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This profile was last updated on 11/25/13  and contains information from public web pages and contributions from the ZoomInfo community.

Ms. Kimberly George

Wrong Kimberly George?

Senior Vice President

Local Address: Chicago, Illinois, United States
Sedgwick Claims Management Services , Inc.
2101 Webster St
Oakland, California 94612
United States

Company Description: Sedgwick Claims Management Services, Inc. is the leading North American provider of innovative claims and productivity management solutions. Sedgwick CMS and its...   more
Background

Employment History

Board Memberships and Affiliations

Education

  • degree , nursing
    Mt. Hood School of Nursing
24 Total References
Web References
"Although workers' comp may not be ...
www.riskandinsurance.com, 25 Nov 2013 [cached]
"Although workers' comp may not be directly documented in the ACA, we will be impacted by accountable care," said Kimberly George, senior vice president and senior health care advisor for Sedgwick Claims Management Services. "I believe if we include ourselves as an industry in the health care reform, we have an opportunity to help shape the quality of care for injured workers."
In her conversations with workers' comp practitioners, George says she has found that some are taking a wait-and-see attitude while others are embracing the potential opportunities. She is urging the industry to understand, discuss, and create solutions in advance of the impact reform will have on workers' comp. "There is one certainty with health reform; nobody knows what will happen," George said.
...
George says the reform is aimed at improving the access to, quality of, and reimbursements for health care. Those are areas where workers' comp practitioners should focus their energies to see how the reform can benefit the system.
Access. "The access to care is not that physicians won't want to treat workers' comp patients. We recognize it is highly reimbursed," George said.
...
"As a health care system evolves, it is a natural progression that nurse practitioners and physician assistants will have a greater role in primary care," George said. "When I think of workers' comp specifically, will a payer or jurisdiction allow a nurse practitioner to be the primary provider? We have to be cognizant as a system; if health care is moving in that direction, we have to as well."
Resisting such a change could likely result in poor outcomes for the workers' comp system, both financially and from the injured worker's perspective. George believes jurisdictions and payers need to get on board with expanding the field of primary care providers.
"Otherwise, they will be waiting for medical appointments that may extend out durations and potentially not provide quality care, so patients will have to wait," George said."Every delay in workers' comp or disability impacts costs."
Quality. The quality of medical care in hospitals is likely to improve as the facilities try to avoid lost reimbursements. As George explained, hospitals may be denied reimbursement for patients who are readmitted.
"Quality around nosocomial -- or hospital acquired infection, and [the desire to] send patients home in a safe way, as well as internal quality measures in hospitals will certainly be an improvement," George said."So while the risks to quality and timely care occur from access, it could improve."
...
"They strive to implement quality measures to improve overall health care for the entire population they serve," George said."An ACO seeks to provide patient-centered treatment programs and manage the continuum of care across the health care delivery system, which includes everything from wellness to chronic disease."
George expects reimbursement systems of ACOs to have a big impact on the workers' comp system.
Opportunities. George says the creation of ACOs and consolidation of medical facilities can be an opportunity to improve the quality of care for injured workers.
"Often today payers want to choose the services they have at different entities; pharmacy by one company, physical therapy from another, diagnostics obtained from yet another. They may be selective where physicians can do the surgery," George said.
Kimberly ...
www.kidschance.org, 5 Jan 2014 [cached]
Kimberly George Sedgwick
The expected proliferation of accountable ...
www.riskandinsurance.com, 25 Nov 2013 [cached]
The expected proliferation of accountable care organizations resulting from the implementation of health care reform may improve the quality of care provided to workers' comp patients, says Kimberly George.
As the senior vice president and senior health care advisor for Sedgwick Claims Management Services, George explains that ACOs typically want to move from a fee-for-service payment system to one based on quality of care.
"Today's fee for service is just 'provide more medicine, do more tests, prescribe more of this.' That is how it is reimbursed," George said.
Those services generate significant ...
www.businessinsurance.com, 16 June 2013 [cached]
Those services generate significant revenue and profit for some TPAs, said Kimberly George, Chicago-based senior vice president of managed care practice and client services for Sedgwick Claims Management Services Inc.
But improving the value for payers is questionable when such services focus solely on obtaining discounts and not on improving injured workers' care, she said.
Sedgwick developed its own in-house bill review practice seven years ago, about seven years after doing the same with nurse case management services. It did so because service providers at the time were inflexible in their delivery of technology, fee structures and service levels that clients demanded, she said.
The integration also allowed Sedgwick to drive down its costs. It did so by using in-house data to establish networks of doctors scored for their abilities to deliver outcomes such as reduced litigation and claims durations, Ms. George said.
adjustercom.com News
www.adjustercom.com, 7 Dec 2011 [cached]
MEMPHIS, Tenn., Dec. 7, 2011 - Kimberly George, Sedgwick senior vice president, managed care practice and client services, has been selected by Business Insurance as one of its 2011 Women to Watch, the company announced today. George was honored by Business Insurance at its Dec. 6. leadership workshop and awards luncheon in New York City. Each year Business Insurance recognizes 25 women for their exceptional work in risk management, benefits management, commercial insurance, and related fields. Honorees are selected by the publication's senior editors based on nominations submitted by readers. Recent professional achievements, influence on the marketplace, and contributions to the advancement of women in business are all part of the selection criteria. George began her career as a certified nursing assistant in a rural eastern Oregon hospital, where she gained experience in long-term care, general medicine, and emergency room operations. She went on to earn a degree in nursing from the Mt. Hood School of Nursing. Through her work as a neuro-trauma nurse, George realized her desire to improve the quality and timely care of patients by implementing better health care delivery models. "Kimberly George is certainly deserving of this national honor and recognition," said David A. North, president and CEO of Sedgwick.
...
Based in Chicago, George oversees the team that sets best practices for more than 1,000 Sedgwick nurses and managed care experts who have responsibility for the clinical consultation, care management, and medical networks that service the injured workers of Sedgwick's clients. She also spearheaded a medical provider benchmarking program that has been implemented across Sedgwick's programs improving quality, timely care. Throughout her career, George has been a leader in the advancement of women. She was a founding member of Women in Workers' Compensation, which evolved into Professionals in Workers' Compensation. George is a frequent guest speaker at sororities, nursing schools, and programs for nurses, where she addresses young women about future career opportunities. "Kimberly has made a positive impact on countless lives," said Don F. Sloan, Sedgwick executive vice president, managed care.
...
More about Kimberly and Business Insurance's 2011 Women to Watch can be found at www.businessinsurance.com.
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