Treating injured workers on a case by case basis using an assigned case manager, who coordinates the employee’s treatments.
Case management is a popular cost control option. It is the treatment of injured workers on a case-by-case basis by an assigned manager, usually a registered nurse, who coordinates with the physician and health plan to determine which care settings are the most effective for quality acre and cost. Respondents in one survey found that safety / injury protection and case management were the most common workers’ compensation cost containment measures. Other workers’ comp cost control techniques include monitoring health care providers for compliance with their fee schedules, and auditing medical bills. Employers can also select insurers based on their level of service and flexibility negotiating rates.
Hospitalization Health and disability insurance
Health insurance looms large in many people’s choice of employer, because such insurance is so expensive. Most employers therefore offer some type of hospitalization, medical and disability insurance.
Hospitalization, health and disability insurance helps protect employees against hospitalization costs and the loss of income arising from off the job accidents or illness. Many employers purchase the insurance from life insurance companies; casually insurance companies; or Blue Cross (for hospital expenses) and Blue Shield (for physician expenses). Organizations, Other contract with health maintenance organizations or preferred provider organizations
Most health insurance plans provide at least basic hospitalization ad surgical and medical insurance for all eligible employees at group rates. Insurance is generally available to all employees – including new non-probationary ones – regardless of health or physical condition. Most basic plan pay for hospital room and board – surgery charges and medical expenses (such as doctors’ visits to the hospital), some also provide major medical coverage to meet the high medical expenses resulting from long term or serious illnesses
Most employers’ insurance plans cover health related expenses like doctors’ visits eye care and dental services. Other plan pays for general and diagnostic visits to the doctor’s office vision care, hearing aids and prescription dugs. In most employers sponsored dental plans, employees pay a specific amount of deductible dental expenses before the plan kicks in with benefits. Disability insurance provides income protection for salary loss due to illness or accident. Payments usually start when normal sick have leave payments end, and may continue until age 65 or beyond. The benefits usually range from 50 to 75% of the employee’s base pay if he or she is disabled.
Health maintenance organization (HMO): A prepaid health care system that generally provides routine round the clock medical services as well as preventive medicine in a clinic type arrangement for employees, who pay a nominal fee in addition to the fixed annual fee the employer, pays.
Many employers offer membership in health maintenance organization (HMO) as a hospital /medical option. The HMO is a medical organizations consisting of specialists (surgeons, psychiatrists and so on) often operating out of a health acre center. It provides routine medical services to employees who pay a nominal fee. Employees often have general practitioner gatekeeper doctors who need to approve appointments with specialists’ doctors. The HMO receives a fixed annual fee per employee from the employer or employer and employee) regardless of whether it provides that person service.
Preferred provider organization (PPOs)
Groups of health care providers that contract with employers’ insurance companies or third party payers to provide medical care services at a reduced fee.
PPOs are a cross between HMOs and the traditional doctor patient arrangement: They are groups of health care providers that contract with employers’ insurance companies or third party payers to provide medical care services at a reduced fee. Unlike HMOs (whose relatively limited lists of health care providers are often located in one health care center), PPOs let employees select providers (like doctors) from a relatively wide list and see them in their offices, often without gatekeeper doctor approval. The providers agree to provide discounts and submit to certain utilization controls such as on the diagnostic tests they can order.