Joint replacement surgery is fairly common in the United States, with more than 285,000 hip replacement surgeries every year. However, if that new hip turns out to be defective—causing further pain or weakening of the joints—this routine hospital procedure could become subject to the complexities of mass tort litigation.
What is mass tort?
Mass tort occurs when a faulty drug or device harms a large number of people, such as a hip replacement that causes tissue and bone death, or a diabetes drug that is linked to bladder cancer. In a mass tort case, each plaintiff files an individual claim resulting from distinct damages and each plaintiff receives his own trial. Mass tort relies on some of the same processes and procedures as subrogation to recover payments. However, due to the complexity of mass tort cases, not every health payer has the technology, expertise, or resources to devote to pursuing mass tort.
Cost recovery opportunity
While mass tort litigation is certainly complex and resource-draining for health plans to pursue, it represents a substantial cost recovery opportunity for health plans, with potentially millions of dollars in legal settlements at stake.
Discovery Health Partners Mass Tort solution
Discovery Health Partners offers a solution to maximize mass tort recoveries with a unique process model that drives measurably better results. Built on the pillars of accurate identification, proactive legal expertise, dashboard visibility, and compliance with regulatory agencies, our solution has the potential to recover millions of dollars for our partner health plans.
Identifying members who received medical care associated with mass torts requires powerful data mining and advanced analytics capabilities. Each case involves a new set of indicators, and requires distinct analytic models. Data is drawn from claims, diagnostic and procedure codes, as well as medical and legal records for more accurate identification with fewer false positives.
Mass tort recoveries require a detailed understanding of complex legal processes and jurisdictions, which some health plans don’t have available to them in-house. Discovery Health Partners has expert in-house legal counsel with a deep knowledge of mass tort and established processes for litigating these claims, which often fall into overlapping jurisdictions. Using advanced state-of-the-art case management software, our legal team proactively tracks cases and pursues recoveries using this systematic approach.
Visibility and compliance
Like any complex process, optimizing mass tort recoveries requires visibility into trends, exceptions and outliers, and performance indicators. Discovery Health Partners’ full-service dashboard provides visibility into your mass tort inventory with detailed reporting. With this transparency, senior management can track trends and cases for more accurate forecasting. It also provides internal and external reporting insights that meet all compliance requirements.
Results with Discovery Health Partners
The best approach to mass tort in today’s post-healthcare reform era is proactive, systematic, and programmatic. Discovery Health Partners has implemented these best practices with our current clients at a rate of 100% satisfaction. We are the leading provider of mass tort solutions, with millions in successful recoveries for our clients, and we are ready to help your health plan identify, pursue, and maximize tort recoveries.
 American Academy of Orthopaedic Surgeons, 2014 – http://orthoinfo.aaos.org/topic.cfm?topic=a00377