Description
For this assignment, the executives at your company must decide on implementing new technology. It can be a new CRM system, cyber security system, artificial intelligence for production, etc. While you may think the executive should know ‘everything,’ that is not always the case. Your job is to write a whitepaper to inform the firm executives of what they need to know to make an informed decision.
For example, if you are in the clothing industry, you can write about how A.I. is used for supply chain management to speed up production processes. If you are in the education industry, what A.I. technologies are being developed?
The white paper should include the following headings:
Title Page.
Table of Contents.
Executive Summary.
A minimum of three informative headings
Key Takeaways.
Conclusion.
Remember to catch people’s attention. It is always a good idea to include some form of graphics. Be creative!
This module has examples of whitepapers and two templates (files attached) you can use to create your own. You do not have to use the templates.
This writing is NOT an APA formatted paper, but it should include a reference page in APA format.
There is no minimum or maximum page limit, and the reason is that you should be able to know if you have enough or too little information to get your point across. As a guide, if your white paper is three pages, I would suspect that it is too short, given the mandatory headings you must have in the paper.
RUBRIC:
– Formatting is professional, headings help the reader locate key information.
– Executive summary: Executive summary includes enough essential information to serve as a useful decision-making tool on its own.
– Introduction: Introduction clearly states the decision that needs to be made and why it is important, and is useful to the reader.
– Substantive information provided: Paper provides substantive information on at least 3 key issues informing the decision.
– Key takeaways: At least 3 key takeaways are clearly described, and their relevance to the decision is explained.
– Conclusion: Conclusion summarizes the most important insights of the paper, and explains their impact on the decision to be made.
– APA reference list: Reference list uses APA format with no errors.
– Title page and TOC included: Title page and table of contents are included and professionally formatted.
MATERIALS:
– Management Communication (book file will be attached) – Chapter 7: Example Bank, page 16. This page provides links to examples of business reports, including whitepapers.
– (4) So… what exactly is a white paper? – YouTube
– (4) How To Write A White Paper In 4 Easy Steps by author of “How To Write A White Paper In One Day” – YouTube
– (4) What is a White Paper – YouTube
– Overview: Whitepapers are commonly used in business to help solve problems and make decisions. According to an article in MediaSpace Solutions (2011), Whitepapers “…are considered to be the most influential form of business collateral, and 76% of people have used white papers as part of their decision-making efforts” (Xiong, 2011).
Whitepapers can generate leads, educate consumers, and contribute to you being a thought leader in the industry.
A whitepaper addresses a current topic related to an industry or a key question faced by an organization. It is designed to provide background information and data that describes the “state of the art” on that topic or question. It is not persuasive to move the reader to a specific action, as a sales proposal would, and it is not an opinion piece. The tone of a whitepaper is professional, fact-based, clear, and concise.
Whitepapers typically demonstrate the writer’s (and his/her/their organization’s) ability to analyze, synthesize, and present information clearly and effectively. Construct your analysis of the topic on good source material and reliable data. Present your conclusions clearly. This kind of writing showcases your knowledge of a topic, establishes your credibility, and builds your reputation as an expert or innovator in a given area.
Unformatted Attachment Preview
WHITE PAPER
SHOPPING
GUARANTEE
How Do You Know If Your Site Is
Optimized for Conversion?
In the early years of ecommerce, just existing
on the Internet was enough. The retailer who
had a functional website was light-years ahead
of their brick and mortar competitors.
Back then, no one was concerned about
optimizing their website for conversion. Even if
they wanted to test how well elements of their
site were performing, they couldn’t. That’s
because no testing tools existed.
The world of ecommerce has grown more
competitive, and the approach to conversion
has become more scientific. Today, robust
testing is crucial to a site’s success. Online
retailers must test every aspect of their
websites to determine how effective the sites
are at turning shoppers into buyers.
How do you know if your site is optimized
for conversion?
You won’t know, not until you test the site
with the right tools and the proper strategy.
This white paper examines the three essential
questions you and every online merchant
must answer to know whether a site is
optimized for conversion:
What needs to be tested?
What is the best tool for the test?
Is the testing strategy structured and
implemented properly?
THE EVOLUTION OF
CONVERSION TESTING
The earliest type of conversion testing was the
time-series test. The formula was simple:
compare this quarter’s sales figures with last
quarter’s sales figures. If sales went up, then
something worked. If sales went down, then
something went wrong.
A handful of tools, like Google Optimizer,
measured traffic for analysis in conjunction
with sales figures and traffic volume. Using this
early form of conversion testing, it was difficult
for retailers to determine which factors
influenced the performance of their sites.
Only in the last several years have more
sophisticated testing tools emerged. Retailers
gained the ability to change the color, design
and other elements of a site, reorganize the
shopping cart, and conduct simple tests on the
sales impact of these changes.
Still, many retailers were stuck using basic
time-series testing that compared sales across
two periods in time.
