A managed care expert witness typically has a background as a physician, legal nurse consultant, specialized medical expert, and/or in the heath insurance industry. According to the National Center for Biotechnology Information, U.S. National Library of Medicine, managed care programs are:
Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as health maintenance organizations and preferred provider organizations.
Litigation support matters requiring a managed care expert witness often involve medical malpractice cases, personal injury, managed care health plan disputes, standards of care, pain management, or medical billing. Expert witness services by a subject matter expert in managed care could include dispute resolution, an expert report, an expert opinion, deposition testimony and courtroom testimony. In a high-profile case, or litigation involving a significant financial stake, legal counsel may request an expert with prior expert testimony experience. The expertise of a managed care expert witness will provide credibility to enable the jury to consider the evidence with the weight it deserves.
Representing the plaintiff or defendant, Cahn Litigation Services has the experience required to turn a search for a managed care subject matter expert around quickly and provide the right balance of expertise and testimony experience.
Please Note: All Cahn Litigation expert witness searches are customized to attorneys' precise specifications and preferences. Attorneys are encouraged to discuss search parameters with a Cahn search specialist.
The below expert witness bios represent a small fraction of those Managed Care experts known by Cahn Litigation Services. These bios are provided to give attorneys a sense of the Managed Care landscape.
This expert has many years of experience in healthcare and in implementing information systems and technologies for process change and value creation. This expert provides consulting on healthcare software development, healthcare product positioning, Healthcare Transformation and Strategic Planning, and Process/Technology Improvement. Through a highly successful consultancy, this expert has provided consulting for many healthcare organizations. This expert has consulted with many companies, leading to many award winning software, technology and product development projects. This expert was the Executive Vice President of a core administration systems software provider to the Health Plan Market where this expert directed new product development. This expert also has served as Associate Professor of Medical Informatics and Director of eHealth Initiatives at a University's School of Health Systems. This expert was the co-founder and Executive Director for an EMR services company. This expert was Vice President of an international healthcare consulting company; and a founding member and CEO of an eHealth Application Solution Provider (ASP). This expert co- founded and was the Chief Technology Officer of an enterprise managed care solutions provider for healthcare networks. This expert was involved with the Department of Health and Human Services in the formulation of the HIPAA Rules. This expert has been intimately involved with the security, privacy, transaction and code set rules. This expert is a past member of the HL7, ANSI X.12, and ActiveX for Healthcare standards groups.
This expert has been in the health care IT field for many years and has been actively been involved in EHR implementations. This expert has been involved in over 200 Hospital implementations and has worked with over 26,000 physicians on their EHR decisions and implementations. This expert has also been involved in over 150 replacements of older or discontinued healthcare specific applications, and has been evaluating EHR products and publishing a report with 3,000+ functionality. This expert has extensive experience in health care redesign and organizational restructuring along with a comprehensive background in start-up and replacement of multi-facility health information platforms, including financial, clinical, managed care and decision support systems. This expert tracks industry trends, conducts member surveys, publishes case studies, assesses best practices, and performs benchmarking studies, and evaluates over 70 product categories within healthcare that are offered by more than 500 software, RCM, and Value Based Reimbursement (VBR) vendors that are in the care Coordination and Population Health Marketplace. This expert specializes in the evaluation, selection, and ranking of vendors in the VBR, RCM, HIE, and PMS/EHR hospital and physician healthcare marketplace. Annually this expert publishes a detailed report on VBR, HIE, and PMS/EHR software product functional, usability, and company viability. This evaluation decision tool has been used by more than 25,000 physicians, more than 20 ACOs/IPAs, and over 200 Hospitals. Additionally, this expert has conducted more than 400 PMS/EHR searches, selections, and contract negotiations for small physician offices to large IPA.
This expert provides independent advisory and consultative services designed to assist physicians and hospitals in evaluating and selecting technology to enable the creation of a digital medical office of the future. For Hospital clients, this expert conducts operational reviews, technology selections, and assists in development of long range plans. This expert has extensive prior litigation experience including deposition and courtroom testimony.