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IARP CONNECT Code of Conduct

  • 1.  Response to "An Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning"

    Posted 09-06-2022 14:41
      |   view attached
    I attempted to have the attached published in the Journal of Life Care Planning, as a Letter To The Editor, however it was rejected.  I have attached the letter.  It is my response to 

    "An    Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning, by Amber Allison, Aubrey Corwin, Michele J. Albers, Heidee White and Robert H. Taylor, all of Vocational Diagnostics, Inc.   

    I a

    Attachment(s)

    pdf
    Letter to the Editor_9-6-2022.pdf   170 KB 1 version


  • 2.  RE: Response to "An Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning"

    Posted 09-06-2022 17:58
    Edited by Rebecca Busch 09-06-2022 19:36

    Harold 

    just one quick comment - not so much directed at the article - but more the reference to Optum data supplied to Fairhealth - the data they provide for a particular CPT code is NOT parsed by license type. Meaning that the number associated at the 80th percentile May include claims data of nurse Practioner and or MD etc. The lack of parsing by license type may dilute  the aggregated data. The definition you referenced states that the UCC should consider same specialty - which means when a number is used regardless of percentile selected the analysis should consider hey I am projecting 99213 for a NP OB/GYne or MD neurology etc.  It would appear that an LCP could use the reference provided to support the use of the 8Oth percentile - that being said the ultimate conclusion should be supported within the actual LCP- which is consistent with our standards 

    In prior responses to this subject I have referenced that prior bills may include current specialty providers that the LCP may consider from an overall perspective. This may conflict with prior discussions of surveying 3 providers. That being said, a current active provider of an individual could be compared to a data base as part of the analysis.


    regardless, I support the notion that one size does not fit all. Otherwise we would not be needed.

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    Rebecca Busch
    CEO
    rebecca@mbaaudit.com
    Westmont, IL United States
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    Original Message


  • 3.  RE: Response to "An Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning"

    Posted 09-12-2022 17:22
    This is a long overdue discussion.  I suspect that the 56% of Summit participants who use the 75th - 80th% do so because it is what was taught in training programs. It fits the definitions of dogma:

         Dogma is a belief or set of beliefs that is accepted by the members of a group without being questioned or doubted.
     
         A principle or set of principles laid down by an authority as incontrovertibly true.

    Using subjective opinions and feelings to refute a journal article that attempts to inject some objective data exemplifies the difficulty in having a fair discussion. Just because something was done in the past does not mean it is right for the future. I think we need to be open to hearing all ideas and in supporting objective research that will help us move forward with credible methods.

    The concept of "client's/evaluee's best interest" is subjective. Why stop at the 80th%? Why not take the highest amount we can find? Once we start to create arguments about using less than 100%, we need something objective to support any other number. 

    BTW, the consensus statement that says we use "Non-discounted/market rate prices" is internally inconsistent. If you look up the definition of market rate, it is clearly not meaning non-discounted. Although that may be what life care planners meant when that statement was created, it is not what it means. Yet, we have not been able or willing to address that.

    Kudos to the article authors and to the JCLP editor for bringing this into the open. And to everyone who takes the time to think about what it means to them and contributes to the public dialog.


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    Karen Preston
    Consultant
    kpreston@rns-hcc.com
    Sacramento, CA United States
    (916) 929-6506
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    Original Message


  • 4.  RE: Response to "An Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning"

    Posted 09-07-2022 11:47
    Edited by Rebecca Busch 09-07-2022 11:50
    so sorry back again - what i really like about these list serv discussions is that it forces me to think - my brain is on overload from my last three depositions - so this reaction is more from an expert testimony perspective - i reviewed our practice standards - i could comment on many of them but i going going to pull this one STANDARD: The life care planner uses a consistent, valid and reliable approach to research, data collection, analysis, and planning. 

    i am relying on those who have worked on the standards to correct me please - what i like about this standard is that the ultimate control of any research, the supporting foundation to an opinion is that what is aggregated by the expert in on the expert to support their opinion.   It is about the expert supporting their basis.  So if the 50% percentile does not work for your plan then just support any price that your analysis concludes to be appropriate.   So again, not a direct comment regarding the article but just a general comment about articles - just be cause an article is peer reviewed and published does not mean it is applicable in all circumstances.  The user of the data is ultimately responsible for supporting their opinion.  

    on a personal note, i know i am on the list of people who have sent letters to the editor often highlighting published articles in which my training education and experience would not support the use of the content by the author(s) - that being said i was always told that i could generate discussions on this list serve but more importantly that i can do my own research and get it published!  

    I write many articles for many organizations and i can tell you the vigorous editing and commentaries i receive on submissions has been at times painful (to the editors you have a thankless but an important job) and the questions asked of the article can be consuming but what i can tell you the best part is that it forces me to find the right words to articulate the subject i am tackling.  

    When it comes to healthcare costing - i am hands on deck for anyone who wants to continue writing about this subject - it may become apparent that this is a subject of interest for me.

    I look forward to the ongoing work product of the costing committee.  I will let this rest for awhile. 

    thanks for all of your patience as a flush this out.




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    Rebecca Busch
    CEO
    rebecca@mbaaudit.com
    Westmont, IL United States
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    Original Message


  • 5.  RE: Response to "An Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning"

    Posted 09-08-2022 12:09

    Defense attorneys will be using this article to cross examine Life Care Planners when they use anything but the 50th percentile, plain and simple. "Mr. Tremp, I see you utilized the 75th percentile in the Life Care Plan you developed; do you have any literature supporting your use of anything but the 50th percentile?  This here peer reviewed article, written by your colleagues, within your industry, concludes it's to be the 50th percentile; so that means your Life Care Plan is invalid, overinflated, speculative," yada, yada... so on and so forth. 

    During the discussion forum at the Dallas conference during May of this year, nobody around me agreed that the 50th was the be all end all. Many talked about using a range, or a specific percentile such as the 75thpercentile.  I do remember, a colleague standing up stating, "use the methodology, percentile, costing resources that you yourself can support." 

    To that, I agree. 



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    Robert Tremp
    r.tremp@deutschtremp.com
    Traverse City, MI United States
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    Original Message


  • 6.  RE: Response to "An Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning"

    Posted 09-09-2022 11:03
    Robert
    I am in agreement with your statement and find it intriguing that every author of the article works for the same business. It would seem as if they are trying to insulate their opinion and make it a standard because they published a piece in a journal saying it is. Just my two cents. 

    Kind Regards,

    Jammie 



     

          

     





    Original Message


  • 7.  RE: Response to "An Analysis of Usual, Customary, and Reasonable Charges in Life Care Planning"

    Posted 05-08-2024 17:38

    Robert this is what is happening now. A defense attorney is taking this article and is running with it as standard practice of the 50th percentile citing this is IARP's stance. 



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    Jenn Toles MS CRC CLCP CCM
    Guided Life Care Planning Services
    info@guidedlifecare.com
    Lithia, Florida
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    Original Message