Determining medical cost projections is a complex process that must include several important elements, including the state in which the person who experienced personal injury lives. Understanding medical cost projections in Texas requires a deep knowledge of five key factors such as the healthcare law for the state, local healthcare provider costs and insurance reimbursement rates.
You have to examine these pieces for the long-term to provide an accurate accounting of expected costs for the injured party to have a high quality of life today and tomorrow. The basic things you must consider when navigating the complexities of medical cost projections in Texas are:
State-specific healthcare regulations
An understanding of the environment the model you are creating will exist in can impact the accuracy of life care planning. Some recent healthcare laws in Texas that are relevant to medical cost projections include:
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- Itemized bills: Healthcare providers must send patients an itemized bill of services before collecting money.
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- Plain-language descriptions: Hospitals and physicians must provide a plain-language description of every service provided.
The impact of local healthcare providers and facilities on costs
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The concentration of hospitals where a person lives can impact medical cost projections. For example, when there are fewer hospitals in a market, prices can increase by as much as 12% because there is less need for competitive pricing in healthcare. Also, if a hospital has excess capacity or staff, costs tend to be higher. You must take into account these variables during the life care planning process.
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The role of regional economic factors in influencing medical costs
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As with any industry, inflation can contribute to higher costs for care. Workforce shortages and supply chain issues in a given area can also negatively impact prices. Shortages of healthcare workers often mean the ones who are working can negotiate higher wages. While these factors are often time-bound, because they are cyclical in nature, it is advisable to account for economic factors while building medical cost projections.
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How to work with life care planners to develop accurate projections for your clients
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It is the responsibility of the legal team to provide the life care planning experts with in-depth information about a client’s injury, including rehabilitation needs and long-term prognosis. The benefit of working with a knowledgeable third party like LCPpro® is that we have a comprehensive understanding of how to model future medical costs. The non-biased opinion life care planners provide is based on medical records, reimbursement rates and the healthcare system in Texas.
Medical cost projections can help you get the legal process started for a personal injury case. The models are simple for trained life care planning professionals to build and are a powerful tool when used in conjunction with initial offers and/or demand letters.
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Best practices for collecting and organizing medical records to support cost projections
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When collecting and organizing medical records for a personal injury case, the best practices include:
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- Obtain a signed medical release form and request all relevant records, including x-rays, scans and treatment plans, from every healthcare provider your client was treated by.
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- Thorough documentation of all injuries and treatments, as well as recommendations for future care and any limitations to daily activities caused by the disability.
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- Keep copies of all documents for your client and ensure that any new records are adding to the collection.
LCPpro® understands the importance of life care planning and will partner with you to create a thorough and timely model. Contact us today.
