Network Challenges Today

The workers' compensation industry today is still faced with many challenges to contain and reduce medical costs and over utilization. The managed care industry struggles to find answers that would genuinely have an impact. Most often the answer to this old dilemma is to just make it bigger rather than better. Take for example medical provider networks. No matter how a Preferred Provider Organization (PPO) is packaged, it is still based on penetration and discounts. The basic philosophy is that the "super sized" networks with the fattest directories are the best. However, when you look closely at any existing network, this is what we find:

Most providers come from Group Health
•   Only a small percentage of providers even understand Work Comp
•   The directories that have providers that no longer exist
•   Providers who no longer take workers' comp patients
•   Providers who are not even in the network (providers who have not signed a network participation contract)

Another important fact about networks, whether large or small, is that they cannot ensure quality medical outcomes. PPO's have difficulty monitoring or measuring success.

There is still another idea in the industry on how to repackage a network. By taking multiple networks, analyze their penetration and discounts and select which network is best by jurisdiction. This is a great idea, but how does this repackaging address the real issues of containing medical costs or providers who don't even know workers' compensation. Optimizing a network in this way is just a repackaged network of penetration and discounts.

Networks That Make A Difference

At Signature Networks PLUS we decided to do things differently. We changed the rules and we have a solution that makes a difference.

If you could have your own customized provider network, with access to the right providers, who know and understand the workers' compensation industry, and achieve better treatment outcomes, sustained return-to-work results, and impact indemnity costs, would you be interested?

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