Auto Insurance Does Not Mean The Same Things To People In The Financial Profession

It is amazing how much literature has been written about the car insurance business online. The main approach in use by the bulk of the writings is in the direction of selling car insurance, rather than offer it in the proper context of insurance product or ‘a product to protect your assets and wealth.’ That is why when searching for the phrase ‘auto insurance’ a large number of websites emerge with the ‘selling’ phrases like affordable auto insurance, or cheap auto insurance or low cost auto insurance.In the early part of 2011 and according to Google AdWords there were 8,100; 74,000; 9,900 monthly searches for the above key phrases, respectively. On the other hand, there were only 110 searches for the phrase ‘reliable auto insurance’, 170 searches for ‘quality auto insurance’, and 8,100 for ‘top auto insurance companies.’ It is rather easy to conclude that most of the searches on line are about price, not quality of insurance.A basic principle in marketing is to understand what people ‘want’ and design and package your product or service to meet what the folks want. Looking at those numbers we can tell that most people want cheap auto insurance. As a marketer, if you design any campaign without considering that analysis you may eventually flunk the marketing tests, close your website and go do something else.So what’s the difference between auto insurance polices? From a ‘financial planning viewpoint’ car insurance comparison should never be based on price only, and perhaps most people agree that cheap insurance is not necessarily the best car insurance. But what most people do not know is that an insurance policy with the best rated company may also be one of the most problematic contract. An auto insurance policy should be compared in reference with three factors:1. Price: of course the cheaper the better.2. Company Rating: Non standard companies are more flexible than their standard or preferred counterparts with regard to past violations found on the MVR activities of the drivers and the credit score of the car insurance applicants. However, non standard companies are harsher than others in customer service and paying claims. Most of complains come from non standard insurance companies. While preferred companies do not hesitate to quickly pay for smaller claims suck as seven or eight thousand dollars claim, or even little more; all companies from top to bottom will try to examine the application to see if they have to or do not have to pay a $100,000 claim.3. Liability Limits. This is the most ignored, least understood, but is the most important aspect of the policy which affect customers during time they need the insurance. It measures how much protection you have in the event you get sued. A professional financial advisor will never ever sell you an auto insurance policy at low limits if he/she has enough information that you and your spouse have enough wealth to be sued for in the event that you or a family household member cause a major auto accident and your car insurance pays the maximum on the policy which turns out not to be enough.There are many insurance policies sold with superior insurance companies at the lowest liability limits mandated by the state. In the State of Illinois these limits are 20/40/15, which means that in the event you cause an accident that is your fault and you get sued by others, then your company will pay to others on your behalf no more than $20,000 for bodily injury for one person, no more than $40,000 for bodily injury for all other people in the accident, and a maximum of $15,000 for any and all property damage you case in that accident. If you are a business owner and you cause a major accident resulting in a unbeaten lawsuit of $300,000 and your insurance company maxed the payment on the policy and paid $20,000, the difference of $280,000 will have to come from your own money!Financial Planners and Auto Insurance Marketers Are Not in HarmonyFinancial planners are not in harmony with insurance marketers about the weight that needs to be placed on limits of liability in auto insurance. Marketers like to stress the aspects of price and company rating, while financial planners like to stress the importance of liability limits first, then company rating second, and perhaps price at a later stage.Although financial planners and auto insurance marketers have the common goals of maximizing their earnings while providing their services, the scope of their operations is different. Auto insurance marketers make their money by selling as many polices as they can have. The marketer does his best to make as many sales as possible, hence making small amount of money on too many policies sold. Financial planners work differently as they try to make big money from each of the few number of customers they have. Selling an auto policy is not the primary concern of a financial planner, but for him or her auto insurance is one of the fundamental subjects of the financial planning process.Car insurance agents look at auto insurance as a way to protect the car itself in the event of theft, fire or another loss, besides the fact that it’s the law. Financial planners look at auto insurance as an integral part of their clients risk management process. To the financial planner an auto policy is not to repair the car in the event of loss, but is mainly about protecting the assets and wealth of the insured, especially against potential lawsuits.Some auto insurance marketers would even suggest to cut down on liability insurance as a way to