Basic testing may work for smaller companies
and those just entering the marketplace. Very
small companies can safely conclude that a
1 1
major event, such as launching a new product
line or changing a price, has a direct impact on
sales from one month to another. Detailed
analytics aren’t necessary to draw conclusions
about huge changes to a small website.
The effectiveness of social media and
content marketing is a moving target.
In today’s fiercely competitive ecommerce
environment of large retail sites and heavy
traffic volume, time-series testing is incapable of
supporting accurate conclusions and strategic
decision-making. Reaching a conclusion takes
too much time. Things change fast on the
Internet, and retailers can’t afford to wait a year,
a quarter, or even a month to measure changes
to their websites. This type of testing can’t
account for products with seasonal sales cycles
or the huge sales boosts most retailers
experience during the holidays.
Mobile devices change the ecommerce
ecosystem.
Fortunately, testing tools have reached a
higher level of sophistication.
Retailers can now deploy tools that,
when paired with the right testing
strategy, give them valuable analytics
that empower them to maintain a high
level of optimization for conversion.
Data breaches at large online retailers
increase shoppers’ fears.
With so many uncontrollable variables, testing
is a means to understand the impact of what
can be controlled. What worked last month
may not work this month. A recent change
once considered a stroke of genius may
actually drag down conversions. Retailers must
continuously take the pulse of their
ecommerce site so that they have the accurate
and timely information they need to adapt and
make strategic decisions.
What Needs to Be Tested?
The first question is, what needs to be tested?
To determine your testing strategy, consider
the additions or changes you made to your
retail site. Perhaps your test examines:
The impact of a free shipping offer
A merchant reliability seal, or
A guaranteed shopping program
on conversions.
CHOOSING THE RIGHT
TESTING STRATEGY
The conversion rate of every retail site is
constantly affected by changes on the Internet
that are outside of the retailer’s control:
Search engines routinely modify their
SEO algorithms.
Competitors tweak their sites to provide
better shopping experiences.
Once you understand what to test, you can
choose the best retail testing methodology to
get accurate analytics.
What Is the Best Methodology for the Test?
A time-series test introduces the test element,
tracks conversion over time, and then
compares conversion rates between the two
time periods. It’s a simple process that’s easy
to execute. However, this testing methodology
does not produce quality analytics to support
strategic decision-making.
2
In nearly every instance, the A/B split test
yields far more accurate and reliable results.
A/B testing randomly divides website traffic
into two similarly composed groups,
introduces the test element to one of the
groups, then compares the performance of
the test element between the two groups.
This methodology is best because it
effectively isolates the tested element,
allowing merchants to directly attribute any
positive or negative performance difference
to that element.
Also consider whether a single-page test or a
site-wide test is required. Single-page testing
rotates elements on a specific page on a
per-view basis, regardless of the previous or
subsequent pages seen by the visitor. This
methodology works well when you attempt to
measure the impact of one element on
increasing click-throughs to the next page.
Site-wide testing, on the other hand,
introduces and maintains elements that are
persistent throughout a potential buyer’s visit
to the site and measures the overall impact on
conversion. When paired with A/B split testing,
site-wide testing becomes a highly effective
methodology that offers retailers detailed
analytics about a tested element.
Is the Testing Strategy Structured and
Implemented Properly?
A/B site-wide testing presents significant
technical challenges. To get the best analytics,
structure and implement the test with precision.
Use only the tools and testing strategies
specifically designed for this type of testing.
Otherwise, the test will produce unreliable
analytics and will waste your resources.
Critically important, ensure that the tool used
is accurately calibrated to conduct a true
site-wide test: each visitor must be in a group
that consistently sees, or consistently does not
see, the element being tested. Don’t cut
corners. Avoid the common mistakes, such as
using free tools that are not sophisticated
enough to accurately track visitors or measure
the impact of site-wide changes.
Also, the tool must be capable of tracking the
lifetime impact of an element on the visitor.
Because shoppers often visit multiple retail
sites before making a purchase, the tool must
consistently track repeat visitors. Those who
start in one test group must remain in that
same group throughout the duration of the
test period.
Testing tools that rely on cookies to track
visitors are less effective because as many as
65 percent of Internet users delete cookies and
39 percent change their browser settings to
block cookies.1 When members of a testing
group are intermittently exposed to the tested
element because their browsing behavior
cannot be properly tracked, the reliability of
the test is destroyed. The best tools use IP
addresses and related data, in addition to
cookies, to provide accurate analytics with
greater reliability.
NORTON SHOPPING GUARANTEE
OFFERS FREE SITE-WIDE
A/B TESTING
Site-wide A/B testing is the most effective way
to ensure that the chosen conversion
optimization solutions are producing the
desired ROI. Retailers who have chosen to
implement the Norton Shopping Guarantee to
Because testing is a process and not a
goal, every retailer can benefit from a
partnership with a technology provider
that understands the purchasing
dynamics of online shoppers as well as
the complexities involved with testing
conversion optimization.
