A preliminary investigation of the effects of a provider network on costs and lost-time in workers' compensation

Journal of Occupational and Environmental Medicine

Volumn 47, Issue 1, 2005, Pages 3-10

  Bernacki, Edward J ^a   Tao, Xuguang ^a   Yuspeh, Larry ^b  

^a JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b Louisiana Workers' Compensation Corporation   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ABSENTEEISM; HEALTH CARE COST; HUMAN; INSURANCE; MAJOR CLINICAL STUDY; MEDICAL CARE; OCCUPATIONAL ACCIDENT; OCCUPATIONAL MEDICINE; OCCUPATIONAL PHYSICIAN; REVIEW; WORKMAN COMPENSATION;

ABSENTEEISM; ACCIDENTS, OCCUPATIONAL; COST SAVINGS; HUMANS; INSURANCE CLAIM REVIEW; LOUISIANA; PROVIDER-SPONSORED ORGANIZATIONS; WORKERS' COMPENSATION; WOUNDS AND INJURIES;

EID: 12344262698     PISSN: 10762752     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.jom.0000152745.75983.27     Document Type: Review

References (28)

1. Miller, LA. Networks in workers' compensation medical delivery. Occup Med. 1998;13:717-725.
2. Nadler SF, Mulford GJ, Wagner KL, et al. Improving the workers' compensation system case management perspective. Am J Phys Med Rehabil. 2000;1:98-99.
3. Nikolaj S, Bon B. Health care management in workers' compensation. Occup Med. 1998;13:357-379.
4. Linz DH, Ford LF, Nightingale, MJ, et al. Care management of work injuries: results of a 1-year pilot outcome assurance program. J Occup Environ Med. 2001;43:959-968.
5. Bernacki EJ, Tsai SP, Managed care for workers' compensation: three years of experience in an "employee choice" state. J Occup Med. 1996;38:1091-1097.
6. Bernacki EJ, Guidera JA, Schaefer JA, Tsai SP. A facilitated early return to work program at a large urban medical center. J Occup Med. 2000;42:1172-1177.
7. Bernacki EJ, Schaefer JA. Human factors and ergonomics programming in the health care industry. Clin Occup Environ Med. 2001;1:261-227.
8. Bernacki, EJ, Tsai, SP. Ten years' experience using an integrated workers' compensation management system to control workers' compensation costs. J Occup Med. 2003;45:5:508-516.
9. Victor RA, Wang D, Borba P. Provider choice laws, network involvement, and medical costs. Workers' Compensation Research Institution, Cambridge, MA, December 2002; available at: http://www.wcrinet.org; accessed December 3, 2004.
10. Victor RB, Fleischman CA. How choice of provider and recessions affect medical costs in workers' compensation. Workers' Compensation Research Institution, Cambridge, MA, June, 1990; available at: http://www.wcrinet.org; accessed December 3, 2004.
11. Fox SE, Victor RA, Zhao X. The impact of initial treatment by network providers on workers' compensation medical costs and disability payments. Workers' Compensation Research Institution, Cambridge, MA, August 2001; available at: http://www.wcrinet.org; accessed December 3, 2004.
12. Victor, RA. Evidence of effectiveness of policy levers to contain medical costs in workers' compensation -Workers' Compensation Research Institution, Cambridge, MA, November 2003; available at: http://www.wcrinet.org; accessed December 3, 2004.
13. Atcheson SG, Brunner RL, Greenwald EJ, et al. Paying doctors more: use of musculoskeletal specialists and increased physician pay to decrease workers' compensation costs. J Occup Environ Med. 2001;43:672-679.
14. Galizzi M, Boden LI. What are the most important factors shaping return to work? Evidence from Wisconsin. Workers' Compensation Research Institution, Cambridge, MA, October 1996; available at: http://www.wcrinet.org; accessed December 3, 2004.
15. Swedlow A, Gardner LB. Provider Experience in the California workers' compensation system and volume-based outcomes-does "practice make perfect?" December 2002. California Workers' Compensation Institute. available at: http://www.cwci.org; accessed December 3, 2004.
16. Wickizer TM. Controlling outpatient medical equipment costs through utilization management. Med Care. 1995;33:383-391.
17. Wickizer TM, Lessler D. Utilization management: issues, effects and future prospects. Annu Rev Public Health. 2002;23:233-254.
18. Wickizer TM, Franklin G, Gluck JV, Fulton-Kehoe D. Improving quality through identifying inappropriate care: the use of guidelines based utilization review protocols in the Washington sate workers' compensation system. J Occup Environ Med. 2004;43:198-204.
19. Gotowka TD, Smith RB. Focused psychiatric review: impacts on expense and utilization. Benefits Quarterly. 1991;7:73-81.
20. Hodgkin D. The impact of private utilization management on psychiatric care: a review of the literature. J Mental Health Adm. 1992;19:143-157.
21. Yuspeh, L. Occupational care management: measuring outcomes. Patient care: putting you back in the driver's seat: a training conference for physicians, nurses and occupational medicine professions, Windsor Court Hotel, New Orleans, LA, August, 16-17, 2003.
22. Center for Disease and Prevention (CDC). EPI-INFO 6.0, Atlanta: CDC; 2001.
23. Workers' Compensation Research Institute Benchmarks; Average Benefit per Claim with more than seven days of lost-time, 2001/2002. Workers' Compensation Research Institution, Cambridge, MA, September 2004; available at: http://www.wcrinet.org; accessed December 3, 2004.
24. Workplace injuries and illnesses in 1995. Bureau of Labor Statistics; available at: http://stats.bls.gov; accessed December 3, 2004.
25. Biddle J, Boden LI, Reville RT. Older workers face more serious consequences from workplace injuries. National Academy of Social Insurance, December 2003. Available at: http://www.nasi.org; accessed December 3, 2004.
26. Tattrie D, Gotz G, Liu TC. Workers' compensation and the changing age of the workforce. December 2003;.available at: http://www.wcrinet.org; accessed December 3, 2004.
27. th Annual Conference, Ocean City, Maryland. Available from: NCCI, (Robert_Moss@ncci.com).
28. Workers' compensation claim characteristics -2004 update; available at: http://www.ncci.com/nccisearch/industry/claim-cha/claimchatableofcon.htm; accessed December 3, 2004