The Doctors Company Now Using Milliman Datalytics-Defense’s AI platform for Claims-Defense Management

January 17, 2019 by matray

Milliman Inc., a global consulting and actuarial firm, announced that The Doctors Company has implemented Milliman Datalytics-Defense as its advanced analytics legal management platform for processing defense cost invoices. The choice of Datalytics-Defense lets The Doctors Company collaborate with defense counsel to use best practices for defense strategy through artificial intelligence and data-driven decisions. Milliman Datalytics-Defense employs data mining algorithms and machine learning to help insurers and self-insureds detect patterns in attorney billing practices, delivering a better understanding of costs and case strategies.

"At The Doctors Company, we are continually looking for innovative ways to harness the data available to us and use it to improve our operations and increase efficiencies," said Cathy Shutack, senior vice president of claims at The Doctors Company. "With Milliman Datalytics-Defense, we've found a way to apply artificial intelligence based techniques to our vast amounts of data, and use the resulting information to make better data-driven decisions around the claims management process."

Milliman Datalytics-Defense is designed specifically for the insurance industry and has subject matter expertise built into the technology and reporting. The tool's predictive analytic engine is fueled by powerful and proprietary data-mining algorithms that convert text-based data into rich and powerful structured data.

"Leading companies recognize the importance of analyzing the data available to them and unlocking its hidden intelligence as a way to effectively manage and mitigate risk," saidChad C. Karls, principal and consulting actuary with Milliman. "The Doctors Company has a reputation as a forward-thinking organization that understands how a tool like Datalytics-Defense can benefit its members, and I'm looking forward to continuing our work together."

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Indiana Department of Insurance Announces Rate Drop for Patient’s Compensation Fund for 2019-2020

January 14, 2019 by matray

The Indiana Department of Insurance announced that surcharge rates for the Patient’s Compensation Fund (PCF) will decrease for 2019-2020. The new rates will be effective on July 1, 2019. The surcharge rates for physicians will decrease by 10.9 percent and rates for hospitals will decrease by 12.3 percent, which will result in an approximate $20 million dollar savings overall. This is the first decrease in surcharge rates since 2012. An official Bulletin, Bulletin 247, has been posted on the Department's website.

The PCF is a dedicated fund administered by the Indiana Department of Insurance. It was created in 1975 by the Indiana Legislature as a component of the Indiana Medical Malpractice Act. The fund provides excess compensation for patients who have experienced medical malpractice, in addition to the recovery of compensation from a defendant healthcare provider.

The PCF is funded via a surcharge paid by healthcare providers as part of their professional liability insurance premium. The amount of surcharge paid by a healthcare provider is based upon the risk associated with a healthcare provider’s specialty.

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Senior Leadership Changes at Coverys Announced

January 9, 2019 by matray

Effective March 31, 2019, Mary Ursul will step back as the executive vice president at Coverys. Lynnette Matza, CEO and president of PPIC, a Coverys company, will succeed Ursul and assumed the role of executive vice president on Jan. 1, 2019, to ensure an orderly transition.

Ursul began her career with Coverys in 2006 holding a number of positions during her tenure, most recently overseeing Coverys’ Med-IQ operations and the coordination of the companies within the Coverys Strategic Healthcare Alliance. She will be leaving her full-time position, but will continue to work with the Coverys Community Healthcare Foundation as well as on special projects.

“Mary has always been willing to step in and take on any challenge that has come her way. She does so with a keen eye on business operations, but also with a focus on the people including mentoring many of our leadership members,” said Gregg Hanson, CEO and president of Coverys. “Mary’s time with Coverys has been instrumental to the success of MHAIC and WCC as well as their subsequent transition to the Coverys family.”

Lynnette Matza will transition from CEO and president of PPIC to serve as executive vice president, oversee Med-IQ operations, and manage the Coverys Strategic Healthcare Alliance relationships.

“It is crucial to have strong leadership to run the day-to-day operations and to ensure all subsidiaries are aligning our entities’ goals and aspirations,” said Hanson. “We are pleased to have Lynnette transition into this new role, as her financial acumen and business operational knowledge of Coverys will be of great value.”

Matza joined PPIC in 1988 as controller. During her tenure with PPIC, Matza served as vice president of finance, CFO and senior vice president, and president and chief executive officer. She is a member of the American Institute of Certified Public Accountants, the Nebraska Society of Certified Public Accountants, and graduated with high distinction from the University of Nebraska Lincoln with a Bachelor of Science in business administration with an emphasis in accounting.

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Dentists Benefits Insurance Co., Northwest Dentists Insurance Co. Receive Final Approval To Merge With The Dentists Insurance Co.

January 7, 2019 by matray

Dentists Benefits Insurance Co. (DBIC) and Northwest Dentists Insurance Co. (NORDIC), acquired by The Dentists Insurance Co. (TDIC) in February 2017, merged with, and into, their parent company, TDIC, effective Jan. 1, 2019, after final regulatory approval. The merger was approved by the California Department of Insurance (DOI), the Oregon Division of Financial Regulation (DFR) and the Washington State Office of the Insurance Commissioner (OIC).

