Tag Archives: Harvard

Don’t Believe Your Own Fake News!

According to Gallup’s long-running Honesty and Ethics in Professions survey, trust in journalists over the last 40 years has seen a steady decline and is now at an all-time low. Part of the reason is the wide variety of sources available to journalists and the speed with which people are clamoring for news. Back when there were only three primary networks and a limited number of major newspapers, seasoned reporters seemed to keep a tighter rein on journalism’s criteria and standards.

Insurance executives are suffering from many of the same issues when trying to rely on their data and analytics. They may frequently ask themselves, “Where am I getting my news about my business?” and “Can I trust what I’m being told?” Data within the organization can be coming from anywhere inside or outside the company. Analytics can be practiced by those who may be reaching across departmental boundaries. Methods may contain errors. Reporting can be suspect. Decisions may be hastily made based on “fake news.”

No industry is immune. Google Flu Trends (2008-2013) was supposed to predict flu outbreaks better than the Centers for Disease Control and Prevention (CDC) using a geographic picture of search terms loosely related to the flu. Somehow, though, the algorithms consistently overrated correlations and over-predicted outbreaks. After several years of poor results, teams from Northeastern University, the University of Houston and Harvard concluded that one of Google’s primary issues was opaque methodology, making it “dangerous to rely on.”

See also: Innovation Won’t Work Without This  

Here are four actions that insurers can take to close data and analytic gaps and create an environment where news reflects reality and is able to be trusted.

Watermarks

One simple recommendation is to watermark views of data as certified. Certified sources, certified views and certified analyses could carry a mark that would only be allowed if a series of steps had been taken to maintain source and process purity. This Good Housekeeping Seal of Approval will provide your organization’s information consumers with the confidence that they are looking at real news. Of course, the important part in this process is not the mark itself, but developing the methods for certifying.

Attribution

Attributing information that is used in an ad hoc way to the data source also allows other team members to trust that the source is vetted and that the information presented will be verifiable. In any research project, it is common to add data citations, just as one would add a footnote in an article or paper.

Attributions add one other important layer of security to data and analytics — historical reference. If a team member leaves or is assigned to another project, someone attempting to duplicate the analysis a year from now will know where to look for an updated data set. It is also more likely that the results from decisions made on the data are many months or years away. If those results are less than optimal, teams may wish to examine documented data sources and analytic processes.

Governance

Organizationally focusing on the benefits of good data hygiene and creating a culture of data quality will increase your organization’s data quality and improve trust levels for information. Governance is the core of safe data usability. Poor practices and fake news arise most easily from a loosely governed data organization.

The concepts of governance should be communicated throughout the organization so that those who have been practicing data analytics without oversight can “come in from out of the cold” and allow their practices to be verified. But governance teams should always act less like data police and more like best practice facilitators. The goal is to enable the organization to make the best decisions in a timely manner, not to promote rigidity at the cost of opportunity.

See also: Are You Still Selling Newspapers?  

Constant Listening

Finally, when data teams constantly have their ear to the ground and are continuously aligning the information that is available with the needs of the consumers of that information, then best practices will happen naturally. This awareness not only ensures that fake news is kept to a minimum but also ensures that new, less reliable reports and views are not cropping up with the excuse that necessity is the mother of invention.

It also means that data teams will have their eyes open to new sources with which to assist the business. When data teams and business users are frequently helping each other to attain the best results, a crucial bond is formed where everyone is unified behind the visualization of timely, transparent, usable insights. Data stewards will have confidence that their news is real. Business users will have confidence to act upon it.

I’m a Retired Professional…

The insurance industry is a massive market composed of many professionals with various backgrounds.

When consumers consider insurance professionals, they typically think about either the sales or claims end of the business, but there’s so much more.

Generally, national property and casualty insurance carriers are made up of many different departments that ultimately support the sales and service sides of the company. Although the sales side of the industry can have frequent turnover, those who find a home in the various support departments lead amazing careers.

But, as time moves on, and the Baby Boomers decide to start retiring, there is a growing army of retired insurance professionals.

What is one of the best jobs for retired insurance professionals? The gig economy!

Here’s why.

