The Workers' Compensation Medical Dollar
Current Challenges Facing Workers' Compensation Payers:
Finding proven cost management methods and tools for controlling medical costs for injured workers is difficult. This is due to several factors:
- Cost management approaches are not claimant- and adjuster- centric. In order for injured workers to participate in a managed program, it must offer value. Not only must the program must be easy to use by adjusters, case managers and injured workers, it must eliminate out of pocket costs.
- Out of network services increase overall medical spend. A successful program must focus on prospective management of utilization and include outreach strategies to ensure program participation.
- Visibility is missing. Without visibility across the entire medical spend, it is difficult for payers to affect escalating costs and manage outcomes.
How Procura Delivers Value:
Procura addresses these challenges by providing value added solutions for both the payer and the injured worker through:
- Reducing the length of medical disability, resulting in accelerated return to work and lower indemnity costs.
- Reducing unit cost by eliminating multiple touch-points, improving access to clinical specialists and prospectively managing utilization.
- Enhancing injured worker and adjuster satisfaction through ease of access, coordination of services across the entire spectrum of care, elimination of out-of-pocket expenses, reducing administrative burden and providing high-touch service with clear communication and proactive outreach.
- Enabling access to available provider organizations to assist the injured worker with management of workers' compensation related injuries and associated costs.
- Improving program outcomes based on application of clinical compliance protocols and providing integrated solutions that impact the entire continuum of care and provide visibility into program outcomes and reporting metrics.