Over the past decade, the three highest costs experienced by employers in New York State have been been taxes, utilities and workers' compensation. Workers' compensation managed care grew out of a need to help New York companies get a handle on compensation costs. The year 2003 was the fifth year of operation of UHS Hospitals' licensed Workers' Compensation Preferred Provider Organization. (The WC PPO is permanent, pursuant to Article 10 of the Workers' Compensation Law and 10NYCRR Part 32.)
In the traditional state workers' comp system, the employee directs his or her own care and the employer is prohibited from instructing or directing where the employee can seek health care if injured on the job. Under this system, the employer has no ability to control who, when or where the employee seeks medical services. The WC PPO is the only mechanism New York State employers have to control their employees' care. For employers who used the services of the WC PPO of UHS Hospitals, the WC PPO has been a successful strategy for controlling workers' comp costs.
The WC PPO provides intense medical case management and gives employers more control over case outcomes than any other type of management. The cost savings are directly related to the cooperation and team effort of the employer, the claims administrator and the WC PPO. When there is a solid team effort in reducing injuries and a strong return-to-work program, the WC PPO is capable of reducing medical and indemnity cost significantly. All of our WC PPO customers have realized at least a 50 percent reduction in medical and indemnity cost from the year prior to initiating the WC PPO.
The WC PPO of UHS Hospitals is a New York State Department of Health-certified plan that provides or arranges for the coordination and delivery of services under the workers' comp law to diagnose, treat and rehabilitate claimants requiring medical treatment for an occupational disease or injury arising out of the course of employment.
The program is NYSDOH-certified in three counties: Broome, Chenango and Tioga. We offer 24-hour point-of-entry case management, and are a community leader in managing and providing occupational health services. Our provider network has well over 270 providers, including primary care physicians, specialists and surgeons.
Our goals are to ensure prompt medical care for injured workers, enhance quality of care, promote a swift return to work, promote safety in the workplace and reduce health care costs.
- An injury cost 68 percent more if it occurs at work.
- An employer's response in the initial 24-hour period after the injury determines 50 percent of the future claim cost.
- A total of 80 percent of return-to-work decisions are made by the employee.
- A total of 70 percent of all lost work time is medically unnecessary.
Why does the WC PPO work?
- There are no delays in the employee's initial treatment; immediate appointments are given.
- A provider's request for authorization can be granted on the same day.
- Our WC PPO staff and providers make themselves familiar with each employer's work sites and jobs.
- The injured employee gets everything they need right away, bringing a speedy recovery.
Workers Compensation Form - General
Workers Compensation Form - Cayuga Medical