3
increase conversions can conduct free site-wide
A/B tests. Also, Norton Shopping Guarantee
offers users a 20x ROI guarantee. For every
dollar that a retailer invests in Norton Shopping
Guarantee, we guarantee that the merchant will
realize a $20 increase in sales.
The best way to determine if a retail website is
optimized for conversion is to use the right
testing tool along with the proper methodology
for the job. To confirm that your website is
optimized to turn shoppers into buyers,
conduct ongoing robust testing of your
conversion solutions.
1
http://download.microsoft.
com/download/5/3/8/53890306-627c-4efe-8e61-7fe593b013f0/dpd%20privacy%20survey%202013%20presentation_final.
pptx
Microsoft,
Data
Privacy Day 2013 Survey Results, 2013..
Norton Shopping Guarantee is designed to increase
conversion, average order value, repeat buyers and
customer satisfaction. When the Norton Shopping
Guarantee benefits are displayed throughout the buying
process, merchants will reduce shoppers’ concerns
about information security, product authenticity, timely
delivery, and getting a good price.
NORTON SHOPPING GUARANTEE
info@NortonShoppingGuarantee.com
1-855-658-2760, Option 1
1611 N Kent St, #803, Arlington, VA 22209, USA • www.NortonShoppingGuarantee.com
SHOPPING
GUARANTEE
4
Image
Image
Acquisition
Acquisition
Technology
Technology
Choosing the Right
A Machine Vision White Paper
CHOOSING THE RIGHT IMAGE ACQUISITION TECHNOLOGY
1
Today, machine vision is used to ensure the quality of everything from tiny computer
chips to massive space vehicles. Machine vision has evolved to become a vital and
effective automation tool that enables computers to replace human vision in many highspeed and high-precision manufacturing applications.
While improvements in the performance of this technology have encouraged more and
more companies to adopt machine vision, significant challenges remain in designing and
building highly reliable vision systems for truly demanding applications. Not the least of
these is the challenge of integrating a number of discrete components that must work
together efficiently in any system.
This white paper will focus on one of the key processes within the vision system—the
image acquisition process—and more specifically, on the image acquisition board (frame
grabber) and its related software. It will outline the critical functions these components
play and discuss some of the recent engineering innovations being deployed to significantly increase the reliability of this process.
FUNCTIONS DISCUSSED INCLUDE:
•Programmable Delays
•Managing False Triggers
•Time Stamping
•Circular Buffers
•Validating Data Integrity
Frame grabbers play an essential role in ensuring that a machine vision system
acquires an image of the correct target, and that the stored image data correlates
to the correct target and that the data is then transferred reliably to the system’s
memory for processing. Achieving this level of dependability requires integrating various image acquisition control functions—including trigger inputs, strobe outputs,
camera control signals and external I/O—into on-board hardware, and using software functions for command and control.
CAMERA 3
LIGHT
LIGHT
BACKLIGHT
REJECTOR
SENSOR
LIGHT PATH
REJECT BIN
LIGHT
CAMERA 1
LIGHT
CAMERA 2
IMAGE DATA
+ CAMERA CONTROL
PC
CAMERA 1
PASS
GOOD
PROCESSING
CAMERA 2
LIGHTING
CONTROL
CAMERA 3
Typical Machine Vision System
CHOOSING THE RIGHT IMAGE ACQUISITION TECHNOLOGY
2
ACQUIRING THE RIGHT TARGET
Integrating camera control functions such as trigger and strobe control into a vision
system’s on-board hardware sounds simple enough: a trigger input generates a
strobe output for lighting control and camera exposure. Some circumstances, however, demand a delay between the two events, such as when the camera and lighting units are not in the same position on the conveyor as the trigger sensor.
Coordinating the events through software is certainly not reliable—especially given
the inherent variations in the Windows operating system.
To compensate, some frame grabbers permit programmable delays between the signals, so that developers can establish a precise delay between the trigger input and
the firing of the lighting and camera exposure. Unfortunately, any programmed delay
reflects only the theoretical speed of a production line. If the actual speed differs or
is not constant, the camera will not acquire the target properly.
In contrast, a frame grabber that includes an integrated trigger and strobe mechanism always matches the production line’s actual speed by establishing each delay
according to shaft-encoder ticks. This feature allows proper control of the camera to
capture the image of the target being inspected. Although these hardware features
remain under software control, once initialized they act independently to produce
consistent and predictable results.
TRIGGERS, TRIGGERS, AND MORE TRIGGERS
After a camera sensor acquires a target image, the inspection system must read the
data from the sensor and transfer it to the host computer for processing. It’s nearly impossible to anticipate all the conditions that could lead to unreliable image
acquisition. The sensor may never detect the object in the first place, so it won’t generate a trigger signal to the system. To combat this possibility, some frame grabber
manufacturers are working with camera vendors to take advantage of the new camera models’ fast-scan and partial-scan modes that allow the frame grabber to act as
the triggered device.