save money. No sound financial planner will ever make such a suggestion. No way!When does height matter?How high your liability limits should be is the main issue that should prevail when you buy car insurance. You probably need only the minimum liability limits mandated by the states if /when(1) you shopped for higher limits and could not afford it, (2) your current assets or wealth is not big enough to expose you to further lawsuits in the event of at fault auto accident. (3) you are a high risk driver where no one else wants to insure you except at the minimum limits. But, if you have certain amounts of assets and wealth, or is expected to have sizable assets or wealth, then you need to worry about the height of your liability limits.What about if you are not wealthy with plenty of assets? Even for people with little or no wealth, the height of liability limits should be much of a concern to them. This is due to the fact that liability insurance contains certain coverages to pay for your bodily injuries in the event that you get hit by a vehicle that is legally uninsured, or is insured but the insurance on that vehicle was not enough to cover your bodily injuries. According to the Insurance Research Council, approximately 15% to 17% all drivers in the United States are uninsured. Coverages for Uninsured Motorist (UM) and Underinsured Motorist (UIM) vary from states to states with regard to their mandatory status and limit amounts. In Illinois UM is mandatory at the limits of $20,000 for bodily injury per person and $40,000 for bodily injury per accident. Underinsured motorists coverage is not mandatory in Illinois but insurance companies must offer it to clients for policies issued with liability over the state limits. Clients can still reject to have higher uninsured/ underinsured motorists but it must be in writing. As you can see, your liability only policy provides coverage for your bodily injuries, and making sure that you have high limits on both liability, UM and UIM can have tremendous effect on your life.

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The New Approach to Healthcare Enterprise Information Management – EHR, EMR, EIM

Introduction -The lack of a healthcare specific, compliant, cost-effective approach to Enterprise Information Management (aka EIM) is the #1 reason integration, data quality, reporting and performance management initiatives fail in healthcare organizations. How can you build a house without plumbing? Conversely, the organizations that successfully deploy the same initiatives point to full Healthcare centric EIM as the Top reason they were successful (February, 2009 – AHA). The cost of EIM can be staggering – preventing many healthcare organizations from leveraging enterprise information when strategically planning for the entire system. If this is prohibitive for large and medium organizations, how are smaller organizations going to be able to leverage technology that can access vital information inside of their own company if cost prevents consideration?The Basics -What is Enterprise Information Management?Enterprise Information Management means the organization has access to 100% of its data, the data can be exchanged between groups/applications/databases, information is verified and cleansed, and a master data management method is applied. Outliers to EIM are data warehouses, such as an EHR data warehouse, Business Intelligence and Performance Management. Here is a roadmap, in layman terminology, that healthcare organizations follow to determine their EIM requirements.Fact #1: Every healthcare entity, agency, campus or non-profit knows what software it utilizes for its business operations. The applications may be in silos, not accessible by other groups or departments, sometimes within the team that is responsible for it. If information were needed from groups across the enterprise, it has to be requested, in business terminology, of the host group, who would then go to the source of information (the aforementioned software and/or database), retrieve what is needed and submit it to the requestor – hopefully, in a format the requestor can work with (i.e., excel for further analysis as opposed to a document or PDF).Fact #2: Because business terminology can be different WITHIN an organization, there will be further “translating” required when incorporating information that is gathered from the different software packages. This can be a nightmare. The gathering of information, converting it into a different format, translating it into common business terminology and then preparing it for consumption is a lengthy, expensive process – which takes us to Fact #3.Fact #3: Consumers of the gathered information (management, analysts, etc) have to change the type of information required – one-off report requests that are continuously revised so they can change their dimensional view (like rotating the rows of a Rubik’s cube to only get one color grouped, then deciding instead of lining up red, they would really like green to be grouped first). In many cases, this will start the gathering process all over again because the original set of information is missing needed data. It also requires the attention of those that understand this information – typically a highly valued Subject Matter Expert from each silo – time-consuming and costly distractions that impact the requestor as well as the information owner’s group.Fact#4: While large organizations can cope with this costly method in order to gather enough information to make effective and strategic business decisions, the amount of time and money is a