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Wednesday, October 16, 2013

How to Find the Best Doctors for Workers’ Compensation

a White Paper
By Karen Wolfe

Caution: This is called a White Paper because it specifically recommends MedMetrics’ solution.

A poorly performing medical provider is costly, particularly when the patient is an injured worker. For injured workers, certain unique administrative processes must accompany medical treatments and procedures. Even doctors who are highly regarded in their medical specialty may generate negative results in the world of Workers’ Compensation.

Medical doctors might treat the injury with medical expertise while causing complexity for claimants and their employers. For instance, not supporting return to work initiatives drives costs and is known to contribute to extended disability. Continued referral to specialists to find the ultimate answer rather than declaring Maximum Medical Improvement (MMI) can result in claim stalemate rather than resolution. Moreover, frustrated patients often seek legal assistance, further compromising outcome. In other words, finding doctors with knowledge of Workers’ Compensation is essential to cost control and improved outcomes.

Some say finding the good doctors is difficult. In fact, finding the right doctors can be easy when MedMetrics does the work. The process is simple.
The data are transferred to MedMetrics from organizations’ disparate sources of claims data, bill review data, and pharmacy benefits management data (PBM). Claimant-identifiable information is not included so confidentiality is not an issue. MedMetrics does the heavy lifting by giving the organization's IT a list of data items to put into a file for transfer.

MedMetrics imports, integrates, and analyzes the data, then scores providers’ performance based on the facts found in the data. Results and rationale are easy to search and available online any time. Moreover, it’s affordable.

License fees are sized to the organization. The organization or the payer benefits immediately by being able to find the best-in-class doctors any time. Headaches and significant dollars are saved.

Karen Wolfe, BSN, MA, MBA is the founder and president of MedMetrics® LLC, an Internet-based Workers’ Compensation analytics company. MedMetrics focuses on analyzing the medical portion of claims, including medical provider performance evaluation and scoring, with continued monitoring. MedMetrics offers its clients online apps that link analytics to operations, thereby making them actionable.