Life Care Plan Critique and Pricing

A Life Care Plan Critique and Pricing is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized, concise plan for current and future needs with associated costs for individuals who have experienced catastrophic injury or have chronic health care needs.[1]

The definition cited encapsulates the principle that life care planning is to be, at a minimum, a consistent process for the evaluation of patients.

TD&P Consulting specializes in life care plan critique and pricing to ensure they are organized, concise and based on established rules governing medical necessity. Our team of consultants is comprised of physicians, policy professionals, attorneys, actuaries, and economists who assist testifying life care planners in the development and evaluation of their plans for benefit eligibility, Affordable Care Act impacts, insurance coverage, and collateral source implications on market pricing.

Paul Deutsch, one of the founders of life care planning, maintains that “the use of clinical practice guidelines and research literature [, while useful, is not enough] to meet the standards that have become necessary for a properly developed life care plan.”[2] An adequate plan requires a strong foundation, which means that life care planners must be willing to take several essential steps. Specifically, they must be ready to:

  1. Establish a strong connection between the record provided and the recommendations being made in the plan,
  2. Ask questions of the medical professionals involved in treatment to learn information, not in the records,
  3. Utilize consulting specialists,
  4. Rely on clinical practice guidelines, and
  5. Consider the research literature (where possible).[3]

Those who fail to provide this foundation undermine the validity of their plan.

TD&P relies on medical literature and market-driven data to develop pricing models that are systematic, comprehensive and objective. The popularity of our approach has grown in recent years as courts steadily raise the evidentiary bar for the admission of cost data. (See People v. Sanchez, 63 Cal.4th 665 (2016)). Nowhere is this more evident than in personal injury cases involving the testimony of life care planners, who are often asked to testify on future medical expenses.

As the progenitor of the leading methodology for the analysis of medical necessity and valuation of medical expenses, TD&P is uniquely qualified to assist in the development and evaluation of life care plans.

 

Dr. Vera Dvorak, MD
Dr. Vera Dvorak, MD

Our expert Dr. Vera Dvorak, MD, leads our  Life Care Plan Critique and Pricing department. She is an authority on standards of care in the healthcare industry, transitions of care, long term planning in the inpatient and outpatient setting, and medical necessity in the group practice setting.

Dr. Dvorak is a board-certified internist and geriatrician with more than 40 years of professional experience. Over this period, she has led her profession as a (1) practitioner, (2) health insurance executive, (3) hospital system professional, and (4) medical consultant. Dr. Dvorak is well-read and maintains continuous medical education at 100 hours per year. She has devoted her professional career to individual patient care and ensuring that all patients are treated with dignity and respect receiving medically necessary at the right level and the right time. A critical focus of Vera Dr. Dvorak’s career has been to help patients and caregivers clearly understand their medical diagnosis and its impact on the quality of life. Read More on Dr. Dvoark

To learn more about our Life Care Plan Critique and Pricing, contact TD&P Consulting, Inc. at admin@tdphealth.com or call (877) 420-8680.

[1] Neulicht, A. T., Riddick-Grisham, S., & Goodrich, W. R. (2010). Life Care Plan Survey 2009: Process, Methods, and Protocols. Journal of Life Care Planning, 9(4), 131–200. Retrieved from https://cdn.ymaws.com/rehabpro.site-ym.com/resource/resmgr/files/JLCP_Publications/JLCP_Vol_9_No_4.pdf

[2] Susan Riddick-Grisham and Laura M. Deming, Pediatric Life Care Planning and Case Management Second Edition, Page 847.

[3] Deming, L., & Riddick-Grisham, S. (2011). Pediatric life care planning and case management. Boca Raton: CRC Press.