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From The BLOG

Protect Your Business from Unnecessary Employee Treatment Costs with Medical Cost Containment

Someone handing cash over to another person for a workers' comp claim.

According to the Bureau of Labor Statistics, there were 2.8 million incidences of workplace injuries in 2019, which cost businesses upwards of $171 billion, as reported by the U.S. National Security Council. Based on these statistics alone, it’s safe to say that the enactment of workers’ compensation is a necessary strategy the government has devised to compensate employees who became ill or injured in the course of their employment. But behind its usefulness are strict rules that protect the system from abuse. 

Because cost is a major player in the success or failure of a workers’ compensation program, certain rules have to be applied and procedures developed to ensure maximum value for every dollar spent for the medical treatment and care of an injured employee. This boils down to having the right treatment at the lowest possible cost. That’s were medical cost containment comes in.

What is Medical Cost Containment?

In workers’ compensation, medical cost containment or medical cost management is a process typically carried out by providers of workers’ compensation insurance to reduce the cost and maximize the value of workers’ compensation benefits.

A fully functional workers’ compensation program is based on a number of factors that play a part in an employee’s health and well-being. It includes the nature of the business as an employer, your employee population and common injuries your employees sustain in relation to their work.

As an employer, here are the most important steps you need to do to reduce your employees’ medical costs.:

  • Be on the lookout for the latest techniques designed to lessen the number of employee visits to health or medical professionals
  • Ensure the prompt delivery of medical services to employees who are injured on the job.
  • Consider utilizing these services:
    • Nurse case management – for proper planning, management and evaluation of specific aspects of patient care; it should include access to web-based and telephonic hotlines.
    • Injury case management – a type of case management that follows after a serious injury, designed to assess an injured worker’s needs and identify available resources that can provide maximum benefits to the injured worker and his/her family, including the services of medical and vocational experts.
    • Independent medical examination – to ascertain that the treatments recommended by the patient’s attending physician are accurate and necessary.
    • Home care – also known as in home health care services, it refers to medical care services that allow a patient (your injured worker) to stay at home. It may involve the services of professional caregivers including nurses, therapists and aides.
    • Medical bill review – refers to the review conducted on the charges related to the patient’s claims. A medical bill review is intended to ensure accuracy, avoid duplication and ascertain reasonableness of medical charges. It is a major component of an effective healthcare cost containment program.
    • Medical scheduling – it refers to the planned booking of all resources (including people, equipment, places, investigation and events) associated with the patient’s medical care and treatment.

Elements of a Functional Medical Cost Management Program

In order to work effectively, your workers’ comp medical cost containment program should include these essential components:

1. Prompt Reporting of Work-Related Injuries

Early and speedy reporting of work-related injuries can translate into prompt delivery of medical services. Make technology, including the use of smart phones or web-based portals, available to your key personnel to allow them to report work-related injuries quickly. It can prevent possible complications which can trigger additional medical costs.  

2. Early Medical Treatment

The earlier injured workers are given medical treatment, the lesser are the chances of complications, and the better are their chances for early recovery. It can actually help to lessen the injured worker’s medical treatment cost and eliminate possible drivers including intensive care, blood transfusion or fraud.

3. Return-to-Work

While this is another important aspect of a medical cost containment program, a lot of companies fail to see its benefits. An early return-to-work benefits not only the injured worker but the employer as well. 

First, it brings the injured employee back to being productive gradually and allows the company to slowly recover from any setback the injured employee has caused. Second, the injured worker receives medical treatment and recovers from the injury without spending his/her own personal finances.

Follow these three steps to create a workers’ compensation containment plan.

Workers’ compensation is intended for a noble purpose. But it can be abused and used to defray unwanted, duplicate and bloated treatment costs. One way you can identify and avoid unreasonable medical treatment costs is by implementing medical or healthcare cost containment in workers’ compensation.

As always, workers’ compensation will be an effective element of your company’s benefits package. Always keep it free from unwanted costs with an efficient medical cost containment plan from Direct PT/DX.

Contact Direct PT/DX today to find out more! (866) 214-5920 | scheduling@DirectPTDX.com

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