I was privileged last week to spend a few days in Charlotte, NC with Arrowpoint Capital. Julie Fortune, Chief Claims Officer, and her team put together a Medical/Legal Summit in hopes of educating, coordinating, and enhancing the medical management and litigation management of their claims. They pulled together about 120 people including internal claims adjusters, litigation managers, outside vendors, outside legal counsel (from many different jurisdictions), medical experts, and even invited an Arrowpoint actuary (all joking aside, Rich gave a great presentation on the importance of historical cost data to actuaries).
Topics focused on chronic pain management, appropriate use of prescription drug therapy, alternative treatment pathways, Medicare and secondary payment rules, case management, proper use of investigative services, changing rules and regulations at the state level, and how best to use clinical resources like doctors, nurses, and pharmacists.
And this wasn't summer camp, folks. This was an intense conference that started promptly at 8:00 am each morning and lasted well into the night as attendees worked on a rather complicated case study. The Arrowpoint leadership team divided their employees and all of the outside attorneys into eight case teams and had each team present at the end of the conference, incorporating all that they had learned during the course of the conference. And everyone had to present. No free riders. You had to pay attention and really show that you "got it".
Arrowpoint is managing run-off claims, but every payer has a subset of claims that require high levels of coordination amongst many parties, internally and externally, in order to achieve positive outcomes (clinically and legally). And one of my key take-aways from the Summit is how closely those two strategies - clinical and legal - need to be linked.
Does your organization pull together an annual Medical/Legal Summit? If not, why not? This is the sort of education and coordination our industry needs.
Let's get to work.
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