Workers Comp PPOs Save Money
Did Workers Comp PPOs save money? Do Workers Comp Preferred Provider Organizations (PPOs) save money? Do PPOs diminish the level of care that our injured employees would receive vs. having no PPO?
Workers Comp PPOs have gone from a simple discount for certain providers to very complex systems. PPOs vary among each type of service offered. They can be a generalist PPO where all the providers are one large PPO, to specialist PPOs such as Pharmaceutical or Physical Therapy.
The PPOs pre-negotiate a discount from the medical providers. The providers sign on with PPOs to drive more business to their practices.
Do PPOs diminish any type of care? No, as in all the years I have been in Workers Comp, I have never seen an instance where an injured employee in a PPO did not receive the same level of treatment that a non-PPO employee received to treat their injuries.
PPOs do save money if they are examined as to what they are – a group of medical providers that are willing to take a discount. Quite often, the PPOs sign up as many medical providers as possible whether they are industrial-type providers or not. As the PPO makes their $ off the employee seeing one of their medical providers, the marketing department for PPOs will attempt to sign up all the medical providers in a certain area.
Our recommendation is to send the employees to the medical providers that you have an established working relationship with. Sometimes, saving 15% on a medical bill may not be worth it if, for example, the doctor did not know that you have a full Return to Work program in place and wrote an employee out of work with a 25lb weight lifting restriction.
California has proven that medical networks do work for the most part. CA’s Medical Provider Networks (MPNs) have saved employers in CA millions of $ over the last five years. In my opinion, this was the rule that turned the tide for California Workers Comp.
There are also EPOs such as Employers Choice Network out of Charlotte, NC. They can custom-build medical networks, even within the network that you already have in place. They provide the best of both worlds – a discount and industrial-minded medical provider.
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