barrier for smaller or cash strapped institutions, freezing needed data in its silo.Fact #5: If information were accessible (with security and access controls, preventing unauthorized and inappropriate access), time frames for analysis improve, results are timely, strategic planning is effective and costs in time and money are significantly reduced.Integration (with cleansing the data, aka Data Quality) should not be a foreign concept to the mid and smaller organizations. Price has been the overriding factor that prevents these tiers from leveraging enterprise information. A “glass ceiling”, solely based on being limited from technology because of price tag, bars the consideration of EIM. This is the fault of technology vendors. Business Intelligence, Performance Management and Data Integration providers have unknowingly created class warfare between the Large and SMB healthcare organizations. Data Integration is the biggest culprit in this situation. The cost of integration in the typical BI deployment is usually four times the cost of the BI portion. It is easy for the BI providers to tantalize their prospects with functionality and reasonable cost. But, when integration comes into play, reluctance on price introduces itself into the scenario. No action has become the norm at this point.What are the Financial Implications for a Healthcare Organization by maintaining the status quo?Fraud detection is the focal point for CMS in their EHR requirements of healthcare organizations, Let’s take a deeper, more meaningful look at the impact of EHR. Integration, a prominent component of Enterprise Information Management in the New Approach, brings data from all silos of the organization, allowing a Data Quality component to verify and cleanse it. The next step would be to either send it back to its originating source in an accurate state and/or put it into a repository where it will be accessible to auditing (think CMS Sanctions Auditors), Business Intelligence solutions, and Electronic Health Records applications. With instantly accessible EHRs, hospitals and their outlying practices can verify patients with payors, retrieve medical histories for diagnosis and treatment decisions, and update/add patient related information. What impact to treatment does a review of a new patient’s history have for both patient and practice? Here are some elements to consider:1. Diagnosis and treatments that are based on previous patient dispositions – reducing recovery time, eliminating Medicare/Medicaid/Payor denials (based on their interpretation as to fault of the practitioner in original treatment or error incurring additional treatment).2. Instant fraud detection of patients seeking treatment for the same malady across the practices within the organization. Prescription abuse and Medicare fraud saves money not only for the payors, but the healthcare organization as well.3. The Association of Fraud Examiners states that 9% of a Hospital’s revenue each year is actually lost to fraud.One overlooked but common impact is in the cost of managing patient records. Thousands of file folders in storage with new instances being added each time a new patient enters into the system. Millions of pieces of paper capturing patient information, payer data, charts, billing statements, and various items such as photo copies of patient IDs, are all stored in those folders. The folders are then stored in vast filing cabinets – constantly being accessed by filing clerks, nurses, practitioners and assorted staff. Contents of the files being misplaced or filed incorrectly. Hundreds, if not thousands, of square feet being consumed for storage. The AHA projects that an enterprise leveraging Electronic Health Records will recover no less than 15,000 square feet of usable space. That space can be used for additional services, opening up new channels of revenue. The justification is easy: how much would it cost the hospital to build out 15,000 square feet for a new service? The average cost to build space utilized for Health Services is $65 per square foot, or $975,000 total. An EIM solution through the New Approach would be less than 20% of that. Not only has the EIM solution reduced dollars lost to fraud, lowered the days for payor encounters to be paid, increased cash on hand, but it will also open up new services for the patient community and revenue back to the healthcare organization.Electronic data is costly in its own way. Bad aka “Dirty” data has enormous impact. Data can be corrupted by error in data entry, systems maintenance, database platform changes or upgrades, feeds or exchanges of data in an incompatible format, changes in front end applications and fraud, such as identity theft. The impact of bad data has a cause and effect relationship that is pervasive in the financial landscape:1. Bad data can result in payor denials. Mismatched member identification, missing DRG codes, empty fields where data is expected are examples of immediate denials of claims. The delay lowers the amount of Cash on Hand as well as extends the cycle of submitted claim to remittance by at least 30 days.2. Bad data masks fraud. A reversal of digits in a social security number, a claim filed as one person for the treatment of another family member, medical histories that do not reflect all diagnosis and treatments because the patient could not be identified. Fraud has the greatest impact on cost of delivering healthcare in the United States. Ultimately, the health system has to absorb this cost – reducing profitability and limiting growth.3. Bad data results in non-compliance. CMS has already