Risk Analysis
PointRight services begin with a qualitative and quantitative risk analysis as part of the underwriting process. Each facility is assigned a risk level. Areas of risk exposure are detailed and each facility is given a risk management prescription.
The qualitative analysis utilizes PointRight’s comprehensive database of public and private information such as occupancy, payer mix, staffing analysis, survey results, survey deficiencies, and measures of structure, care processes, and clinical outcomes. Data elements of known predictive value are systematically extracted from the application and the loss history and combined with this data to create the quantitative risk analysis. A facility’s performance is benchmarked against other facilities within its state, survey district, and rating territory. Potentially modifiable risk factors that deviate adversely from benchmarks and have significant impact on risk are identified, and a risk management prescription is developed that focuses on those factors.
The result is an estimate of a facility’s likelihood of a significant claim and the likelihood of multiple claims. Using the risk estimates, the risks are stratified so that terms and premiums can be set appropriately. Through discussion with the insured, risk management service funds can be applied to the areas with the highest risk leverage.
