White Paper Summary

Fragmented care negatively affects everyone in the workers’ compensation system — especially injured workers.

Providers working in silos contribute to uncertainty about the diagnosis, disengagement from treatment, and ineffective care pathways. Specifically, when injured workers don’t receive managed, coordinated care, this can mean unnecessary surgeries, the risk of prescription drug dependency, and a delayed return to work.

On the payer side, that all adds up to increased treatment and indemnity costs, contributing to an exorbitant total cost of care.

Workplace musculoskeletal (MSK) injuries are a frequent source of workers’ compensation claims, and a powerful example of the barriers that care fragmentation can create.

By integrating and coordinating the patient experience, managed episodic care programs for MSK injuries can deliver on the promise of whole-person, value-based treatment.

With HERO EpisodicSM, Paradigm has an industry-first solution built to achieve guaranteed outcomes for workplace MSK injuries and financial value — including fixed-cost, bundled pricing for surgical episodes.

This solution leverages clinical expertise and care management resources developed across decades of managing complex and catastrophic injuries.

The goal is a guided, evidence-based approach designed to increase patient engagement.

To do this, HERO Episodic combines people-focused care coordination, value-based payment models that lower total cost of care, and data-driven care pathways utilizing best-in-class provider networks.

To learn more about Paradigm, please visit their website.