PARADIGM MANAGEMENT SERVICES — SOLUTIONS FOR COMPLEX MEDICAL MANAGEMENT
Founded in 1991, Paradigm Management Services is the nation’s leading provider of complex and catastrophic medical management services.
Working in partnership with our clients, we leverage our nationally recognized expert doctors and specialists, the best network of care facilities in the country, and 18 years of clinical data to get patients back to their lives and work at a rate five times higher than the industry average.
By focusing on the patient’s health first, we achieve or exceed targeted health outcomes 99% of the time, and help employers, insurers and other payers save 36% on medical and indemnity expenses.
Additionally, due to our ability to consistently deliver superior outcomes, we are able to stand behind our performance with financial and medical outcomes guarantees. Learn more about the recent independent confirmation of Paradigm's industry leading results by reading our white paper, "Managing the Impossible."
Curtail Escalating Costs
These results are extremely important given the state of the industry. At a time when medical expense outlays and reserves are at an all time high, very few executives are measuring, addressing, or even looking at the very things that can help curb these costs...they don’t know they have a problem that can be significantly curtailed.
Our results are evidence that things can be better, and costs can be significantly decreased. But not by denying care upfront or making cost cutting decisions that actually add long term cost to the business. Results are improved only by making the right medical choices.
Our model puts medical professionals from the Nation’s leading centers of excellence in a role that allows them to consult physician-to-physician with the attending doctors of injured workers. Sourced from the best hospitals and university medical centers, our Paradigm Medical Directors are at the nexus of cutting edge practices, technologies and medical innovations and bring the most up-to-date learning from the laboratory to the patient’s bedside in real-time rather than the years it would take to make its way into the medical journals and mainstream practice.
Our model puts catastrophic nurses with an average of 14 years of experience onsite working with families and medical teams.
Our model leverages 18 years of complex catastrophic case data that helps us determine the resources that will be needed to help get the patient healthy and back to work.
Our cases are extremely severe. Cases that most executives think have no hope. Our results prove what is possible.
Team Approach
Paradigm's process immediately puts the patient at the center of a team of experts, with a focus on high quality care management.
Customized Care Delivery
From the moment the referral is made to us, we begin working to create a custom plan for helping the patient achieve the optimal outcome. That goal drives medical and resource decisions through the entire process.
Client Control
The focus on systematic patient care facilitates clear expectations, high visibility and communication with the client. From the early assessment of your injured worker's condition to the close of the case at outcome achievement, we are in continual contact with you. At the beginning of the case, typically seven days for a catastrophic injury, our "Client Education Conference" gives you a chance to understand the patient's situation in depth through a comprehensive assessment and plan, discussion with the physician leading the case management, the nurse case manager that has been onsite with the patient, and experts from Paradigm that have a wealth of data on comparable cases, outcomes, and common issues associated with the individual case. Paradigm also continually provides updates and reports to you throughout the case so that you are involved and in control along the way.
Our Products
Paradigm Management Services provides catastrophic and complex medical management with three key products:
- Outcome Plan -- Outcome Plans are contracts for new catastrophic injuries including traumatic brain injuries, spinal cord injuries, multiple trauma, amputations and severe burns wherein Paradigm provides expert medical management and pays costs until a guaranteed outcome is reached.
- Complex Large Loss Plan -- Paradigm’s Complex Large Loss plan addresses portfolios of claims with persisting conditions stemming from catastrophic and complex injuries. For cases that exceed $15,000 per month in medical costs with remaining lifetime costs of $500,000 or more, Paradigm corrects the trajectory of medical utilization and expenses while greatly improving the health of the injured worker. Conditions addressed include recurring wounds, severe urinary tract infections, repeated hospitalizations and other medical issues. Paradigm provides expert medical management, pays the medical costs for a contracted period of time (averaging one to two years), and guarantees cost savings.
- Pain Management -- Paradigm takes a comprehensive approach to pain management. The results-oriented program collectively considers a client’s portfolio of complex pain claims and applies early intervention strategies to emerging cases and intense Systematic Care ManagementSM methodologies to costly chronic cases. Paradigm’s biopsychosocial model corrects underlying problems, promotes functional improvement, reduces narcotic usage and helps injured workers get healthy and back to work.
Independent Verification of Results
Independent confirmation of Paradigm's industry leading results was recently established by Robert Briscoe and Christine Fleming, claim consultants with Milliman, Inc., the nation’s foremost actuarial and consulting firm. Paradigm was found to be 5x better than the industry in delivering return-to-work results and 36% less expensive relative (see charts above). The study looked at a randomly selected sample of cases managed by Paradigm and compared those cases to like cases from Milliman's benchmark workers compensation database. For a copy of the study please contact Kelly Wilson at kelly.wilson@paradigmcorp.com.
CALL ON US
We welcome the opportunity to share more detailed information with you. Please call 800-676-6777 to arrange a consultation with the Paradigm team.