Copyright © 2001 Business Insurance

Tech Tools Assist in Cutting Costs November 5, 2001

By: ROBERTO CENICEROS

CORONADO, Calif.-Technology can improve employer's relations with physicians and lower the costs of workers compensation programs, risk managers and technology vendors say.

Contra Costa County School Insurance Group, for example, saved about $1.6 million over two years by purchasing an ``in-house'' bill review system from Newport Beach, Calif.-based StrataCare, said Bridget Moore, CCCSIG's deputy director.

``For some large organizations, that may not seem like a lot of money,'' she said. But for school districts, it is a significant amount that could otherwise be used to finance programs and meet other student needs, she said at the Ninth Annual Business Insurance Workers Compensation and Disability Management Conference in Coronado, Calif. CCCSIG is a Pleasant Hill, Calif.-based joint-powers authority that provides self-insured and self-administered coverage for 20 public schools, covering 30,000 employees and $800 million in payroll.

The money that CCCSIG saved includes $520,600 it would have paid a bill review contractor had it not moved that function in house. The savings resulted even after CCCSIG paid out $687,622 over two years in StrataCare fees and payroll for the CCCSIG staff members who oversaw the StrataCare system. The savings also include $1.02 million from medical bill review improvements.

The new system has helped CCCSIG improve relations with its medical providers, Ms. Moore said. With more efficient bill review, CCCSIG now beats its own goal of paying doctors within 30 days, resolving payments within 15 to 20 days.

``In return for that, they understand that we expect a lot from them with regard to the care that they give our employees,'' she said.

Increasingly, employers want to improve relations and communications with doctors in regard to injured employees to optimize medical treatment and claims handling.

To encourage participation, the communications technology must be simple enough for doctors' offices to use easily. It must also be ``browser-based,'' because doctors do not want to buy software, said Christopher B. Rea, vp for CompConnector in Jacksonville, Fla.

``You have to be able to demonstrate to the doctor that they are going to save time and they will improve their relationship with their key clients,'' he said. ``As long as you can do that, doctors will get online.''

CompConnector specializes in streamlining communications among the various workers compensation system participants via the Internet. One employer client, for example, conducts 85% to 90% of its communications with medical providers over the Internet, Mr. Rea said. That employer also uses the system to deliver first report of injuries directly to medical providers. Even front-line managers can use the system to type up the reports and send them directly.

Doctors can access the system to view descriptions of the range of motion that employees apply in doing certain tasks. Mr. Rea said that one employer client also examines its employees when they are first hired for specific jobs. The exams are then used to benchmark employees' range of motion for various duties. That information, along with the online range-of-motion descriptions, helps doctors determine when injured employees can return to performing specific tasks.

One continuing challenge for employers is to capture data about employees during all phases of their medical treatment, said William L. Granahan, senior consultant for Milliman USA in Wakefield, Mass. Such data are necessary whether or not an injury or illness is work-related, because employers want to help employees return to work regardless of the causes of their ailments, he said.

The challenge requires integrating medical data captured from the workers compensation, health care and disability systems. ``We would then be able to utilize that health care data to make significant improvements in the way we deliver care,'' Mr. Granahan said.

Another challenge is to include medical provider input when making technology enhancements, said Jay B. Blakey, senior vp-operations for Em3 Corp. The Addison, Texas-based company develops Internet-based systems to reduce costs and ensure that injured employees receive high-quality health care by bringing providers, employers and payors into closer alignment.

For example, Em3 created a ``decision support tool'' that allows claims handlers and employers to determine when providers have made correct decisions. Employers can then use that information to ensure that they take the appropriate claims-handling action in the future.

Scott R. Green, the president of StrataCare, moderated the session.

Volume: 35
Publication number: 45

© Copyright Business Insurance 2001