Too many triggers (as in false triggers) can also occur. Or triggers can follow so close
together that the system cannot read the sensor memory completely before the next
exposure occurs. In this case, the system can notify the host application software
of missed triggers through event callbacks. The analysis software becomes aware of
the double trigger and automatically rejects the target into the “not inspected” bin,
flags the error for a human operator to review or takes other appropriate action.
TIME STAMPS
Detecting targets, firing lighting strobes and cameras when the targets are in place
and reading the correct data from the sensor are only the beginning of a reliable
image acquisition process. The system also has to coordinate the image data and
correlate the images with the corresponding physical objects.
Consider a parts-handling unit processing up to 3600 parts/minute. The system
must inspect all four surfaces of each part. Because of positioning, it cannot
acquire all four images at the same location, but must acquire them individually as
the target moves through the system. The imaging system must therefore acquire
14,400 images/minute and correlate four different acquisition locations with the
image data stream. As each object emerges from material handling, the inspection
system must decide whether to accept, reject or re-inspect it.
visit us online @ www.imaging.com
CHOOSING THE RIGHT IMAGE ACQUISITION TECHNOLOGY
3
To correlate all this data, a frame grabber can add an important piece of information
to the mix: a time stamp. A time stamp inserts a unique time code into the image
data structure, derived either from an on-board hardware clock or from the shaftencoder ticks. This provides a direct correlation between the movement of the target through the system and the acquired data.
Shaft encoder
or time stamp
provides a direct
correlation
between target
and data.
CAMERA 3
LIGHT
LIGHT
BACKLIGHT
REJECTOR
SENSOR
LIGHT PATH
CONVEYOR
SLOW DOWN
TRIGGER
CAMERA 1
REJECT
CAMERA 3
CAMERA 2
LIGHT
LIGHT
CAMERA 1
CAMERA 2
SHAFT
ENCODE
IMAGE DATA
+ CAMERA CONTROL
PC
t
CAMERA AND LIGHTING CONTROLS ARE CORRELATED
TO SHAFT ENCODER TICS
TIC A:
CROSSES SENSOR
TIC B:
TIC C:
ACTIVATE CAMERA 1
ACTIVATE CAMERA 2
TIC D:
TIC E:
ACTIVATE CAMERA 3
REJECT ACTIVATOR
LIGHTING
CONTROL
CAMERA 1
CAMERA 2
CAMERA 3
Because there is a time lag between image capture and analysis, the time stamp
ensures that the system always acts on the correct target. The time stamp can also
help with long or high-speed image sequences, where analyzing the time interval
between images can determine if an image was missed during the capture
sequence.
MONITORING THE ACQUISITION PROCESS IN HOST MEMORY
When transferring image data into system memory, software can ensure that the
frame grabber captures all the necessary images accurately. Tracking the events
(Table 1) allows the inspection system to accurately monitor the capture and transfer sequence.
Table 1. Capture and transfer sequence
EVENT
ACTION
Trigger
Notifies the host application that a trigger
event has occurred
Double trigger
Notifies the host that a trigger event
occurred that did not produce image data
Start of frame/field
Notifies the host that an image is being
acquired
End of frame/field
Notifies the host that an image has been
acquired
Start of transfer
Notifies the host that an image is being
transferred to system memory
End of transfer
Notifies the host that an image has been
transferred to system memory
REJECT BIN
CHOOSING THE RIGHT IMAGE ACQUISITION TECHNOLOGY
4
Through these events, the host can monitor the target acquisition process from the
time the object arrives at the inspection point to the time that the image resides in
host memory. To assist the monitoring process, each event can be placed on a specific channel that relates to only one camera. Within each channel, an index counter can increment on each event. An incorrect index value would immediately indicate
that an error has occurred.
Proper system design demands a certain amount of over-capacity to handle peak
loads, such as when a system must acquire, process and analyze the 14,400
images/minute of the earlier example. To reliably process thousands of images, a
machine-vision system can take advantage of circular buffers. By depositing image
data into the next available location within a circular buffer, the system can maintain
multiple images within a single channel.
CAMERA 3
LIGHT
LIGHT
BACKLIGHT
REJECTOR
SENSOR
LIGHT PATH
REJECT BIN
LIGHT
CAMERA 1
LIGHT
CAMERA 2
IMAGE DATA
+ CAMERA CONTROL
PC
CAMERA 1
PROCESSING
CAMERA 2
CPU
LIGHTING
CONTROL
}
PASS
PASS
PASS
PASS
PASS
FAIL
PASS
PASS
GOOD
CAMERA 3
IMAGE BUFFERS
Circular buffers manage data flow
If the system acquires images faster than it can process them, filling up the buffer
space, the frame grabber can deposit the extra image data in a special frame buffer
called the “trash buffer.” The system can then initiate a hardware event, indicating
that there is image data in the trash buffer that must be monitored. As a partial
recovery, the application software can read the image’s time stamp, track that
object through the system and assign it to the “not inspected” bin.
