How Experience and Data Combined Enhance Managed Care Solutions —from Start to Finish
The month of June marks the end of the fiscal year for some organizations and a mid-way reflection point for others.
As risk management teams look back on the experience of supporting employees who were injured on the job over the course of the year, it may also be time to reflect on the approach used to support an employee’s return-to-work journey.
For companies that handle claims internally or those who work with a third-party administrator alike, it may be time for a check-up. Are there more effective ways to help employees restore their health and return to work after an injury?
Broadspire, a Crawford company, provides tailored medical managed care solutions for companies looking to take a comprehensive approach to managing the care of their injured staff. The Medical Management division embraces the company values at each interaction with an Injured worker. They work to restore the injured worker to the highest level of recovery after an injury.
For Erica Fichter, Broadspire’s chief operating officer of medical management and accident and health division, conducting a program health assessment for an organization gives her team the opportunity to “really dive into what that true need is, and then how we can help you manage it.”
Tailored Managed Care Solutions Driven by Data
Drawing from its deep roots in claims handling and data analysis, Broadspire’s team has leveraged multiple components of its traditional service bundle to develop a robust, stand-alone managed care platform that is customizable by client.
To avoid ill-fitted solutions that are much like a square peg placed in a round hole, Fichter’s team focuses on flexibility and client needs.
Whether a payer prefers to start with an early intervention program that starts right from the triage of an injury, or an option that begins with first notice of loss and weaves into case management, “we can be very flexible as to how we sit down with the client, find out what their needs are, and then deliver back to them something that’s going to work best for their program,” Fichter said.
With Broadspire, customized managed care options are backed by experience. By investing in control testing on many of their products, before delving into a comprehensive managed care solution with a payer “we can in good faith say, ‘We’ve tested it, and it works,’” Fichter said.
“And you can have the confidence in that.”
Knowing that the results of controlled tests can have different outcomes when injury care is managed in the real word. Therefore, Fichter’s team develops a framework for measuring outcomes based on the goals determined during a payer’s program assessment.
“We want to make sure that what we’re producing for [payers] is actually bearing fruit, and making sure that it’s meeting the needs,” Fichter said.
The Start-to-Finish Approach
Managing the risks, reducing the costs and restoring the health of injured workers requires 24/7 focused, expert attention. Utilizing the experienced tenure of the Medical Management team, Broadspire can provide an integrated approach to maximizing the recovery of injured workers.
Broadspire’s 24/7 triage program, an integral component of its managed care solution, is the very first step to helping control the cost of a claim, for Jim Kenney, Managed Care Practice Lead at Broadspire. Early intervention comes down to workers having access to a 24-hour service where they can call in and speak to a nurse.
“Providing that access is crucial to ensuring the injured worker gets the appropriate care as soon as possible.” Kenney said.
Rapid access to intervention also helps the employer by allowing the injured worker to speak to a qualified medical expert over the phone, allowing referrals to established network medical providers, when necessary, Kenney said.
Through telephonic case management, field case management and peer-to-peer programs all working in conjunction with each other at the appropriate time and space, Broadspire’s traditional utilization review approach provides a holistic rehabilitation experience for injured workers.
The Benefits of a Diverse and Tenured Team
Broadspire’s stand-alone medical managed care program helps companies better support the needs of their workers regardless of their ethnic background, native language, or abilities. By making a formal commitment to foster a safe and inclusive environment through its own office of inclusion and diversity, Broadspire aims to help payers remove barriers to equitable care in their operations as well.
By developing employee resource groups that empower women, LGBTQ individuals, and professionals with disabilities in the managed care arena, Fichter said, addressing employee diversity “really represents an opportunity for collaboration, creativity, forming [a] sense of belonging … where everybody’s unique perspectives and experiences can be heard and valued.”
The passionate voices and seasoned insight of Broadspire’s diverse and tenured staff come through in the consistent delivery of its managed care services.
From product leaders to case managers, the Broadspire team’s “can do” attitude is an integral element of Broadspire’s ability to customize managed care solutions for clients.
For more information, please visit: https://www.crawco.com/services/workers-compensation.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Crawford & Company®/Broadspire Services, Inc.®. The editorial staff of Risk & Insurance had no role in its preparation.