HMO strategies for managing workers' compensation claims.
Health maintenance organizations (HMOs) have become very active in managing workers' compensation medical expense benefits. A survey of 316 HMOs shows that this activity takes the form of various network models and a range of services--such as utilization review and case management--that may not be linked to a provider network. Of the HMOs surveyed, 78 reported that, by using managed care services and provider discounts, they were able to save from 20 percent to 30 percent on occupational health claim costs.
Gallagher
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PA
Milliman & Robertson, Inc., Radnor, PA, USA.
D019090:Case Management; D017046:Cost Savings; D003625:Data Collection; D018588:Fee-for-Service Plans; D006279:Health Maintenance Organizations / Q000145:classification / Q000458:organization & administration / Q000706:statistics & numerical data*; D007344:Insurance Claim Reporting; D010934:Planning Techniques; D012051:Reimbursement Mechanisms; D014481:United States; D014600:Utilization Review; D014942:Workers' Compensation / Q000191:economics / Q000458:organization & administration*