MAXIMIZING DATA QUALITY
Even if a frame grabber reliably captures data, there’s no guarantee that the data is
usable. What happens if a noise or power glitch merges two pixels or lines together, compromising the data from the camera? Is all the subsequent acquired data
incorrect? Must you restart the system?
To be truly reliable, a frame grabber must ensure that the data is not corrupt.
It should compare the number of pixels and lines being captured to the camera file.
visit us online @ www.imaging.com
CHOOSING THE RIGHT IMAGE ACQUISITION TECHNOLOGY
5
If an error has obliterated some camera data, the system can recover on the next
incoming image. At the same time, the system can set a status flag indicating the
suspect quality of the acquired image.
Frame grabbers that can detect problems and act on them greatly simplify system
development. With such a frame grabber, an OEM doesn’t have to invest time and
effort to understand why a system failed. In addition, the frame grabber can reduce
maintenance and support once the inspection equipment is installed in the field,
lowering total system costs.
CHOOSING THE RIGHT IMAGE ACQUISITION TECHNOLOGY
By gaining more control over the image acquisition process, engineers can expect
significant improvements in the overall performance of their machine vision system,
increasing yield and ultimately ROI.
This demand for improved reliability is why Coreco Imaging has implemented an engineering framework called “Trigger-to-Image Reliability.” Trigger-to-Image Reliability
leverages Coreco Imaging’s hardware and software innovations to control, monitor
and correct the image acquisition process from the time that an external trigger
event occurs to the moment the data is sent to the PCI bus. Trigger-to-Image
Reliability enables more efficient and reliable machine vision inspections by securing the image acquisition process, providing traceability when errors do occur and
permitting graceful recovery from those errors.
HOW TO LEARN MORE
Coreco Imaging is dedicated to helping customers understand and
simplify the complexities of machine vision systems. To that end,
Coreco Imaging offers a comprehensive knowledge base of tutorials,
application notes and white papers prepared by our own engineers
and by third-party machine vision specialists. This knowledge draws
from more than 25 years’ experience solving machine vision problems in
many domains. We invite you to learn more by exploring this knowledge
base at www.imaging.com.
HEADQUARTERS 7075 Place Robert-Joncas, Suite 142, Saint-Laurent, Quebec, Canada H4M 2Z2
T: 514.333.1301 F: 514.333.1388
visit us online @ www.imaging.com
Seven Tough Questions
Every Insurer Must Ask
About your Next Hospital Contract
A White Paper for Health Insurance Executives
Seven Tough Questions Every Insurer Must Ask
1
Contents
Executive Summary
3
Question 1:
4
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12
© 2009 by Health Plus Technologies Inc.
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Seven Tough Questions Every Insurer Must Ask
2
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each contract.
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Seven Tough Questions Every Insurer Must Ask
3
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Background
Your payouts can
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since the biggest
increases fall on the
most costly services.
8SLIPTGSRXVSPGSWXWQSWXGSRXVEGXWMRGPYHIEGETSRXLIXSXEPMRGVIEWITIVQMXXIH
JSVMR¾EXMSRWYGLEW &YXXLMWTIVGIRXEKIGERFIQERMTYPEXIH
0MOIMXSVRSX]SYVGSYRXIVTEVXWJVSQXLILSWTMXEPQE]FIFIXXIVTVITEVIHXS
RIKSXMEXIXLI½RITVMRXSJXLIGSRXVEGX8LI]PMOIP]LEZIFIXXIV½KYVIWSRGSWXWERH
QEVKMRWEXXLIMV½RKIVXMTW8LI]QE]LEZITS[IVJYPRYQFIVGVYRGLMRKWSJX[EVIXLEX
can compare numerous pricing scenarios.
%RHQER]LSWTMXEPWIZIRLMVIWIEWSRIHGSRWYPXERXWXSLIPTXLIQQEMQM^IXLI
revenue cycles from each contract.
;MXLEPPXLMWLIPTSRXLIMVWMHIXLILSWTMXEPQE]WIIEGPIEVTEXLXSQSVITVS½X
&SSWXMRKJIIWJSVWIPIGXIHLMKLP]TVS½XEFPIWIVZMGIW
Hospitals seek to gain from selective fee increases in two ways.
*MVWXXLI]WIIOXSLEZImore services “carved out”ERHTEMHEXEHMWGSYRX
JVSQXLILSWTMXEP´WFMPPIHGLEVKIW8LIWIGLEVKIWEVIQYGLPIWWXVERWTEVIRXXLERE
½IHJII
%RHWIGSRHLSWTMXEPWTVIWWJSVhigher reimbursements for selected
servicesTPERRMRKXSEKKVIWWMZIP]QEVOIXXLIWIWIVZMGIWMRXLIGSQMRKQSRXLW
*SVMRWXERGIF]MRGVIEWMRKGEVHMEGWIVZMGIWF] FYXIZIV]XLMRKIPWISRP] XLI
LSWTMXEPQE]PMQMXXLIEZIVEKIJIIMRGVIEWIMRERI[GSRXVEGXXSXLIWTIGM½IH
&YXXLILSWTMXEPGERXLIRVSPPSYXEbig advertising campaign extolling the
ZMVXYIWSJMXWGEVHMEGGEVIERHTIVJSVQMRKQER]QSVIGEVHMEGTVSGIHYVIW[MXLMRXLI
term of your next contract.
