May 16, 2017

WCRI: Provider Choice Study

Claims Management
, Network Solutions
, Legislation

In a comparison between states where provider choice was given to workers and states where employers controlled provider choice, there is little impact on the average costs per claim, according to a new study by the Workers Compensation Research Institute (WCRI).

The average cost difference for medical costs was near zero.

However, the study found differences across injury types. Back-related injuries were a primary contributor to higher indemnity costs, and were among the most expensive cases in states where workers controlled provider choice. These injuries had higher medical and indemnity costs, according to the study.

John Ruser, WCRI President and CEO, said policymakers might focus on factors affecting costs, in states where workers have control of provider choice.

Ruser’s statement suggests policymakers in states where workers have control of provider choice “might focus on factors affecting costs for the most costly cases.”  

CorVel’s performance based PPO network focuses on such factors as physicians’ practice patterns and behaviors, rather than the “outcomes” as determined by costs. Their network was built from the ground up to ensure the quality of care delivered to patients. Every directly contracted CorCare provider has been selected based on specialization in comp-related care, quality of delivery, range of services, cost and location. Working with our provider partners, CorVel outlines and monitors return to work protocols as well as adherence to evidence based practice guidelines, prescribing methods and appropriate billing practices.

Direct, performance based contracts enable CorVel to improve the delivery of care and provide clients with superior results.