In the claims arena, you focus on the cost of a service rather than the potential value a service may add to your claim. You buy services for what they cost rather than what they do. You assume you’re adding value to your claim by controlling cost and passing on service that has value.
From a claims perspective, the success of a work injury claim gets judged by the overall claim cost. The two major components of claim costs are medical treatment expenditures, and the time an injured employee is out of work receiving indemnity benefits.
We participated in some interesting dialogue just recently, about Workers’ Comp costs. Workers’ Compensation has a cost problem that we’re all trying to patch up or put a band-aid on. Our efforts include implementing a pharmacy program, engaging with a bill review provider, aligning with a physical therapy network, discounting both DME (Durable Medical Equipment), diagnostics and maybe even psych treatment, all with the intent of creating SAVINGS. But there is a problem. Costs are still going up! We can all recognize that while a healthy managed care program SHOULD be leveraging all of the above, we’re not actually saving anything.
What LENS ARE You LOOKING THROUGH?
Weeks ago, we discussed the necessity of looking through the lens of the injured worker to truly understand the root cause of psychosocial factors that are impacting workers’ compensation claims. The industry has changed, claim volumes are now comprised of “job description induced pain” more so than acute accidents.