Knowledge is power

Tracy Melina’s role at Coverys entails not just helping risk managers deal with existing challenges, but also giving them the knowledge to stay ahead of the game, as she explained to HRMR.

As a risk consultant for medical professional liability insurance and services provider Coverys, Tracy Melina has a unique overview of the challenges faced by healthcare risk managers in a range of organizations in the New Jersey and Connecticut territory.

Her role entails working with physician practices and hospitals to help reduce their risk by performing risk assessments, consulting on specific situations, and developing educational programs tailored to their needs.

In addition, she supports the Coverys Helpline and mentor programs; provides editorial support for literature on current risk management issues; and assists in promoting Coverys’ monthly webinars, programs-to-go, e-newsletters, white papers, and opinion letters covering trending topics.

“The most rewarding part of my current role at Coverys is working with our insureds to find ways to improve healthcare while minimizing the risk,” she says. “Coverys works with the Institute for Healthcare Improvement (IHI) which provides the opportunity to develop processes with partner groups to reduce the opportunity for misdiagnosis.”

One of her biggest challenges is educating busy policyholders on the value and benefits of the risk management program to which they have access through Coverys.

“Healthcare is changing so rapidly, and hospitals and providers are busy ensuring they are meeting standards within their practices, so finding time to learn about the risk management resources available to them can be a challenge,” she says.

A career in healthcare

Melina began her career in healthcare after high school, working as a secretary on a hospital medical surgical unit.

“My parents did not have the means to assist me with college tuition so I applied for a job at the hospital where my sister was attending nursing school. I was able to get tuition assistance from the hospital and go to college part-time as I continued to work. I received my Bachelor of Science in administration of justice with a minor in business from Rutgers University in New Jersey,” she says.

“Telemedicine, or video consulting, is providing new ways for physicians to treat patients in areas where access was not previously possible."

“During my time at the hospital, I was promoted to a role in the risk management and security department, working with our agent to obtain insurance coverage for all lines of insurance. While in this role, I obtained my insurance license, completed the ASHRM module for risk management, and passed the certification exam for certified professional in healthcare risk management (CPHRM).”

The hospital where she was employed underwent a merger and she was promoted to a management position in risk management. In this role, she worked closely with partner companies, nursing homes, assisted livings, home health, and physician practices.

“I then decided to further my education and earned an MBA in risk management and insurance from Florida State University.
“I have worked for a few healthcare systems since and found my home at Coverys in May 2014,” she says.

Challenges for 2016

Besides working directly with physician practices and hospitals, Melina is currently working with the firm’s underwriting department to look at simulation lab programs for possible partnering with Coverys. She is also working on developing long-term post-acute care tools for clients.

“In addition to my work in projects and client services at Coverys, the company supports my involvement in local and regional risk management organizations. I serve on the board of the Society for Health Care Risk Management (SHCRM) of New Jersey, where we are working hard to increase membership from all perspectives, including hospital and physicians’ office representatives, insurance agents, and attorneys.”

In addition, the board is trying to find a way to balance workload with member programs. The SHCRM board is in the process of developing a survey to distribute to members to identify their ‘pain points’ and help identify ways SCHRM can meet their needs. For example, the annual SHCRM conference in May 2015 presented status updates of the healthcare insurance market and state regulatory matters.

“This information was well received and will be included in the May 2016 SHCRM conference program to ensure that our colleagues in risk management have the most up-to-date information available, which will allow them to make informed decisions for their organizations,” she says.

Common concerns

SHCRM identifies members’ concerns and interests through surveys and develops its programs with the information gathered. The current areas of concern are similar to those of Coverys’ policyholders: cyber liability and workplace violence in healthcare.SHCRM addresses these issues by providing educational resources including presentations and specialized programs. For example, in November 2015, SHCRM hosted an agent to provide an educational presentation on cyber liability risks, market coverage options, and limits available. An enterprise risk management (ERM) and high reliability organization program was launched in February 2016 and a full-day program through the SHCRM on the topic of workplace violence is planned for May 2016.

“In 2015 and 2016, the SHCRM NJ board identified how we can best serve our members and risk management professionals by offering relevant and contemporary educational resources,” Melina says.

“A recent webinar addressed lesbian, gay, bisexual, transgender (LGBT) health disparities and the LGBT community’s impact on public health. This included the legal and ethical risks that healthcare institutions face related to LGBT healthcare issues and development of plans that work towards reducing health disparities and improving overall quality of care.”

A changing profession

Since beginning her career in the healthcare industry, Melina has seen risk management evolve from a clinical risk management focus to an all-encompassing function in healthcare risk.
“The buildings, business affiliations, insurance coverages, corporate compliance, and patient safety all provide an inclusive approach as risk managers focus on ways to reduce the organization’s liability through ERM,” she says.

As healthcare continues to face challenges such as complex care for an aging patient population, varying forms of health benefit programs with the implementation of healthcare reform and the way healthcare is being provided, risk managers will also have to stay on top of the new areas of risk, says Melina.

“Telemedicine, or video consulting, is providing new ways for physicians to treat patients in areas where access was not previously possible. Technological advancements of smartphone applications and wearable health and fitness devices will aid as diagnostic tools. Cybersecurity will become a bigger issue with the changes in medical technology and the enhancement of data modeling.”

As the landscape changes, Melina believes that kindness and knowledge are power, and her mission continues to be to keep risk managers well informed so that they can move forward with confidence.

“By focusing on topics affecting healthcare risk managers today, we are conveying the knowledge they need to move forward in their careers and to share that knowledge with colleagues,” she says.