majority of medical costs are driven by a small fraction of your workforce, and that group changes almost every quarter. The biggest impact we can have on both our plan premiums and the health of our employees is the early identification of a potentially catastrophic medical episode and then to intervene with an application of appropriate care. Medical Risk Management takes a plan sponsor from being a “consumer of health care” to being a “responsible manager of his or her medical plan”.
Dennis Passovoy is the president of RFG, Inc., an Employee Engagement Advisory firm in Austin, TX that believes in inspiring and harnessing the limitless power of individuals to create unstoppable organizations. He can be reached at dpassovoy@rfg.com.
