Managing Outcomes Through Value-based Healthcare Providers

claims_outcomesCatastrophic Workers' Compensation claims have severe implications for the injured worker and significant direct and indirect costs for the insured. The multiple traumatic injuries, lengthy hospitalizations, and coordination of specialists that characterize these claims require a comprehensive approach to determine the most appropriate action in the acute and rehabilitation phases of recovery. Early intervention and the facilitation of a value-based healthcare approach can be the difference in improving quality of life for the claimant and reducing costs to the insured.

Approaching catastrophic Workers' Compensation claims on a case-by-case basis and engaging a value-based healthcare provider who focuses on producing positive outcomes can reduce costs through an improved outcome for the injured worker. When engaged promptly, the provider manages the delivery of specialized care, collaboration among medical providers, and coordination of services. The result is the proactive detection of impending complications in the acute phase of the claim and a consistent approach to the management of care along the recovery continuum.

There are many value-based providers in the marketplace who offer an expansive selection of services to choose from. While the decision to involve a provider is ultimately determined by the insured, deciding which provider to engage and how to leverage their services can involve a complex evaluation process. When weighing the providers and services available, special consideration should be given to the following:

  • Determination of resource allocation
  • Timely and consistent assessment of care
  • Proximity of experienced providers and specialists to the claimant's location
  • Communication of physicians, treatment facilities, third-party administrators (TPA), and the claimant's family

For assistance in determining if engaging a value-based healthcare provider is an option to explore, contact an Old Republic Risk Management Claims Specialist at (262) 797-3400 or visit us at www.orrm.com.

Claim Department

The Old Republic Risk Management Claim Department provides oversight of the claims handled by the Third Party Administrators (TPAs) selected by our Insureds. Claim Specialists liaise with the TPA Adjusters and Insureds to provide guidance on the management of serious claims. The Claim Department is based out of our corporate office in Brookfield, WI.