NEWPORT BEACH, Calif.--(BUSINESS WIRE)--Outcomes-based network management can improve MPN performance and reduce costs and litigation, according to findings presented by Harbor Health Systems and the California Workers’ Compensation Institute at the CAJPA 2016 Conference.
During their session, “Starting at the Finish Line: Applying an Outcomes-Based Approach to Workers’ Compensation Physician Networks,” speakers Kent Spafford, Board of Directors, One Call Care Management (“One Call”), and Advisor to Harbor Health Systems, and Alex Swedlow, President of CWCI, explained the type of data that can be analyzed in order to identify high-performing networks and providers, and the results that can be achieved by utilizing top networks.
“Identifying best doctors requires an analysis of multiple variables, including cost, duration, recidivism, and total disability of claims,” noted Spafford. “With these objective measures and the ability to get more injured workers treated by the top twenty percent of scored physicians, results in MPNs are improving in terms of lower costs, less litigation, and shorter claims duration.”
Harbor Health results cited by Spafford in the presentation include:
- Measurement of MPNs showed a 20 percent reduction in indemnity costs with the use of an outcomes management program.
- One large TPA realized overall claim cost reductions of almost 20 percent.
- A mid-sized TPA saw the percentage of closed claims increase by 50 percent and average claim amount decrease by 9.1 percent in nine months with an MPN using high-performing physicians.
- A large employer measured a 10 percent litigation and recidivism rate with five-star orthopedic surgeons versus a 64 percent litigation rate and 29 percent recidivism rate for one-star surgeons. Differences in average total costs were $25,789 for the five-star surgeons and $240,249 for the one-star surgeons.
Click here to view the Harbor Health presentation.
To learn more about how an outcomes-based approach can reduce risk and produce cost savings for your organization, visit http://harborhealthsystems.com/.
About Harbor Health Systems
Harbor Health Systems, a One Call Care Management company based in Newport Beach, Calif., leads a revolution in medical networks that allows customers to build and manage a medical system based on quality performance of providers rather than the “lowest bidder medicine” that is typical of PPOs and HMOs. Harbor Health builds and manages outcomes-based medical networks, and supplies the tools, software, and services to help their customers build, implement, and optimize custom networks. With Harbor Health Systems, companies can identify physicians and other medical professionals who have exceptional skills in clinical, patient care, and business management. By working with these healthcare professionals, payers and self-insured employers can greatly reduce the cost of care, complications, and time away from work. For more information, visit Harborhealthsystems.com.
About One Call Care Management
One Call Care Management (One Call) is the nation’s leading provider of specialized solutions to the workers’ compensation industry. One Call's solutions enable faster, more efficient, and more cost-effective claims resolution. One Call provides reliable, consistent connections to care with expertise in high end diagnostics, physical therapy and transportation services, post-discharge home care and durable medical equipment, dental and doctor specialty services, complex care management, and the language services required for today’s multicultural workforce. With a focus on injured workers’ needs across the continuum of care, One Call enables maximum medical improvement and superior outcomes. For more information, visit www.onecallcm.com.