As physician organizations adapt to the changing and challenging nature of the U.S. health care industry, they are experiencing unprecedented pressure to control costs, improve quality and assume some or all of the financial risk of delivering care to their patients. Dubraski & Associates is a privately-held, independent insurance brokerage and consulting company that specializes in providing unbiased solutions to the health care industry across all lines of business. We provide all of our health care clients, including medical groups, with value-based recommendations and solutions that will meet their goals and ensure their financial protection.
Medical malpractice insurance is a key coverage for medical groups and may be structured to provide separate or shared limits per physician above a retention or on a first dollar basis. The structure of the program depends on several factors including the risk appetite, specialty and location of the group. In addition to commercial insurance, alternative risk funding mechanisms may be considered including risk retention groups and captives.
Physician Life & Disability Transparent Auction
Leveraging a proprietary transparent reverse auction Request for Proposal approach allows for a broader network of carriers to compete more efficiently. During the transparent secondary phase of pricing, the “true” market rate is identified for life, disability, dental, vision and prescription benefit management. Forty percent of the time, groups remain with the current carrier, just with better pricing and terms. Average premium savings is 24 percent.
Medical and Dental Benefits
We understand the uniqueness of being both a provider of services and an employer offering quality benefits to recruit and retain key employees. With costs spiraling, we utilize our specialized, extensive knowledge and relationships to structure, negotiate, and implement cost effective programs. Funding methods include fully insured, self-funded, stop-loss, and refund/retro provisions.
Pharmacy Benefit Management
Pharmaceuticals play an increasingly important role in the prevention, cure and management of disease. Spending on prescription drugs has increased at double-digit rates for the past decade. It is now the third largest component of health care expenses. However, the structure surrounding the pricing and delivery of prescription drugs is murky and confusing. Leveraging the buying power of a nationwide client network or using a Transparent (Pass-Through) PBM Model, working together we will implement a customized approach to pharmacy cost reduction that fits your company’s business goals and culture.
Catastrophic claim frequency and severity are on the rise and the typical employer stop-loss solutions are insufficient in today’s challenging health care environment. Consideration should be given to specialized carriers who understand health care (contracting, networks, utilization, etc.) and various funding mechanisms should be explored. Using detailed financial analysis, we design, structure and negotiate superior pricing, enhanced contract terms and provisions. A dedicated Claims Service Center acts as a liaison between the client and carrier.
As the U.S. health care industry evolves, management liability insurance provides medical groups and their directors and officers with protection for the complex management and employment related exposures that may arise.
Data Privacy & Security
Data privacy and security insurance provides health care organizations with a means to transfer and manage the risks of this emerging exposure in an industry that is becoming increasingly reliant upon technology.
Managed Care Errors & Omissions Liability
Managed care errors and omissions insurance responds to disputes surrounding contractual arrangements with physicians, allegations related to improper administration of medical services, billing, credentialing and other managed care activities.
Managed Care Stop-Loss
The level of risk being assumed by medical groups varies widely. In addition to traditional specific stop-loss, quota-share and aggregate stop-loss are available as are specialty carve out programs and alternative funding structures.
ACOs are becoming a common vehicle used by medical groups to assume financial risk. Each ACO has a unique size, structure and risk appetite. Products designed specifically for ACOs to meet their unique risk transfer requirements are available.
To learn more about how Dubraski & Associates can help physician organizations, contact us. 1.877.792.4640