Event Calendar

Thursday, October 22, 2020

Lunch & Learn: Calculating Reasonable Value of Medical Losses in Turbulent Times

Date(s): October 22, 2020

Time: 12:00 PM  PST - 1:00 PM  PST




1 CLE credit confirmed

 

Calculating Reasonable Value of Medical Losses in Turbulent Times
 
Topics to be discussed include:

Sources of large medical losses 
  • Industrial accidents
  • Mass transit
  • Utilities
  • Motor vehicle accidents
  • Catastrophic events (e.g., weather; terrorism; negligence)
The problem with medical charges/bills
  • Past medical is based on amounts not transacted in the marketplace
  • Future medical is typically made up, or based on “calls” to providers
However, courts allow “reasonable value” 
  • What is reasonable value in legal terms?
  • How does it compare to reasonable value in economic / business terms?
  • How do we calculate it?
Applications
  • Defense of health of health care providers in in calculating losses (e.g., contract disputes; business interruption): were the charged amounts reasonable?
  • Catastrophic events that result in medical losses: billed amounts can escalate rapidly and can result in massive medical loss amounts.
 

Zoom login information will be emailed to registrants.

Presenters:

John E. Schneider, CEO, Avalon Health Economics

Dr. Schneider was one of the founding partners of the Health Economics Consulting Group, LLC (HECG), and then served as Senior Director of the U.S. health economics operations of Oxford Outcomes before starting Avalon Health Economics in 2013 by bringing together the consulting practices of several industry and academic colleagues. Prior to starting HECG, Dr. Schneider was on the faculty in the Department of Health Management and Policy and the Department of Economics at the University of Iowa. His PhD is in Health Services and Policy Analysis from the University of California Berkeley, with a concentration in health economics. He has over 25 years of experience studying economic and organizational aspects of the health care industry, including professional appointments at the Center for Health Economics Research, and the California Association of Health Plans. Dr. Schneider has also served as a consultant to managed care organizations, state health departments, trade associations, medical device manufacturers, large pharmaceutical companies, and others. He has also served as an expert witness in several legal proceedings. 


Cara Scheibling, Director & Principal, Avalon Health Economics
Cara Scheibling manages projects across all of Avalon’s practice areas. Her focus is on cost accounting, cost analysis, and economic valuation. With more than 10 years of experience in health economics, Cara has developed expertise in developing cost estimates for economic models of pharmaceuticals and medical devices, developing unit cost measures for model adaptations, and estimating reasonable costs of medical services in a variety of health care litigation applications. In addition to experience and skills in cost modelling in Excel, she has extensive experience in health policy analysis and technical writing. Prior to joining Avalon Health Economics, Cara has been a Health Economist and Policy Analyst at Oxford Outcomes, Ltd. At Oxford, she contributed to studies of ambulatory surgery center economic impact, orthopedic surgeon ownership of ancillary services, hospital access, and cost analysis for litigation support projects and health policy analyses. She has a bachelor’s degree in Political Science with a minor in Business from Drew University, and is currently in the Executive MBA program at the Haslam College of Business at the University of Tennessee.
 
Avalon Health Economics LLC (“AHE”) was formed by a group of experienced academic and industry health economists and associates, bringing together several existing consulting practices. The company’s origins were in the Health Economics Consulting Group LLC, which started in 2004 and merged with Oxford Outcomes in 2009. We provide high-quality, high-value real-world health economics consulting and research services relying on unparalleled industry knowledge and experience, accurate and defensible research, and attentive project management. 




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