Products help you control workers’ comp costs
Risk Data provides two ways to keep track
Risk Data in Irvine, CA, has two new products designed specifically to reduce worker’s comp costs. ProviderCompare and CompCompare provide case managers with analyses of provider performance and a method for measuring cost savings generated by managed care and return- to-work efforts.
ProviderCompare allows case managers to look at claims data for comparisons and rankings of physician’s financial outcomes, medical and indemnity costs, and treatment patterns so they can select providers who achieve the best outcomes. CompCompare is a benchmarking tool that generates industrywide comparisons of claims so case managers can compare their clients’ claims data to those of other employers in the industry.
"Managed care customers constantly want to know whether their managed care programs are working," says Fred Scardellette, ARM, MBA, vice president of information management and services for Intracorp, a care management company in Philadelphia that uses both programs.
"They want you to be able to tell them which programs are working and which aren’t. Comp-Compare measures pre- and post-care management performance. It’s the neutral third party in the outcomes measurement process."
ProviderCompare helps care managers assess provider performance, especially on return-to-work, says Scardellette.
"There are other ways to measure performance, but for workers’ comp return-to-work is the most important. Provider-Compare helps us better manage our provider network," he says."If providers’ outcomes vary greatly from their peers’, we can show the physicians how their performance stacks up against other physicians and suggest changes they can make to bring their own practice more in line with the industry."
The program tracks the following measures of provider effectiveness:
• vocational dollars spent on employee retraining;
• litigation expenses;
• medical dollars broken down by procedure performed;
• frequency and average cost per case for surgery, hospital services, laboratory work, radiology, and medications.
While ProviderCompare helps care managers develop more efficient provider networks and select appropriate providers, CompCompare is used by managed care organizations to promote the success of their programs, says Sean M. Downs, senior vice president of sales and marketing for Risk Data. "Payers that have bought the program use it to demonstrate that their managed care plans get results," he says. "They are advertising those results to give themselves an advantage in the market."
In addition, some third-party administrators who enter into performance-based pricing arrangements use CompCompare as the agreed upon tool for measuring and calculating performance-based fees, Downs says.
"We don’t use either ProviderCompare or CompCompare on a daily basis. These are monthly or quarterly review tools that help us track the effectiveness of our care management and report that to our customers," Scardellette says. "They help us determine where to make improvements and quantify what we do."
[Editor’s note: For more information on Provider-Compare or CompCompare, contact: Risk Data, 111 Pacifica, Third Floor, Irvine, CA 92618. Telephone: (800) 326-6472. Fax: (714) 753-8020. Internet: http://www.riskdata.com. Intracorp has developed its own case management software system, Intracorp Case Management System (ICMS), that supports case managers in their daily caseload. For more information on ICMS, contact: Fred Scardellette, Intracorp, 1601 Chestnut St., 2 Liberty Place, TLP 12, Philadelphia, PA 19192. Telephone: (215) 761-7200.]
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