Managed care for workers' compensation: three years of experience in an "employee choice" state

Journal of Occupational and Environmental Medicine
E J Bernacki, S P Tsai

Abstract

Managed care techniques are becoming increasingly available to manage the medical indemnity losses associated with injuries paid for under the workers' compensation system. The authors describe 3 years' experience of identifying and abating workplace hazards and medically managing cases utilizing a preferred provider organization established solely for workers' compensation cases. In the model described, the occupational physician/nurse case-management team coordinates the entire process, from prevention of accidents to facilitated return to work. During the study period (1992 to 1995), per-capita losses were reduced by 23%, from $241 in fiscal year 1992 (the year before the managed care initiative), to $185 in fiscal year 1995. (Hereafter, each year referred to indicates that fiscal year.) In 1992, 22 lost-time cases per 1000 employees occurred, whereas the number of lost-time cases in the years 1993 to 1995 averaged 12 to 14 per 1000 employees. The rate of "medical only" cases dropped significantly from 155 per 1000 in 1992 to 96 per 1000 in 1995. The per-capita amount of monies spent on medical care decreased from $81 in 1992 to $63 in 1995. The most significant savings in medical costs related to claims associated with new ...Continue Reading

References

Nov 1, 1995·Journal of Occupational and Environmental Medicine·M P McGrailE J Bernacki

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Citations

Jan 23, 1999·American Journal of Industrial Medicine·T R Miller, D T Levy
Oct 13, 2001·American Journal of Industrial Medicine·L RudolphK Dervin
Sep 28, 2005·International Archives of Occupational and Environmental Health·Stefano PorruLorenzo Alessio
Oct 29, 2005·Journal of Occupational Rehabilitation·Renée-Louise FrancheUNKNOWN Institute for Work & Health (IWH) Workplace-Based RTW Intervention Literature Review Research Team
Sep 14, 2006·Journal of Occupational Medicine and Toxicology·Asim SahaPranab Kumar Nag
Oct 12, 2007·Journal of Occupational Rehabilitation·Radoslaw WasiakJohannes R Anema
Jun 24, 1998·Journal of Occupational and Environmental Medicine·J Green-McKenzieE Bernacki
Jul 24, 1998·Journal of Occupational and Environmental Medicine·E J Bernacki, J A Guidera
May 24, 2003·Journal of Occupational and Environmental Medicine·Edward J Bernacki, Shan P Tsai
Dec 28, 2000·Journal of Occupational and Environmental Medicine·E J BernackiS Tsai
Mar 26, 2002·Journal of Occupational and Environmental Medicine·Andrew E LincolnVirginia I Miller
Dec 12, 2017·Journal of Occupational and Environmental Medicine·Xuguang Grant TaoEdward J Bernacki
Sep 13, 2006·Journal of Occupational and Environmental Medicine·Edward J BernackiLarry Yuspeh
Jul 12, 2007·Journal of Occupational and Environmental Medicine·Edward J BernackiXuguang Tao
Mar 4, 2000·American Journal of Physical Medicine & Rehabilitation·S F NadlerN Just
Jun 26, 2001·American Journal of Physical Medicine & Rehabilitation·A J HaigM Theissen
Dec 1, 2001·Journal of Occupational and Environmental Medicine·D H LinzC D Shepherd
Dec 26, 2002·Journal of Occupational and Environmental Medicine·Judith Green-McKenzieEdward Emmett
Dec 13, 2001·The Journal of Bone and Joint Surgery. American Volume·J M Melhorn
Apr 17, 2001·Clinical Orthopaedics and Related Research·J M Melhorn
May 25, 2021·Journal of Occupational and Environmental Medicine·Edward J BernackiXuguang Grant Tao

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