How Do You Measure Healthcare Subrogation Performance?

4.3
How Do You Measure Healthcare Subrogation Performance?

In my first blog entry in this series, I explained why HR/Benefits professionals, CFOs, VPs of Finance, etc., should care greatly about ensuring that their heal

How Do You Measure Healthcare Subrogation Performance?

In my first blog entry in this series, I explained why HR/Benefits professionals, CFOs, VPs of Finance, etc., should care greatly about ensuring that their healthcare subrogation program is best-in-class. For a company with 40,000 participants on its plan, the swing can be $1,000,000 per year to go from underperforming to best-in-class.

That difference can create an even bigger swing in top-line revenue equivalent savings. For a company that takes 5% to the bottom line, a $1,000,000 improvement in recoveries translates into $20,000,000 in new top-line revenue equivalent every year.

In my second blog entry in the series, I explained how to obtain your subrogation reports so that you could compare your current results with best-in-class results. In my most recent blog entry, I explained how to overcome obstacles to obtaining your reports. I’ve prepared short videos that cover these topics. Please check them out.

Also Read-age of decadence power tubes

For many years, subrogation companies used vague measurements like “percentage of claims paid”, etc., to evaluate subrogation recoveries. Because measurements like this tend to be “moving targets” and are prone to abuse, we began using dollars recovered, per member, per year. While some in the industry still try to throw in a lot of different data points that may or may not be relevant to this ultimate, best standard, there doesn’t appear to be any argument today that dollars recovered, PMPY, is the best standard for evaluating subrogation performance.

With this in mind, once you obtain your reports, it will be important to be sure that the report contains only subrogation claims and not “duplicate payment” recoveries, etc. Once you do that, the calculations are relatively simple. You add up the dollars recovered in a year or “trailing 12 month” period and then divide that number by the number of “belly buttons” — employees plus dependents — on the plan: $7.00 PMPY or below is poor, $7.00-$12.00 is fair, $12.00-$16.00 is good, and $16.00 and above is best-in-class.

Of course, once you do this analysis, you will need to subtract fees when doing a comparison with another subrogation company in order to truly compare apples-to-apples.

If you need help with this process, we assist companies at no charge and no obligation in doing these calculations. Please contact me at tom@benefitrecoveryinc.com

To see a short video on my YouTube Channel about this topic, please see https://btartboxes.com/. Please subscribe to my YouTube Channel while you are there. To sign up to attend my webinar, The Five Most Costly Health Plan Mistakes Companies Make Today, please point your web browser.

Read more-destiny 2 weapon core edz