Retirement Flexibility

Gig platforms connect people to paying clients. It’s as simple as that. This includes freelancers, contingent workers, temp employees and the millions of digital nomads currently working from home on their own terms. The gig economy is the perfect retirement option for those wanting to remain social, earn supplemental income and maintain a flexible part-time job.

Why do we say this? Gig workers make their own hours, choose their own clients, meet new people and bring in some extra cash.

According to a study conducted in 2016 by Harvard University economics professor Lawrence Kats, nearly 24% of those between ages 55 and 74 were working in the gig economy in some capacity.

Further, according to a study by JP Morgan, 67% of pre-retirement workers said they planned to continue working in retirement. However, only 25% actually did.

Why not? Because most don’t even know where to start. That’s where we come in.

See also: The Stubborn Myths About Older Workers

The Best Retirement Gig: WeGoLook

We think the best job for retired insurance professionals is WeGoLook, a popular gig platform that specializes in asset verification tasks, something all insurance professionals are familiar with!

WeGoLook’s gig workers, whom we call “Lookers,” engage in a variety of tasks that any insurance professional will understand. These include:

  • Real estate verifications;
  • Auto verifications;
  • Heavy equipment verifications;
  • Various insurance solutions;
  • Courier services;
  • Document retrievals; and
  • Custom tasks and other field services.

Let’s break down a typical gig, or “Look,” for you:

A customer in Idaho buys a used car on eBay but wants to make sure that the seller in Oklahoma City is legitimate and that the car is “as described.” Mr. Idaho places a quick order through WeGoLook, which is integrated directly into the eBay Motors platform, pays a fee, and a “Looker” (the future you!) is dispatched to the physical location of the vehicle.

Acting as boots on the ground for the customer, a Looker will answer many questions about the item, snap some photos, check capability and then submit a secure report directly on the WeGoLook smartphone app for delivery to the client.

WeGoLook has more than 30,000 Lookers across North America taking on these type of side gigs on a daily basis.

You could, too!

The services WeGoLook provides for insurance clients — and others — are ones that companies realize they no longer need full-time staffing for.

Tasks such as property verifications, data collection, photographs and videos, asset condition verification, mobile notarizations, police and court report retrieval, etc., are easily contracted out to skilled on-demand gig workers.

Insurance Roles: Potential in Gig Economy

Although most insurers have departments that handle underwriting, actuarial, legal, licensing, marketing, claims and inspections matters, many contract with on-demand gig workers who are qualified to perform the service required.

That’s where WeGoLook comes in, connecting people to tasks. We are already operating in the insurance space. In fact, we were recently acquired by Crawford & Co.

See also: How Telemedicine, AI Are Transforming Care  

Final Thoughts

As years of working in the insurance industry go by, like most workers, insurance professionals look forward to a comfortable retirement.

But, like many other retired workers, insurance professionals want to supplement their retirement income by working part-time and remaining in the industry they know and love.

Fortunately, technology today allows a retired individual to use their skills on an on-demand basis so they can work when they want and where they want — in the industry of their choice.

How Work Comp Can Outdo Group Health

We all know the current healthcare system in the U.S. delivers erratic quality at unsustainable, yet ever-increasing, costs. Workers’ compensation medical care is affected by those costs. 

A major shift in the health industry, value-based healthcare, will benefit workers’ compensation. Embracing selected new medical management methodologies put forth in value-based healthcare has the potential to be powerful.

Value-based healthcare means restructuring how medical care is organized, measured and reimbursed. It moves away from a supply-driven system organized around what physicians do to a patient-centered system organized around what patients need. The focus is shifted from volume and profitability to patient outcomes (quality care). When fully implemented, the overall impact will be nothing less than staggering.

Porter and Lee, healthcare industry strategists at Harvard, have described six value strategies necessary to achieve healthcare industry transformation. Many of the changes are now underway in ACOs (accountable care organizations) such as the Cleveland Clinic, proving the concept. These defined initiatives produce desired results—quality care at less cost. 

Six components of value-based healthcare

The following briefly describes the methodologies necessary to transform healthcare, according to Porter and Lee.