8LMWGERGEYWI]SYVTE]SYXWXSMRGVIEWIHVEQEXMGEPP]WMRGIXLIFMKKIWXTIVGIRXEKI
increase falls on some of the most costly services.
8LMWWXVEXIK]MWLEVHXSHIXIGXNYWXF]PSSOMRKEXSRIRYQFIVJSVXLISZIVEPPMR¾EXMSR
VEXIEPPS[IHMRXLIGSRXVEGX
Seven Tough Questions Every Insurer Must Ask
4
Tough question #2:
How much of this contract will be paid on billed
GLEVKIWERHLS[QYGLSR½IHVEXIW#
8LIGSWXSJER]GPEMQTEMHEXE½IHVEXIMWQYGLIEWMIVXSTVIHMGX
XLERXLIGSWXSJEGPEMQTEMHEXEHMWGSYRXJVSQXLILSWTMXEP´WFMPPIH
GLEVKIW9RHIVXLMWGSRXVEGX[LEXTSVXMSRSJ]SYVTE]QIRXW[MPPFI
GEPGYPEXIHEXE½IHVEXI#
Background
The cost of claims
TEMHEXEHMWGSYRX
JVSQFMPPIHGLEVKIW
MWLEVHXSTVIHMGX
ERHMQTSWWMFPIXS
control.
The single best metric for controlling your costs is the percentage of total
HSPPEVWTEMHEXE½IHVEXI to a hospital.
Knowing this number helps protect you against strategic price increases that are
GPIEVP]MRXLILSWTMXEP´WFIWXMRXIVIWXW
%W]SYORS[QSWXGSRXVEGXWWIXE½IHTVMGI for certain hospital services such
EWHIPMZIV]GEVHMEGGEXLIXIVM^EXMSRERHSFWIVZEXMSRWIVZMGIW=SYVXIEQ[SVOWLEVH
XSTIKXLIWIWIVZMGIWEXE½IHVEXI8LIWIGSWXWEVIJEMVP]TVIHMGXEFPIWMRGIXLISRP]
ZEVMEFPIMWLS[QER]XMQIWIEGLWIVZMGIMWHIPMZIVIH
&YXMRQER]GSRXVEGXWRSXLMRKIPWIMW½IH7SWIVZMGIWPMOIGLIQSXLIVET]HMEP]WMW
MQTPERXEFPIWERHLMKLGSWXHVYKWEVITEMHat a discount from the hospital’s
charge master.
8LMWMRXVSHYGIWEWIGSRHZEVMEFPIRSXWTIGM½IHMRXLIGSRXVEGX,S[QYGLHSIWXLI
LSWTMXEPGLEVKIJSVIEGLWIVZMGI#
7SXLIGSWXSJGPEMQWTEMHEXEHMWGSYRXJVSQFMPPIHGLEVKIWMWQYGLLEVHIVXS
TVIHMGXERHMQTSWWMFPIJSV]SYXSGSRXVSP
‘PIEVP]XLIQSVIWIVZMGIW]SYMRWYVIEXE½IHTVMGIXLIPIWWVMWOSJ]SYVGSWXW
WTMVEPMRKYT[EVHWERHXLIJI[IVSTXMSRWJSVELSWTMXEPXSIRLERGIMXWVIZIRYIW
simply by increasing charges.
Seven Tough Questions Every Insurer Must Ask
5
Tough question #3:
Does this stop-loss clause capture only the true
outliers, or does it also enhance the hospital’s
revenues?
The purpose of a stop-loss clause is to protect a hospital from losing
QSRI]SRXLIQSWXWIVMSYWP]MPPTISTPI&YXHSIWXLMWGSRXVEGXEPPS[E
LSWTMXEPXSQSZIQER]QSVITEXMIRXWMRXSXLIWXSTPSWWGEXIKSV]#
Background
-X´WGPIEVP]MRXLI
LSWTMXEP´WMRXIVIWX
to classify as many
EHQMWWMSRWEW
possible
as outliers.
%XEGIVXEMRXLVIWLSPHEREHQMWWMSRFIGSQIWERSYXPMIVKIRIVEPP]TEMHEXEHMWGSYRX
EKEMRWXFMPPIHGLEVKIW8LMWXLVIWLSPHMWKIRIVEPP]EWTIGM½GRYQFIVMRXLIWXSTPSWW
GPEYWIQSWXSJXIREVSYRH
8LIVEXMSREPIJSVXLMWMWGPIEV,SWTMXEPW[ERXXSTVSXIGXXLIQWIPZIWEKEMRWXPSWMRK
QSRI]SREJI[TEXMIRXW[LSEVIKVEZIP]MPPERHRIIHEPSXSJWIVZMGIWSZIVEPSRK
stay. Fair enough.
