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Predictive Analytics and Life Care Plans

As more companies recognize and utilize predictive analytics in their Casualty, Health, and Disability programs, an advanced Life Care Planning (LCP) approach for chronic and legacy cases crystalizes the key claimant and family issues during the first 30-60 days after an occurrence or discovery.


The approach to building an effective risk and claim predictive model, is to understand the all of the components of an LCP for 5-10% of the cases which impact 50-70% of the cost of a program. The programs utilizing Predictive Analytics with Life Care Planning criteria generally have much better case outcomes at a lower cost.

Life Care Planning is a method of determining the care for persons with permanent or chronic medical conditions. The methodology is also helpful to address the potential issues for persons who may have more complicated temporary conditions during a recovery period. The forecasted costs of current and ongoing care are brought together in effective tools for successful recovery. The use of technology is now changing the way LCPs are formulated and delivered.

Additionally, the components of an LCP are now being programmed and benchmarked within Predictive Analytic models to enable teams to analyze the current diagnoses and opinions of physical and/or mental impairment and disability. As each case is reviewed and analyzed, these components are then “reprogrammed” for tailoring the future care requirements to the specific needs of the individual and family.

For example, the key components of a Life Care Plan are able to meet the objectives of an individual’s conditions including to:

1.  Minimize or eliminate physical and psychological pain and suffering;

2.  Gain the highest level of function for an individual and their family;

3.  Prevent future complications associated with the injury or condition;

4.  Maintain the best possible quality of life.

Additionally, the LCPs and related approaches help to envision the case details and dynamics for individuals, adjusters, attorneys, self-insurers, insurers, mediators and courts in a completely transparent way. In the past, the plans were often utilized after a case has been litigated.

Because the Life Care Plan components are now being built into Predictive Analytics, the teams are now able to formulate clear paths of recovery from the beginning of a case, often within 30-60 days. By using this technology, the payer organization saves time and money, perhaps as much as 40% for these types of cases. Also, the claimant and their family are better served with clear planning and monitoring.

 

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By Robert J. Blackburn, Managing Principal, Blackburn Group, Inc., contact him at This email address is being protected from spambots. You need JavaScript enabled to view it..

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