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Risk Management Services

Risk, in insurance terms, is the possibility of a loss or other adverse event that has the potential to interfere with an organization’s ability to fulfill its mandate.

Risk management then is the identification, assessment, evaluation and prioritization of risk followed by coordinated and economical application of resources to minimize, monitor, and control the probability and/or impact of unfortunate events or to maximize the realization of opportunities.

The strategies to manage risk typically include transferring the risk to another party, avoiding the risk, reducing the negative effect or probability of the risk, or even accepting some or all of the potential or actual consequences of a particular risk.

Specific to healthcare, the majority of risk of financial loss is directly correlated with patient loss. The strategic and consistent deployment of a risk management plan designed to target this “cost driver” will be effective at minimizing this exposure and protecting the healthcare organization, which is the ultimate objective of risk management.

The systematic gathering and utilization of data are essential to this concept and practice. Risk management programs consist of both proactive and reactive components. Proactive components include activities to prevent adverse occurrences (i.e., “losses”), and reactive components include actions in response to adverse occurrences. In both cases, the risk management process comprises:

  • Diagnosis – Identification of risk or potential risk.
  • Assessment – Calculation of the probability of adverse effect from the risk situation.
  • Prognosis – Estimation of the impact of the adverse effect.
  • Management – Control of the risk.

Prevail can help medical groups and healthcare organizations evaluate, structure and implement effective risk management and loss prevention programs.