As a result of the merger, DBIC and NORDIC are now united as one company operating as The Dentists Insurance Co. The name and logo have changed and policyholders can expect a smooth transition with no disruption to the service they have come to trust and rely upon.

"The merger gives policyholders peace of mind, knowing that TDIC has a single vision to only protect dentists," said TDIC Board Chair Daniel Davidson, DMD. "For nearly 40 years, TDIC has provided exceptional service and high-quality products to our policyholders and we will continue this legacy with the merging of DBIC and NORDIC."

TDIC focuses exclusively on supporting the dental profession by offering a comprehensive suite of professional insurance products to more than 24,000 dentists in 15 states. With this merger, TDIC now extends its exceptional legacy, brand values, financial strength and stability to over 5,000 additional policyholders in five states.

TDIC has been rated A (Excellent) by A.M. Best for 24 consecutive years.

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LAMMICO Names New Chairman of the Board

January 4, 2019 by matray

In preparation for his transition to president/CEO in March 2019, J. Michael Conerly, MD, will step down from his position as chairman of the LAMMICO Board of Directors. Accordingly, the Board elected Frederick J. White, III, MD, as LAMMICO's chairman of the Board effective Jan. 1, 2019. White's extensive experience with LAMMICO makes him well prepared for this position. He joined the Risk Management Committee in 1999 and became a member of the LAMMICO Board of Directors in 2001. White has also served as senior vice president of Risk Management & Patient Safety, chair of the Governance Committee and as a member of the Executive, Audit & Legislative Activities Committees. White received his medical degree from Louisiana State University Health Sciences Center School of Medicine in Shreveport and completed his residency and internship at the University of Arkansas for Medical Sciences. He holds a Bachelor of Science in Business Administration and is currently pursuing a Master of Business Administration at LSU-Shreveport. He is a board-certified cardiologist practicing at Willis-Knighton Cardiology and was co-founder and partner of Cardiovascular Consultants, LLP in Shreveport.  

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BETA Healthcare Group Announces New BETA Council Positions

December 20, 2018 by matray

BETA Healthcare Group, a professional liability insurer of hospitals on the West Coast, announced the appointment of Mike Moody as chair and Kim Milstien as vice chair of the BETA Council, the governing body of BETA Risk Management Authority (BETARMA). They will lead the BETA Council in providing central oversight of the member-governed liability and workers’ compensation program serving hospitals, healthcare facilities and providers.

Mike Moody, senior vice president, Partnership Integration & Development at John Muir Health, replaces retiring chair Jim Raggio, CEO of Lompoc Valley Medical Center. Moody has been a member of the BETA Council since 2014 and vice chair since 2017.

BETA Healthcare Group’s new vice chair, Kim Milstien, is CEO of the Ventura County Medical Center and Santa Paula Hospital at Ventura County Healthcare Agency. Milstien joined the BETA Council in 2014.

“We are very excited to have Mike Moody and Kim Milstien move into their new leadership roles on the BETA Council,” said Tom Wander, CEO of BETA Healthcare Group. “They bring not only their professional career expertise and visionary leadership to bear in their roles on the Council, but also a deep knowledge of, and passion for, BETA’s focus on relationships and partnering with its members to manage risk.”

The BETA Council provides leadership and governance, with its members elected from among participating facilities. It makes policy decisions and meets quarterly to vote on all matters affecting the program, including strategic goals, coverage changes and new product decisions.

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AM Best Assigns Financial Strength Rating of A+ (Superior) and a Long-Term Issuer Credit Rating of “aa-” to MLMIC Insurance Co.

December 20, 2018 by matray

AM Best has assigned a Financial Strength Rating of A+ (Superior) and a Long-Term Issuer Credit Rating of “aa-” to MLMIC Insurance Co. The outlook assigned to these Credit Ratings (ratings) is stable.

The ratings reflect MLMIC’s balance sheet strength, which AM Best categorizes as strongest, as well as its adequate operating performance, limited business profile and appropriate enterprise risk management. The ratings also benefit from the financial support provided by MLMIC’s direct parent company, National Indemnity Company, which is ultimately owned by Berkshire Hathaway Inc.

MLMIC’s risk-adjusted capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR) is categorized as strongest and AM Best expects it to remain at a similar level in prospective years. The balance sheet strength assessment also considers the company’s track record of positive reserves development, as well as good financial flexibility provided by its publicly traded ultimate parent Berkshire Hathaway Inc.

MLMIC has historically generated an adequate level of operating results, supported by modest underwriting profits and moderate investment returns. Underwriting results have consistently benefited from reserve releases on prior accident years. Prospectively, AM Best does not expect any material change in the company’s profitability levels.

MLMIC’s insurance portfolio is concentrated in the medical malpractice line of business. The company underwrites risks only within New York state, which represents one of the nation’s most challenging market environments. However, management has been able to operate successfully through underwriting cycles while maintaining MLMIC’s leading market position within New York. In addition, risk management capabilities have proven appropriate for the risk profile of the company.