begun the architecture and deployment of Sanctions Data Exchanges. These exchanges are a network of data repositories that are used to connect to health healthcare system, retrieve CMS related data, and store it for auditing. The retrieval will only be limited to the patient encounters that show a potential for denial or fraud, so the repository will not be a store of all Medicare and Medicaid patient encounters. But, the exchange has to be able to read the data in its provider data source in order for CMS to apply certain conditions against the information it is reading. What happens when the information is incomplete or wrong? The healthcare system is held accountable for the encounters it cannot read. That means automatic and unrecoverable denials of claims PRIOR to an audit, regardless of claim legitimacy.The Price Fix by Big Box Healthcare Technology FirmsAre the major healthcare software and technology vendors (Big Box) price gouging? Probably not. They are a victim of their own solution strategies. Through acquired and some organic growth (McKesson, Eclipsys, Cerner, etc), they find their EIM solutions lose their agnostic approach. This is bad…very bad for health systems of all sizes. With very few exceptions, the vast majority of healthcare organizations DO NOT BUY all applications and modules from a single stack player. How could they? Healthcare systems grow similarly – some organic, some through acquisition. When a hospital organization finds over the course of time, an application that is reliable, such as a billing system, there is tremendous reluctance to remove a proven solution that everyone knows how to use. Because the major technology providers in the healthcare space act as a “One Stop Shop”, they spend most of their time working on integrating in their own product suite with little to no regard to other applications. Subsequently, they find themselves trapped: they have to position all products/modules to maintain the accessibility and integrity of their data. This is problematic for the hospital that is trying to solve one problem but then must purchase additional solutions to apply to areas that are not broken, just to be able to integrate information. That is like going to the hardware store for a screwdriver and coming back with a 112 piece tool set with a rolling, 4 foot cart built for NASCAR. You will probably never use 90+% of those tools and will no longer be able to park in your own garage because the new tool box takes up too much space!IT resources – including people – must be utilized. In today’s economy, leveraging internal IT staff to administer a solution post-deployment is a given. If those IT resources do not feel comfortable in supporting the integration plan, then status quo will be justified. This is the “anti” approach to providing solutions in the healthcare industry: the sales leaders from Big Box technology firms want their sales people in front of the business side of the organization and to stop selling to IT. While this is a common sense approach, the economy in 2010 mandates that IT has to at least validate their ability to administer new technology solutions. The prospect of long-term professional consulting engagements to follow post installation has been shrinking at the same rate as healthcare organizations profit margins.Empowering the healthcare organization to utilize its existing IT staff to administer and develop with the new products is not part of the business plan when Big Box players market to the industry. It is the exact opposite – recurring revenue from lengthy, and sometimes permanent, professional services consulting engagements is part of the overall target. The initial price quote for a Big Box solution is scary enough, but the fact remains that it is still not representative of what the ongoing cost to maintain through consulting arrangements. This is a variable cost, which is difficult to predict, and drives finance managers and executives crazy.Solving the Dilemma – A Better Solution through a New Approach at a Fraction of the CostWhen Healthcare Business Experts combine talents with Technology Architects, EIM Solutions cost drop dramatically. This is the New Approach to Healthcare EIM, providing the way health organizations will be able to provide successful solutions at significantly reduced costs – opening the door for health systems of all sizes.The EIM Firm (using the New Approach) versus Big Box Healthcare Technology Providers:Smaller, more agile firms bring many benefits to Healthcare Organizations of any size. The benefits:1. They are focused on specific verticals – just like the Big Box Health Technology providers. Subject Matter Experts (SME) in the smaller firms typically are industry veterans with years of experience and success in their approach who see their resume as a service offering better utilized when they are able to apply their methods for successful strategy planning as opposed to learning the methods of a Big Box player. Their income is better since their revenue is applied into a smaller operating cost, extending lower pricing for solutions that are MORE EFFECTIVE and offering stronger client/vendor relationships as the SME limits themselves to a certain number of clients.2. Solutions built on proven approaches and strategies. Again, the firm’s SMEs are able to define a methodology that can be re-used or re-configured in each client instance. This saves time and money for the client as delivery is accelerated and the cost of architecting is eliminated.3. The firms themselves develop solutions and methodologies agnostically. Their understanding of