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
United Health Services 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 United Health Services 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 United Health Services 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.
Fast Facts
- 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