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HHS Seeks Public Input on Improving Care Coordination and Reducing the Regulatory Burdens of the HIPAA Rules

December 14, 2018 by matray

The U.S. Department of Health & Human Services (HHS), Office for Civil Rights (OCR), issued a Request for Information (RFI) seeking input from the public on how the Health Insurance Portability & Accountability Act (HIPAA) Rules, especially the HIPAA Privacy Rule, could be modified to further the HHS Secretary’s goal of promoting coordinated, value-based healthcare. This RFI is a part of the Regulatory Sprint to Coordinated Care, an initiative led by Deputy Secretary Eric Hargan.     HHS developed the HIPAA Rules to protect individuals’ health information privacy and security interests, while permitting information sharing needed for important purposes. However, in recent years, OCR has heard calls to revisit aspects of the Rules that may limit or discourage information sharing needed for coordinated care or to facilitate the transformation to value-based health care. The RFI requests information on any provisions of the HIPAA Rules that may present obstacles to these goals without meaningfully contributing to the privacy and security of protected health information (PHI) and/or patients’ ability to exercise their rights with respect to their PHI.     “This RFI is another crucial step in our Regulatory Sprint to Coordinated Care, which is taking a close look at how regulations like HIPAA can be fine-tuned to incentivize care coordination and improve patient care, while ensuring that we fulfill HIPAA’s promise to protect privacy and security,” said deputy secretary Hargan. “In addressing the opioid crisis, we’ve heard stories about how the Privacy Rule can get in the way of patients and families getting the help they need. We’ve also heard how the Rule may impede other forms of care coordination that can drive value. I look forward to hearing from the public on potential improvements to HIPAA, while maintaining the important safeguards for patients’ health information.”     “We are looking for candid feedback about how the existing HIPAA regulations are working in the real world and how we can improve them,” said OCR director Roger Severino. “We are committed to pursuing the changes needed to improve quality of care and eliminate undue burdens on covered entities while maintaining robust privacy and security protections for individuals’ health information.”     In addition to requesting broad input on the HIPAA Rules, the RFI also seeks comments on specific areas of the HIPAA Privacy Rule, including:

  • Encouraging information-sharing for treatment and care coordination
  • Facilitating parental involvement in care
  • Addressing the opioid crisis and serious mental illness
  • Accounting for disclosures of PHI for treatment, payment, and health care operations as required by the HITECH Act
  • Changing the current requirement for certain providers to make a good faith effort to obtain an acknowledgment of receipt of the Notice of Privacy Practices
  Public comments on the RFI will be due by February 11, 2019.  The RFI may be downloaded from the Federal Register at:

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Hub International Acquires the Assets of Pennsylvania-Based Nolen Associates, Inc.

December 13, 2018 by matray

Hub International Limited, a global insurance brokerage, announced that it has acquired the assets of Nolen Associates, Inc. Terms of the transaction were not disclosed. Located in Springfield, Penn., Nolen Associates is a full-service medical malpractice insurance agency that represents more than 1,000 healthcare professionals throughout PennsylvaniaNew YorkNew JerseyDelaware and Maryland. Further strengthening Hub's Healthcare practice, Ray Nolen, president of Nolen Associates, and vice presidents Patrick Nolen and Michael Nolen will report to Shawn McLaughlin, national practice leader of Hub Healthcare and CSO for Hub New England. "We are excited to add the expertise of Ray, Pat and Mike to Hub's expanding Healthcare practice," McLaughlin said. "We look forward to enhancing the great, personalized service their clients are accustomed to with the resources of Hub's Healthcare Specialty."

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Physicians Insurance teams with Milliman Datalytics-Defense to Apply Machine-Learning to Claims Management Strategies

December 6, 2018 by matray

Milliman, Inc., a global consulting and actuarial firm, recently announced that Physicians Insurance A Mutual Company has selected Milliman Datalytics-Defense as its advanced analytics legal management platform for processing defense cost invoices. Milliman Datalytics-Defense employs data mining algorithms and machine learning to help insurers and self-insureds detect patterns in attorney billing practices, delivering a better understanding of both costs and defense strategies.

“At Physicians Insurance we seek out forward-thinking solutions that provide value to our members,”says John Domeika, Physicians Insurance A Mutual senior vice president. “With Milliman Datalytics-Defense, we’ve gained an innovative claims handling process that will improve strategies and help us best steward our member resources.”

Milliman Datalytics-Defense is designed specifically for the insurance industry and has subject matter expertise built into the technology and reporting. The tool’s predictive analytic engine is fueled by a powerful and proprietary data-mining algorithm for greater accuracy and the ability to turn text into structured data.

“To manage and mitigate risk effectively today, it’s necessary to employ tools that take advantage of advanced analytics techniques like data mining and machine learning,” saidChad C. Karls, principal and consulting actuary with Milliman. “We look forward to working with Physicians Insurance to help reduce costs and increase transparency in the claims handling process.” 

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