&YX[L]WLSYPHLSWTMXEPWTVS½XSRXLSWIWEQIGEWIWEXXLIITIRWI
SJMRWYVERGIGSQTERMIW#(SR´X]SYHIWIVZIWSQITVSXIGXMSREW[IPP#;L]RSX
RIKSXMEXIXSTVIZIRXXLILSWTMXEPJVSQQSZMRKQER]QSVIEHQMWWMSRWMRXSXLI
SYXPMIVGEXIKSV]EX]SYVITIRWI#
-JXLILSWTMXEPGSRXMRYSYWP]FYQTWYTMXWGLEVKIQEWXIV°FYXXLIWXSTPSWWXLVIWLSPH
RIZIVQSZIW°SZIVXMQIXLIWIMRGVIEWIW[MPPTYWLQSVIEHQMWWMSRWTEWXXLI
XLVIWLSPHXSFIGSQISYXPMIVW
8LIRXLIKEQIGLERKIWWSXLILSWTMXEPMWTEMHSREHMWGSYRXJVSQFMPPIHGLEVKIW
-X´WGPIEVP]MRXLILSWTMXEP´WMRXIVIWXXSGPEWWMJ]EWQER]EHQMWWMSRWEWTSWWMFPIEW
outliers. %WTVS½XWSRSYXPMIVWQSYRXJSVXLILSWTMXEPPSWWIWQSYRX
for the insurer.
1IHMGEVIITIGXWXLEXSYXPMIVWQEOIYT SJXSXEPMRTEXMIRXGSWXW&YXXLEX
MWETTPMIHEGVSWWXLIIRXMVIW]WXIQRSXSRELSWTMXEPF]LSWTMXEPFEWMWEJXIVEPPXLI
[SVWXGEWIWEVIWIPHSQHMWXVMFYXIHIUYEPP]EQSRKLSWTMXEPW
7SERMRWYVIVWLSYPHIZEPYEXISYXPMIVGSWXWXLIWEQI[E]
(SR´XXV]XSPMQMXSYXPMIVWXS SJEHQMWWMSRWXSER]SRILSWTMXEPFYXHSGLIGO
XLITIVGIRXEKIEGVSWWEPPXLILSWTMXEPWMREVIKMSRXSQEOIWYVIMX´WRSX[MPHP]SYXSJ
proportion.
Seven Tough Questions Every Insurer Must Ask
6
Tough question #4:
-WXLMWLSWTMXEPTVS½XMRKYRVIEWSREFP]JVSQ
outlier admissions, or are you reimbursing it
near cost?
Is the margin a hospital makes on outlier cases through the stop-loss
GPEYWILMKLIVXLERMXWQEVKMRSREPPSXLIVWIVZMGIW#-WXLMWTEVXSJXLI
GSRXVEGXJEMVERHVIEWSREFPI#
Background
If a hospital tries
XSMPPIKEPP]±KEQI²
1IHMGEVI[SYPHR´X
XLI]HSXLIWEQI
XS]SY#
4VS½XMWRSXEHMVX][SVH&YXWLSYPHLSWTMXEPWFIQEOMRKERISVFMXERX
YRVIEWSREFPITVS½XSVENYWXM½IHTVIHMGXEFPITVS½X#
%PQSWXIZIV]SRIMRXLILIEPXLGEVIW]WXIQ[SYPHEKVIIXLEXoutlier cases
should be paid at close to costWSXLEXXLIIQTLEWMWJSVXLIWIEHQMWWMSRWMW
SRWEZMRKPMZIWRSXQEOMRKQSRI]
&YX1IH4%’VITSVXIHYRYWYEPP]PEVKIMRGVIEWIWMRLSWTMXEPGLEVKIWMRERH
ERHWYWTIGXIHWSQILSWTMXEPWSJ±QERMTYPEXMRK1IHMGEVISYXPMIVTE]QIRXW²-R
1IHMGEVIYTHEXIHMXWSYXPMIVTSPMG]XSGYVFXLMWTVEGXMGI1
Numerous lawsuitsLEZIFIIRPEYRGLIHXSVIGSZIVMPPIKEPSYXPMIVGPEMQWEKEMRWX
1IHMGEVI
*SVIEQTPISRIGSRWYPXMRK½VQMR2I[.IVWI]TEMHQMPPMSREJXIVIRGSYVEKMRK
LSWTMXEPWXSMR¾EXIGLEVKIWXSWUYII^IQSVISYXSJ1IHMGEVISYXPMIVTE]QIRXW2
3XLIVWIXXPIQIRXW[MXLMRHMZMHYEPLSWTMXEPWLEZIXSXEPIHQMPPMSRQMPPMSR
QMPPMSRQMPPMSRERHQMPPMSR
8LEX´WQSVIXLERQMPPMSRMRSYXPMIVVIPEXIH½RIWMR alone. 3
,EZI]SYJEPPIRTVI]XSXLIWEQIXEGXMGW#
%JXIVEPPMJELSWTMXEP[MPPXV]XSMPPIKEPP]±KEQI²XLI1IHMGEVIW]WXIQ°TVSFEFP]
XLIQSWXLIEZMP]VIKYPEXIHTEVXSJSYVMRHYWXV]°[SYPHR´XXLI]HSXLIWEQIXSER
MRWYVERGIGSQTER]#
6IQIQFIVF]HI½RMXMSRERSYXPMIVMWEXXLIQSWXGSWXP]IRHSJXLIWTIGXVYQFIMRK
TEMHEXEHMWGSYRXEKEMRWXFMPPIHGLEVKIW
=IXXLIWIGEWIW°[LMGLEVIWYTTSWIHXSFISRP]XLI QSWXITIRWMZI
EHQMWWMSRW°VSYXMRIP]KIRIVEXI XS SJXLIXSXEPFMPPMRKWJSVGIVXEMRLSWTMXEPW
in any given year.
