In response to a nationwide workers’ compensation crisis driven by spiraling medical costs, Calabasas, Calif.-based PTPN announced the launch of PTPN CompDirect, a program designed to achieve better outcomes for injured patients while controlling costs through more efficient use of services.
“Across the nation, state legislatures are seeking regulatory solutions for the workers’ compensation crisis; however, changing the way medical care is delivered and making healthcare providers more accountable can bring real relief on the cost front and improve the quality of care workers receive,” said PTPN president & CEO Michael Weinper, MPH, PT.
Nationally, workers’ compensation premiums have increased more than 50% in the last three years, according to the Insurance Information Institute, with the greatest increases in California and Florida. Higher premiums, fueled primarily by increases in medical costs, are creating financial burdens for businesses already under pressure from an economic downturn.
Weinper noted that while state-mandated fee schedules set prices for most types of medical services, there is no control over utilization of care. Many providers just deliver more visits to drive up revenues, and there is no certainty that the providers have expertise in treating workers’ compensation patients. “PTPN CompDirect addresses both these problems, and incentivizes everyone involved to deliver good care cost-effectively,” he observed.
By enrolling only rehabilitation practitioners in independent practice, PTPN reportedly has no conflicts of interest in ownership that can drive up utilization or reduce the quality of patient care.
Workers’ compensation carriers who contract with PTPN CompDirect can offer patients convenient access to a local, regional or national network of providers through one contract with negotiated rates. PTPN CompDirect directs injured patients to highly qualified therapists at the start of their treatment, and makes sure that experienced peer review case managers oversee the delivery of that care. Payors receive timely communication about the progress of these patients. There is no middleman, so the process is less expensive, more efficient, and more effective in getting workers well and back on the job.
With over 10 years of experience in case management and capitation and one-third of its business volume in managed workers’ compensation, PTPN is the only network with an ongoing quality assurance program that regularly audits providers and measures patient satisfaction. In an independent outcomes management program, PTPN members reportedly delivered 62% more functional improvement for each dollar spent than the national average, while delivering 97.9 percent “very satisfied” ratings from patients.
PTPN members are further qualified by being required to pass the strictest credentialing standards in the industry, exceeding those the National Commission for Quality Assurance (NCQA) require for physicians in managed care plans, and often those required by state licensing, Medicare and community standards.
Topics Workers' Compensation
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