  1. Integrated practice units (IPUs)—meaning multiple specialists practice together, resulting in comprehensive and integrated medical care rather than fragmented, duplicated services
  1. Measure true outcomes and costs for every patientWhen outcomes are measured and reported publicly, providers are under pressure to improve. Fraud and self-dealing are reduced.
  1. Bundled paymentsPayment bundles are capitated single payments for all the patient’s needs during defined episodes of care, such as specific surgical procedures. Providers are rewarded for delivering quality while spending less.
  1. Integrate care delivery systemsServices are concentrated and integrated to eliminate fragmentation and to optimize the quality of care delivered at any given location.
  1.  Expand geographic reachCenters of excellence are developed where expertise is gained through higher volume of similar procedures.
  1.   Information technologyData mining powerfully enables the first five initiatives and informs services and decisions.

As Porter and Lee say, “Whether providers like it or not, healthcare is evolving from a proficiency-based art to a data-driven science, from freelance physicians to hospital-employed physicians, from one-size-fits-all community hospitals to vast hospital networks organized around centers of excellence.”

Value-based medical management in workers’ comp

The goal of value-based medical care is to enhance quality outcomes for patients (injured workers) while reducing costs. Focusing on quality (what the patient needs) actually reduces costs.

For group health, the measures are physical and philosophical, requiring widespread disruption in how services are organized, delivered and reimbursed. However, workers’ compensation payers can benefit by incorporating three of the six value measures into their medical management process now.

  1. Measure true outcomes and costs for every patient (the injured worker)

Physician performance is scored based on injured workers’ experience and outcomes along with cost. Providers who score poorly can be avoided.

  1. Bundle payments

Bundling is capitating payments for all the services required for procedures such as specific surgical procedures, including all associated pre-op and post-op care. The costs are kept in line because providers need to stay under the cap to be profitable. They also focus on quality, because re-dos, redundancy and complications add cost to the service bundle, thereby diminishing profits. Prepare to see bundled payment options available to workers’ compensation sooner rather than later.

  1. Information technology

The data in workers’ compensation, while in silos, is all organized around individual claims and injured workers. When the data is integrated at the claim level, patient experience, provider performance, outcome and cost analysis opportunities are unlimited. The more comprehensive and accurate the data, the greater the opportunity for gain.

Those who cling to traditional seat-of-the-pants medical management will be left behind. Those in group health may be hampered by slow regulatory change, organizational upheaval and resistant providers, while workers’ compensation payers are free to adopt transformative value measures now. Organizations that progress rapidly to implement the value agenda will reap huge benefits.

How Insurance Helps End Hunger, Poverty

These remarks were delivered at the United Nations Sustainable Development Summit on Friday, Sept. 25, 2015.

Good afternoon, excellencies, ministers, ladies and gentlemen. My name is Mike Morrissey, and I’m president and CEO of the International Insurance Society. We are a nonprofit research and idea exchange organization representing life and non-life insurers, as well as regulators and risk management scholars, from nearly 100 countries.

Professor Shawn Cole of Harvard, a world-leading expert in development economics, has said, “Risk is one of the greatest challenges faced by poor people around the world.”

This can be seen as the risk of flood, earthquake, hurricane or cyclone. It can also be experienced as crop failure, livestock mortality, illness or death of a family member or in food or water security. The ability to manage and finance risk is therefore a key element in the development of societies, and thus in alleviating poverty and hunger.

The insurance industry has played a key role in this effort by expanding access to risk protection and risk management advice, for centuries in the developed world, and now very broadly in Sub Saharan Africa, South Asia, Latin America and in other less-developed areas. With nearly one billion people living on about one U.S. dollar a day, this form of social protection is vital, since the poor are often those most exposed, just one loss event away from calamity for themselves, their families and their possessions.

At the UN Insurance Sector Summit, which took place at the ECOSOC Chamber here last June, I sat next to Secretary General Ban Ki-moon as he complimented the insurance industry for its vital role in mitigating and reducing risk and thereby raising living standards where help is needed most. But he also called for the industry to do more in the future, and so the industry continues to innovate in ways that offer more protection for more people, and makes a major contribution to reducing poverty and hunger.

A few examples are worthwhile to make the insurance industry’s role clear.

German Insurer Allianz is a world leader in microinsurance, the protection of low-income people. Allianz provides crop, livestock and other coverage for 125 million farmers in India and China, and participates in the Africa Risk Capacity pool to insure governments against natural catastrophes. Peruvian insurer La Positiva has tailored agricultural coverage for rural farmers who have limited access to communications and healthcare. A new Bermuda-based venture called Blue Marble Microinsurance has developed savings and protection products, among them some linked to poor women’s key life-cycle triggers.