the diversity of systems that exist in the technology of a healthcare organization allows them to not only develop adaptable solutions but also add a Business Process Management Plan (BPM). The BPM will define for the organization EXACTLY how information is received, processed, cleansed, stored, shared and accessed. It also will define an action plan for training IT for administration and support as well as end users at all levels on how they will leverage it going forward. BPM planning in a healthcare organization is a low six figure investment with an outside consulting group. The EIM firms will include it in the cost of the solution. Basically, it is the difference in being told what is wrong and here are the recommendations to fix it versus here is what is wrong and this is how it will be fixed with the new solution.What is a typical EIM Firm solution?1. Solution Assessment, noting the current systems, data sources and methods of sharing information as well as business processes, key personnel identification that are gate keepers if information, timeliness of providing information and overall effectiveness in leveraging enterprise information for strategic business planning. See figures 1 for an example of the information process flow visual component of an actual assessment.2. EIM solution that contains an integration engine that accesses all data sources – reading and writing back to the database or application, providing data quality services and maintaining HIPAA as well as HL7 requirements. See Figure 2 for a diagram.3. EHR Data Warehouse. A repository to build Electronic Health Records through the integrated data flow.4. EHR Portal for patient entry (when additional information needs to be added) via a browser.5. Business Intelligence Dashboards for metrics, AD Hoc analysis and Performance Management Scorecards on organizational goals and objectives.6. Onsite implementation and integration of the EIM solution.7. Onsite training during installation for IT and end users. Ongoing training provided via webinars, documentation and technical support staff.8. Relationships maintained by the Subject Matter Experts for the life of the solution.9. Stimulus “HITECH” Act pays $44,000 per physician for an EHR solution implemented. The SME creates the grant request to be submitted so the healthcare organization receives Stimulus funds to pay for the total EIM solutionKey Element of the SolutionOnsite Delivery and full time support are key. But, the most important element is training. Why? As noted earlier, it is paramount that existing IT investments, namely personnel, be able to not only administer but also conduct development as the need arises. In Healthcare, CMS managed Medicare/Medicaid is already margins that are in the negative. As private payers follow suit, the number of uncollectable encounters will increase, impacting current profitability models and increasing future cost for treatment. By mitigating IT costs, the Total Cost of Ownership (TCO) qualifier should actually evolve to a Return on Investment (ROI). ROI is immediate for this solution approach, but it is sustained year over year by leveraging internal IT to support and develop. Now, the Healthcare Organization has eliminated costly professional service consulting engagements and re-investments into new feature licensing. This takes a variable cost every year and makes it a fixed, yet smaller amount – a sensible financial approach to accomplish a proven strategy.Summary -Why EIM? Whether it is Omnibus, “Obama”-care or an edit (not overhaul) of the Healthcare industry, Healthcare Organizations know these truths:1. Electronic Health Records are necessary for the Fraud detection unit of CMS. Each organization must comply with accessibility, HIPAA and format. Fraud reduces overall revenues for a hospital by 9% (ACFE)2. EHR/EHR have proven to be highly effective in eliminating internal waste, patient fraud, practice fraud and paper overhead. Vast amount of space within the facilities that had been used to store patient records in hard copy can now be utilized to provide additional services and open new revenue streams.3. Bad or “dirty” data in electronic or hard copy format is costly. According to the AHA (September, 2008), the average cost of a patient record with good or accurate information is $343 annually. The annual cost of a patient record with bad information is $2,054 annually. On average, 18% of patient information within a healthcare organization is bad.4. Strategies developed by healthcare organizations without 100% of the information they own that is also timely and relevant are ineffective. Objectives cannot be defined, successful processes cannot be identified and improvement plans have little to no metrics in which to determine success.5. Stimulus/HITECH Act pays $44,000 per physician when EHR is part of the EIM solution. With the smaller EIM firms, Stimulus pays for the entire solution.Why a New Approach EIM Firm?1. Subject Matter Expertise from consultants that have proven methodologies.2. Agility to adapt to the client need instead of the Big Box approach of the client adapting to their product limitations.3. A Better Solution at a Fraction of the Cost. Their solutions are based on needs and not features.4. Relationships with the vendor, resulting in improved services, maximum values from vendor solutions and a focused approach to the client needs and goals.5. A Return on Investment as opposed to a Total Cost of Ownership. Clients need to see solutions that immediately pay for itself and then recover lost revenue while offering channels to new profit centers.