From Claims to Coverage: Using Fall Prevention to Lower Insurance Costs

Operational costs for long-term care providers are surging, squeezing already thin margins and putting pressure on care quality. What many operators may not realize is that effective fall prevention isn’t just better for residents—it’s a strategic lever for insurance reimbursements and optimizing overall operations. In fact, preventing a single fall can mean the difference between a stable balance sheet and a budget crisis.

The True Cost of a Fall

Falls are not just a clinical issue—they are one of the most expensive and preventable risks in long-term care. When you factor in liability claims, insurance deductibles, and premium increases, the average total of a fall is $62,521. 

Unlocking Hidden Dollars in Insurance Policies

Here’s something many long-term care operators don’t realize: Most insurance providers already encourage proactive safety efforts—and will often help pay for them.

• Many policies include loss prevention services. These are funding pools set aside specifically to support investments in solutions that lower fall risk and liability exposure.
• Using these services reduces overall insurance risk. Fewer incidents mean fewer claims and – over time – lower premiums.
• Fall prevention may be eligible for insurance reimbursements. Medicare covers various preventive services that can help reduce the chance of falls. 

Caspar AI: At the Forefront of Proactive Fall Prevention

One of the most effective ways to leverage this funding is by implementing solutions like Caspar’s AI-driven fall prevention.

• Intelligent insights: Our AI agent analyzes activity patterns and provides real-time alerts and actionable insights to care teams.
• Contactless monitoring: Our solution delivers continuous oversight without cameras or wearables—preserving resident privacy while ensuring real-time safety.
• Proven ROI: In a 100-bed facility, Caspar AI’s fall prevention can generate $250K–$300K in annual savings and additional revenue, paying for itself in fewer than four months.
• Extended benefits: Fewer injuries don’t just mean healthier residents—they translate into lower liability insurance premiums, fewer costly claims, and reduced caregiver burnout, which in turn improves staff retention.
• Beyond falls: Caspar AI also provides comprehensive health monitoring, 99% adherence rates, and personalized care plans—delivering a holistic safety net that strengthens both resident outcomes and operational efficiency.

The Bottom Line: A Financial Victory

The evidence is clear: Falls create massive direct and indirect financial burdens, making prevention not only a clinical imperative but also a business-critical investment. By tapping into insurer-backed loss prevention funds and adopting innovative tools like Caspar AI, operators can protect their residents, reduce liability insurance costs, and strengthen their bottom line.