Thomas Cox PhD, RN
Standard Errors: Our Failing Health Care (Finance) Systems And How To Fix Them is a monograph about insurance, managed care, health care provider capitation and insurance risk transferring health care finance mechanisms.
Insurance risk transferring health care finance mechanisms include: Capitation contracting, Bundled and Episode based payment schemes, the Medicare/Medicaid Prospective Payment Systems, the Diagnosis Related Groups (DRGs) system and other profit/risk sharing agreements between public and private health insurers, managed care organizations, government insurance programs and intra-organizational budgets to health care providers.
These insurance risk assuming health care providers include: Physicians, Hospitals, Nursing homes, Home health agencies, Nurses, Allied health professionals and paraprofessionals.
When these insurance risk assuming health care providers accept these insurance risk transfers, they become their patients' small, very inefficient health insurers. As inefficient health insurers they are less likely to earn reasonable profits, more likely to incur operating losses, significantly more likely to become insolvent than the public and private insurers, managed care organizations and health maintenance organizations would, if they retained their insurance risks.
Risk transferring organizations avoid their obligation to manage their policyholders' health insurance risks and earn excessively high, risk-free profits while health care providers are placed at excessive financial risk and patient care is compromised.
StandardErrors.org provides resources for health care providers, patients and families, attorneys, health care provider executives and financial analysts, health care policy analysts, academicians and researchers concerned about the diminishing quality and quantity of health care services.
StandardErrors.org provides articles, tools and resources to analyze how health care provider insurance risk assumption affects health care systems, providers, consumers and our health care (finance) systems.
Thomas Cox PhD RN is a nurse, mathematician, statistician, social worker, chartered property casualty underwriter and licensed health care risk manager with extensive experience in insurance rate making and reserving, health care planning, research and delivery.
"Standard Errors: Our Failing Health Care (Finance) Systems And How To Fix Them" Second Edition, was released in September, 2012.
I provide educational and consulting services in risk assessment, risk management, financial analysis and quality improvement for health and allied health care professionals and facilities, academic institutions, attorneys and consumers.