Are you protecting yourself against this type of unreasonable overbilling#
±,IEPXLGEVI7TIRHMRKERHXLI1IHMGEVI4VSKVEQ²1IH4%’.YRITEKI
±2.GSRWYPXERG][MPPTE]XSWIXXPISYXPMIVGEWI²1SHIVR,IEPXLGEVI1EVGL
4VIZMSYWMWWYIW1SHIVR,IEPXLGEVIVIXVMIZIH2SZIQFIV
Seven Tough Questions Every Insurer Must Ask
7
Tough question #5:
Is this contract competitive, compared to
Medicare rates?
1IHMGEVIGSRWXERXP]VIZMI[WMXWTE]QIRXWXSWXE]GYVVIRX[MXLXLI
PEXIWXQIHMGEPTVEGXMGIWERHXSFPSGOYRVIEWSREFPITVMGMRKXEGXMGWF]
LSWTMXEPW,S[HSIWXLMWGSRXVEGXGSQTEVIXSXLIVEXIW1IHMGEVIMW
TE]MRKRS[#
Background
8LIHMJJIVIRGI
between what
1IHMGEVITE]W
ERH[LEX]SYTE]MW
XLILSWTMXEP´WTVS½X
%W]SYORS[1IHMGEVIMWXLIPEVKIWXWMRKPIFY]IVSJLIEPXLGEVIMRXLIGSYRXV]
VITVIWIRXMRKFMPPMSRSJGPEMQWMR4
8SKIXXLIQSWXJVSQIZIV]XETE]IV´WHSPPEVMedicare’s goal is to reimburse
hospitals at cost4VS½XWEVIRSXWYTTSWIHXS¾S[JVSQXLILSWTMXEPWXE]WSJ
WIRMSVGMXM^IRWYRHIV1IHMGEVI
8SQIIXXLMWKSEP1IHMGEVIVIWIEVGLIVWGSRWXERXP]VIZMI[LSWTMXEPJIIWERHQIHMGEP
TVSGIHYVIWMRGPYHMRKXLIPEXIWXEHZERGIWXLEXGERWLSVXIRLSWTMXEPWXE]WERHVIHYGI
costs.
)ZIV]UYEVXIV1IHMGEVIMWWYIWEHNYWXIHJIIWGLIHYPIWXSVI¾IGXMXWPEXIWX½RHMRKW
3ZIVXMQIQER]TE]QIRXWKSHS[RIWTIGMEPP]XLIRI[IVXIGLRSPSKMIWERH
TVSGIHYVIW
‘LIGOMRKXLIWI1IHMGEVIJIIWGERTVSZMHI]SY[MXLYWIJYPFIRGLQEVOWJSVX[S
reasons.
*MVWX]SYGERGSRWMHIV1IHMGEVIJIIWan approximation of a hospital’s
costsTVSFEFP]GPSWIVXLER]SYGERKIX[MXL]SYVS[RVIWIEVGL7SXLIHMJJIVIRGI
FIX[IIR[LEX1IHMGEVITE]WJSVEWIVZMGIERH[LEX]SYVIMQFYVWIELSWTMXEPJSV
XLEXWIVZMGIMWVSYKLP]XLEXLSWTMXEP´WTVS½XQEVKMR
7IGSRH1IHMGEVIJIIWVI¾IGXXLIPEXIWXEHZERGIWMRXIGLRSPSK]ERHXVIEXQIRX
TVSXSGSPW[LMGLXLILSWTMXEPQE]RSXXIPP]SYEFSYX
3JGSYVWIMX´WRSXMRXLILSWTMXEP´WMRXIVIWXXSHMWGYWWER]reductionsMR1IHMGEVI
JIIW&YX]SY[MPPPMOIP]
