Magazine article Risk Management

Applying Managed Care to Workers' Comp: Integrated Approach

Magazine article Risk Management

Applying Managed Care to Workers' Comp: Integrated Approach

Article excerpt

Following a path first explored successfully in group health plans, a growing number of employers are finding that managed care initiatives can provide a number of benefits in workers' compensation programs as well. By adopting techniques such as preferred provider networks, employee education and rehabilitation programs, employers can reduce their workers' compensation costs and return employees to the workplace sooner.

"We're seeing a great deal of employer interest in managed care networks that integrate physical therapy, workers' compensation and return-to-work programs," says Liz Short, director of property/casualty managed care for Philadelphia-based Intracorp. "More employers are reaming that by partnering with networks that offer quality providers and help them communicate with employees better, they can get employees back on the job sooner and reduce their expenses."

Achieving these benefits often depends on establishing an effective integrated program anchored by a managed care organization able to meet an employer's need for effective employee care, communications and claims administration.

"The most important elements in the success of a program are the quality of the providers and making sure that the preferred provider network you select has a strong focus on occupational health," says Ms. Short. "You need to explore the specific knowledge and experience that the providers have in workers' compensation. Similarly, you want to consider the network's and the providers' return-to-work philosophy."

Although the network will bear responsibility for selecting specific providers, employers should review the network's process for doing so to ensure that employees will receive effective care.

"Employers must ask a number of questions to determine how the managed care organization defines a quality provider," Ms. Short recommends. "What kind of screening process does the network have to verify credentials, licensing and sanctions? How strong of a commitment do the managed care organization and the providers have to reviewing provider performance and adopting best practices?"

Once a network is selected, providers should be reviewed to make sure the employer is receiving the quality of care it is contracting for.

"Some companies assume that once they make a commitment to a managed care organization, their role is over," Ms. …

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