Effective medical cost containment strategies don’t focus on one or two areas. Nor do they throw every possible trick and tip at the problem in a disorganized panic. Rather, the most successful employers and insurers employ a “total lost cost” or “TLC” approach, using a wide-reaching but well-coordinated array of strategies to combat multiple lines of cost escalation with a single well-designed program.
When seeking improvements at your company, you may want to consider these useful and effective medical cost containment strategies:
- Institute a Medical Provider Network (MPN). A Medical Provider Network is a group of doctors, hospitals and specialized providers that have a prearranged relationship for medical treatment when an employee is injured on the job. Any employee injured at work goes directly to a provider in the MPN, minimizing paperwork and treatment time while maximizing the results of quick, effective care. These panels result in fewer lost workdays, lower medical costs, and lower litigation rates, according to the Work Comp Roundup blog.
- Employ Nurse Case Management. Nurse case managers can help improve patient outcomes by orchestrating long-term care. Paradigm’s dedicated Network Managers, for example, have deep experience managing catastrophic and complex injuries. They ensure the best, most organized acute and post-acute care available.
- Use Rehabilitation Networks. These prearranged medical networks offer specialized care for helping injured people recover from specific injuries. Dedicated rehabilitation centers can help stabilize the injured person’s medical condition and maximize the medical outcome while lowering lifetime costs.
- Build in a Utilization Review. These reviews are designed to independently confirm the need for a medical service. These reviews may include precertification reviews before care is provided, concurrent reviews while an employee is hospitalized or undergoing care, and retrospective reviews to verify the need for services that have already been provided. In each case, a third-party helps you confirm the need for the service, minimizing cases of fraud or misuse.
- Encourage Chronic Pain Management. Chronic pain can have drastic long-term costs—both monetary and personal—for injured workers. An organized chronic pain management team can use data mining and virtual online “check-ins” with injured parties to monitor and evaluate biopsychosocial impacts. This can help to minimize the impact of chronic pain, improve employee health and minimize costs.
Paradigm can help companies better manage their catastrophic and complex claims. Our medical cost containment strategies ensure the best possible medical outcomes for injured workers while reducing lifetime medical costs. Paradigm is the only company to stand behind our promises with medical and financial guarantees.