Medical Cost Projection

A Medical Cost Projection (MCP) is a concise report that estimates future medical and related care costs over an appropriate projection period based on the available records, provider recommendations, and case-specific information. MCPs are most often used in minor-to-moderate injury matters. For cases of greater severity, a life care plan may be appropriate.

Helpful For:

Plaintiff and defense counsel, insurers, and other stakeholders evaluating future medical damages

When to use:

Minor/Moderate injury cases. When a concise projection of future medical and related costs is appropriate based on the nature of the injuries and available information

What is Medical Cost Projection?

The basic outline of the report follows a structure somewhat like this:

General outline of the information about the case

A chronology of the client’s history of health care since injury

A summary of the medical records reviewed for the past medical history

A summary of ongoing care to date

A summary of the client’s current abilities related to activities of daily living (ADLs) and instrumental activities of daily living (IADLs)

  • Rehabilitation care such as physical therapy and occupational therapy
  • Vocational therapy
  • Cost of future medical procedures
  • Medication use
  • Lost earning capacity
  • Durable Medical equipment (DME) and supplies
  • Cost of transportation
  • Home modification
  • Vehicle modification
  • In home Caregiver services Short-term or long-term care
  • Orthotics or prosthetics

Summary of Medical Cost Projection

What kind of cases Can a medical cost projection used for?

  • Amputations

  • Back or Neck Injury with Chronic Pain Syndrome

  • Knee injury

  • Cerebral Palsy

  • Concussion

  • Chronic Pain

  • Deafness

  • Dog bites

  • Slip and Fall

  • Hand Surgery

  • Hearing loss

  • Motor Vehicle Accidents (MVA)

  • Medical Malpractice

  • Orthopedic Injuries

  • Paraplegia

  • Personal Injury

  • Psychological Trauma

  • Spinal Cord Injuries

  • Sports injury

  • Traumatic Brain Injuries

Medical Cost Projection Methodology

The process of putting together a Medical Cost Projection

1

Medical Record Review

Review of associated records related to the person’s medical history and other relevant documents. An interview is not always required, depending on the case

2

Written communication with providers

Obtain and review treatment recommendations from the client’s providers

3

Outcome Identification/Medical Research

Research concerning the documented condition, likely future care needs, and case-specific treatment considerations

4

Cost Research

Concise written report identifying projected future care items and associated cost estimates based on the available records and research

5

Written Medical Cost Projection Report

Condensed, simplified, abstract document providing estimations of items and services for injured or disabled persons

When is a Medical Cost Projection helpful?

Demand packages

A medical cost projection can help quantify claimed future medical expenses in a structured and transparent format.

Claim reserves

Setting the right amount of money aside for a claim is important, especially when trying to figure out how much future medical care might cost because of an injury. To do this well, you need to know how serious the injury is and what kind of treatment might be needed in the future. This report can assist with estimating projected future medical costs based on the available records and case information

Negotiations

If you are going to have any luck with negotiations going your way, having something to negotiate with helps. Having a solid medical cost projection report can give you confidence for a productive negotiation on behalf of your client when you are in talks with other attorneys and insurances companies.

Settlement request

Before you can ask for a fair settlement, it's important to know what the future costs for the injured person might be. Having an estimate of these medical expenses with a Medical Cost Projection can strengthen your case.

Advantage and Disadvantages

Pros

  • Can be completed quickly. Turn around time is as quick as 2 weeks. Rush reports available.

  • May be requested for one procedure only (ex: joint replacement surgery or spinal cord stimulator)

  • Not necessary to collaborate with the injured person or their providers. (However, efforts are made to make contact for more accurate assessment)

  • Medical Cost Projections can later be developed into a life care plan if needed later

Cons

  • Not the best choice for more complex cases

  • Not suitable if expert testimony is required.

FAQ

  • Clarify projected future medical and related care costs
  • Organize future care needs in a structured format
  • Assist counsel, insurers, and fact-finders in evaluating claimed damages
  • Identify the assumptions, sources, and limitations underlying the projection

A medical cost projection is typically shorter than a full life care plan and typically does not require an interview, depending on the case. The report is based on the available medical records, other case materials, and provider recommendations.

Typical turn around time is 1-2 weeks. Rush reports are available less than 7 days based on availability.

In order to make create a comprehensive medical cost projection, we would need medical records, written reports/recommendations by other experts, and deposition transcripts. More details outlined in our Retainer Agreement.  

Life care plan is better for:

  • Moderate to severe cases.
  • Expert testimony is needed for deposition or trials

Medical Cost Projection is better for:

  • Minor to moderate cases
  • Speed matters, usually for negotiating a settlement, mediation or settlement, completing insurance claims