These efforts, and many more like them, link the worlds of finance and development, expanding access to protection from the unique set of risks faced by the world’s poor. Through our industry’s efforts, and through public private partnerships with governments and international institutions to capitalize on both the risk assessment and long-term investing capabilities of insurance organizations, the sustainable development goals of ending extreme poverty and hunger can and will be achieved.

Better Outcomes for Chronic Pain

The workers’ comp industry is burdened with perhaps 200,000 or more injured workers on long-term opioid treatment for chronic pain. Many more workers enter these ranks yearly. For 10 years, I have observed this awful misery slowly accumulate. But claims payers can do more to prevent new case and resolve “legacy” cases. It will require from them more commitment to best practice care and a lot more frank, open collaboration among themselves and with medical providers.

Conservative care is hugely under-exploited as an approach to prevent and resolve chronic pain among injured workers. Workers’ compensation claims payers would not have paid so much for opioid treatment, failed surgeries and claims settlements had they adopted conservative care decades ago, when research support for this approach was already pretty strong. The failure to promote this approach cost the policyholders perhaps $100 billion in higher premiums and cost injured workers years of disability and, in some cases, funerals.

By conservative care, I refer to functional restoration programs, which came into existence in the 1970s or earlier. Cognitive behavioral therapy became established in the 1980s. Coaching, as a non-medical method of helping persons in pain, has been around forever but recently gained visibility as a scalable form of intervention. There’s a lot of innovation going on, such as the PGAP program imported from Canada and a number of nerve-stimulation services such as Scrambler in New England.

Payers need to learn how to create conditions within which conservative care can prosper rather than repeatedly blossom only to die.

A friend prods me to use the term “evidence-based medicine.” But “conservative care” is my choice for an umbrella term because it is easy to remember, though inexact.

A few years ago, I talked by phone with a senior medical case manager at a claims payer in Kentucky, an epicenter of opioid prescribing excesses, who had never heard of functional restoration programs. This reminded me of the Harvard professor who spent a year in Munich without ever hearing about Oktoberfest.

The long history of insurers includes many instances where they brought risk management solutions like conservative care to the market. The first modern evidence of that goes all the way back to London fire insurers in the late 17th century. Mutual insurance companies played an essential role in introducing automatic fire-suppressing sprinkler systems to American factories in the late 19th century.

In my special report published by WorkCompCentral, “We’re Beating Back Opioids – Now What?”, I propose that claims payers and selected medical providers collaborate for the purpose of better success in treatment. This is particularly valuable for conservative care. The collaborations would allow each party to act on its own but to pool information. Periodically, analysts will dig into the database to report on the group’s experience on outcomes and costs.

The healthcare community, sometimes with the explicit support of health insurers, engages in collaborations to improve health outcomes. A Health Affairs article in 2011 is titled, “How a Regional Collaborative of Hospitals and Physicians in Michigan Cut Costs and Improved the Quality of Care.” The article addresses surgical collaborations, for instance:

  • Michigan BCBS has been supporting since 2006 a bariatric surgery data-sharing project involving 27 hospitals and some 7,000 patients a year.
  • Its major general and vascular surgery collaboration recorded 50,000 patients a year.

The article concludes that “results from the Michigan initiative suggest that hospitals participating in regional collaborative improvement programs improve far more quickly than they can on their own. Practice variation across hospitals and surgeons creates innumerable “natural experiments” for identifying what works and what doesn’t.

Elsewhere, collaborations among independent medical providers have been noted in asthma, diabetes, surgery and congestive heart failure.

Another analysis of collaborations commented that “real improvements [in treatment] are likely to occur if the range of professionals responsible for providing a particular service are brought together to share their different knowledge and experiences, agree what improvements they would like to see, test these in practice and jointly learn from their results.

Claims payers need to help this cross-fertilization happen. Hard as it may seem, they need to “own” the need to build conservative care resources in their markets. Physicians don’t understand conservative care; referral patterns are not set; and the providers of conservative care are often under-resourced. Claims payers need to step up.