What is Systematic Care Management?

Posted by Paradigm on February 27, 2012 under Amputation, Systematic Care Management | Be the First to Comment

Paradigm helps our clients by serving as a medical hub connecting injured workers to medical experts, high quality providers and a clinical support infrastructure. We do this using Systematic Care Management℠, our proprietary medical management system. The methodology integrates and coordinates healthcare and case management services to achieve the industry’s best medical outcomes for the most complex claims.

Since treatment for those with catastrophic and complex injuries requires deep expertise, and involves multiple facilities and providers over a period of years, these claims have an increased risk for complications. Systematic Care Management supplements the treating medical team with a welcome, coordinated safety net to help mitigate missed information, inconsistencies between provider practices, medical errors and general fragmentation.

Systematic Care Management includes:

• Physician led consultative team with onsite nurse case managers
• Comprehensive recovery planning
• Access to top providers and centers of excellence
• Administrative infrastructure designed specifically for complex cases
• Proprietary analytic models and 20 years of catastrophic and complex case data
• One-of-a-kind outcome guarantees

Our Approach and Results

We wrap a complete team of experts around the injured person, including a nurse case manager, medical director, account team, clinical team, and medical specialists. As a result, we achieve 5 times better medical outcomes, compared to industry benchmarks, as detailed in Figure A. This ultimately translates into substantial savings for our clients.

 

Our Services

Paradigm built the comprehensive, Systematic Care Management model specifically to address the needs of those with catastrophic and complex injuries, including traumatic brain injuries, spinal cord injuries, amputations, burns, wounds and chronic pain. We offer our workers’ compensation carrier and large employers clients a variety of services including:

• Outcome Plans for acute catastrophic injuries such as traumatic brain injuries, multiple traumas, spinal cord injuries, amputations and severe burns.
• Complex Large Loss Plans for legacy cases with persisting problems such as chronic wounds, recurring hospitalizations, recurrent infections or escalating medical needs.
• Pain Management for emerging or chronic pain conditions including fibromyalgia, failed back syndrome and approximately 30+ other pain diagnoses.
• Portfolio Medical Management for complex large losses and pain claims wherein we guarantee reserve reductions for the entire portfolio of claims

At Paradigm, we pride ourselves on providing the best results for people with complex medical needs. For more information on our full service offerings, please feel free to contact us or call: 800-942-1725. We also invite you to join our social communities on Facebook, Twitter, LinkedIn, and YouTube.