05/23/2010
CONCORD, CA – May 25, 2010 – Paradigm Management Services today introduced a new program for portfolios of cases with persisting conditions stemming from catastrophic and complex injuries. For the first time, workers’ compensation insurance carriers will receive a guarantee of medical improvement and lower reserves for a portfolio of large loss claims when contracting for medical management.
Although cost containment efforts have increased over the past five years, common tools have yet to make significant impacts in reducing the 6.2% of claims that drive 49.9% of medical losses. Making matters worse for carriers are rising reserve deficiencies and deteriorating loss ratios impacted by high medical costs.
“Net written premiums in our industry have declined by 20.7% since 2007 while net combined loss ratios have deteriorated to 110%,” said Paradigm President Kevin Fleming. “Other traditional growth levers, such as insured payroll, approved premium rates and investment income, face unprecedented pressure. All this leads to a significant capital challenge and the need for a specialized solution. Fortunately, we can help our clients address their reserve deficiencies and make it easier for them to reallocate capital by attacking their number one workers’ compensation claim expense driver, medical costs.”
Paradigm succeeds in significantly improving medical outcomes and decreasing expenses in catastrophic, complex large loss and chronic pain claims using a proprietary Systematic Care ManagementSM methodology. In fact, recent independent analysis by Milliman, Inc. indicated that Paradigm reduced lifetime medical costs and reserves by 29% for large loss claims during a multi-year period. Specifically, Paradigm averages 50% improvement in physician costs, 28% improvement in attendant care costs and 22% improvement in pharmacy costs.
“Every carrier has a segment of medically volatile claims that consume a disproportionate amount of resources. This product was designed to address this class of claims—those with recurrent hospitalizations, high levels of pharmaceutical expenses and multiple ongoing complications,” said Fleming. “Our successful track record of improving medical outcomes allows us to offer these portfolio-level guarantees. We are so confident in our ability to address each case’s clinical state that we will also guarantee the reserve savings associated with the improved outcomes.”
The Complex Large Loss Portfolio offering begins with a highly analytic, multi-step review of the claim portfolio. The contract structure provides a single rate and reserve reduction guarantees based on an independent, third party baseline of expenses. Paradigm then provides comprehensive medical, social, psychological and vocational course correction to stabilize and improve the injured worker’s condition.
About Paradigm Management Services, LLC
Paradigm Management Services provides acute and ongoing catastrophic and complex case management services for traumatic brain injuries, spinal cord injuries, amputations, burns, wounds and chronic pain. As the nation’s leading provider of complex and catastrophic medical management in the workers’ compensation industry, Paradigm achieves 5x better medical outcomes and lowers total costs by 36%. Paradigm accomplishes this by bringing together nationally recognized doctors and specialists, the best network of care facilities in the country, and nearly 20 years of clinical data to guide decisions. For more information, visit www.paradigmcorp.com.
Paradigm recently won the 2010 Case In Point Platinum Award for the nation’s best Workers’ Compensation Case Management Program.
