Charles Crispin: Delving in the intricacies of managed care reinsurance

Charles Crispin’s name has almost become synonymous to “managed care.” With over a decade of experience in the healthcare industry, it’s hard to see why not. From 1997 to 2010, Mr. Crispin was affiliated with Evergreen Re, one of the largest and most comprehensive brokers of managed care reinsurance.

Charles Crispin. Image Credit: flickr.com/photos/goulao

Managed care reinsurers use dynamic, actuarially tested risk analyses to provide health plans, physician groups, and health management organizations (HMOs) essential information and premium services and solutions to serve as protection from ruinous claims and financial downturn. Reinsurers also align nicely with a health plan’s interest in minimizing its reinsurance premium increases through effective medical management, always striving to achieve best patient outcomes.

Managed care reinsurers, like Charles Crispin, have also taken healthcare farther by including services that help small and medium health plans control the cost of the most expensive cases.

Charles Crispin. Image Credit: flickr.com/photos/harwig

One way to have this done is by helping HMO clients manage potentially costly cases so that reinsurers can help reduce their own risk. HMO reinsurers try to lower the risk by offering medical management expertise, usually at little or no extra cost.

But more than the amount of reduced risk is the high quality of outcome that results from the recommended options. Reinsurers, as a rule, would not suggest anything that does not promote a favorable outcome. Since solutions, no matter how short-term, are always seen in the context of long-term results, then much deliberation is being conducted prior to effecting any action. As a result, incentives are very much aligned to the healthcare goals for the patient.

Charles Crispin. Image Credit: flickr.com/photos/deathtiny42

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