Want your workers’ compensation program to go further? Provide better care? Save more? Us too. However, myths about managed care may cause you to sit idle, questioning if making a change and propelling into a new space is beneficial. These common misconceptions can blur your vision and blind you from seeing the cost-saving and efficiency-boosting potential that lies ahead. Kerri Wilson, President and COO, and Zebrah L. Jahnke, VP of Business Development at EK Health, are leading the way in debunking these myths and shedding light on the real advantages of managed care.
MYTH: Bundling is the easiest, most efficient solution.
FACT: The answer to efficiency often lies in tailored solutions
"You can dream bigger. Customization is possible and yields better experiences for all. The trick to customization is flexibility in choice” asserts Wilson. “True flexibility is about seamlessly weaving together your services to address the intricacies of each case and your overall program. One size does not fit all, and recognizing this is paramount to the success of your program.” By strategically aligning resources, utilizing automation, collaborating for innovative solutions, and building tools that suit the direct needs of your injured workers, management, and adjusters, you innately build increased efficiencies and greater focus in the process. Achieving this level of strategy requires choice and results in stronger collaboration, focus on driving outcomes, a broader mindset, more eyes on the details, and ultimately superior outcomes. Jahnke adds, “Not only can unbundling managed care create customized efficiencies and enhanced experiences, you can also rest easy knowing hidden fees and revenue sharing are diminished. There’s transparency - in the process and the cost - you know where your money is being spent.”
MYTH: Case Management is expensive.
FACT: Putting off the use of Case Management results in medical expenses being further out of your control.
Effective Case Management, when used on the right claim at the right time (not every time), has proven to reduce overall costs. “Timely intervention is the linchpin; it propels progress, creates clear communication, facilitates smoother transitions, and reduces litigation - yielding financial savings, better return-to-work timelines, and a better experience for the employee. Early intervention is often underutilized and even overlooked, yet it improves outcomes for all parties in the long run,” stated Jahnke.
MYTH: Managed care is a one-size-fits-all solution.
FACT: Managed care programs are designed to be flexible and adaptable. Limiting flexibility implies every workers’ compensation claim, every program, and every industry has the same challenges and needs.
No one knows your program better than you. In an unbundled model, with vetted partners who share similar values, you have a voice and it matters. Wilson highlights the kaleidoscope of workers' compensation claims, stressing the need for personalized approaches. "Every single workers' compensation case is unique," she affirms. ”The success of each hinges on crafting solutions that intricately address the individualized medical and rehabilitation needs, dispelling the myth of a uniform fix. Your greatest assets - your people and your dollars - deserve more than a plug-and-play solution.” Jahnke adds, “In a world where dollars are set aside and insurance is purchased based on anticipated future costs with vastly differing exposures, doesn’t it make sense that no two programs would look the same? Customization and flexibility shouldn’t just be accessible, it should be expected.”
MYTH: Managed care only focuses on cost containment.
FACT: Successful managed care strikes a delicate balance between advocacy and outcomes, nurturing both employee well-being and cost savings.
Jahnke underscores this, “Managed care with integrity emphasizes and prioritizes employee well-being. The employee is the single most important factor in every workers’ compensation claim. Every decision matters. If we lose sight of this central focus, everyone loses. Decisions are critical - on program design, claim handling, treatment plans, the right doc, when to collaborate, ensuring accountability, defining success, measuring success…the list goes on and on. If we aren’t laser-focused on what’s truly important at each step of the process, we are missing the goal. We are in the business of improving human lives. If we focus on the employee first, we will ultimately improve cost containment.”
The Takeaway
Consider the choices and determine what works best for you, then advocate for it. Our industry has been slow to change; join us in debunking that fact.
Dream Bigger. Experience Better.
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