Sep 9, 2025 | Uncategorized
Employers, providers, TPAs and other workers’ comp stakeholders need to work together to succeed.
In today’s world — where medical cost inflation is outpacing overall inflation — ensuring injured workers receive the treatment they need and return to work in a timely fashion is critical to keep costs in-line.
A number of factors, including provider consolidation and changes in billing practices are contributing to these increased costs.
“The same set of practices or treatments that would have cost $100 five years ago now cost between $130 and $140, representing a 30-40% inflation in overall charges,” said Sandip Chatterjee, chief product officer, MedRisk.
Sandip Chatterjee, chief product officer, MedRisk
There are a number of ways workers’ comp stakeholders can manage costs, including some strategies targeted specifically toward musculoskeletal injuries, which make up the majority of workers’ comp claims. These injuries can often be treated effectively with early physical therapy interventions, but differing state regulations and physicians treating patients with a formulaic, rather than individualized approach can make it challenging to ensure workers are getting the care they need, when they need it.
Fortunately, workers’ comp stakeholders can collaborate effectively to get workers the care they need while managing costs. TPAs, like Davies, are leveraging partnerships with managed physical therapy networks like MedRisk and SPNet to access discounted networks, use data and analytics to identify industry trends and at-risk claims and support recovery while managing costs through utilization review.
“Our strategic partners like MedRisk and SPNet provide data analytics and tools that help us identify trends and areas for cost savings. Our partnership with SPNet goes beyond a discounted network; their utilization review improves outcomes and manages costs by providing injured workers with only the necessary treatment related to their industrial accident,” said Beverly Adkins, president of the Third-Party Administrator, Davies North America.
“The tight integration with MedRisk’s network reduces administrative costs. We closely monitor network penetration through reports because keeping clients within the network and using those providers is key to controlling costs.”
Ensuring Effective Claims Management
Beverly Adkins, president, Davies North America
Effective claims management needs three key ingredients: timely and accurate injury reporting, leveraging technology and data analytics to improve outcomes and clear communication and collaboration amongst workers’ comp stakeholders.
“The sooner we can initiate care, the sooner the injured worker can complete treatment and recover. That’s our primary goal in this ecosystem – to help injured workers return to their pre-injury health,” Adkins said.
Timely and accurate injury reporting plays a key role in avoiding delays in care. Treating injuries — especially those of the musculoskeletal variety — in a timely manner is key in helping an injured worker recover and get back to their pre-injury level of function.
“Evidence shows that patients who receive PT sooner for certain conditions, such as acute and subacute low back pain, shoulder strains, and neck conditions, achieve better outcomes faster,” said Brian Peers, vice president of clinical services and provider management, MedRisk.
Making sure patients are being treated quickly is important, but so is making sure they’re receiving appropriate care. Adjusters and nurse case managers should proactively review files and leverage data insights to make sure an injured worker is receiving the right treatment and identify any potential hurdles in the recovery process.
Brian Peers, vice president of clinical services and provider management, MedRisk
“Doctors often prescribe standard treatments, such as physical therapy three times a week for four weeks, which may not be necessary for the injured worker to return to their pre-injury status,” Adkins said.
“We train our staff to review these recommendations against guidelines and authorize only what is needed. We rely on our strategic partners to assist in this process. If additional treatment is required, we can increase it, but our focus is on the injured worker’s recovery while managing costs through effective utilization review.”
This approach also allows workers’ comp stakeholders to focus on keeping employees at work.
“We work to keep employees at work rather than just focusing on return-to-work,” Adkins said.
“We emphasize the importance of keeping employees engaged and at work whenever medically appropriate. We also provide training to our occupational medicine physicians to help them understand the unique aspects of workers’ compensation and support recovery-oriented care.”
Collaborating to Get Injured Workers Back on the Job
Effective communication, leveraging data and analytics and ensuring injured workers get the right treatments swiftly is key to managing costs and helping workers get back or as feasibly close to their pre-injury level of function.
“Our model is like a map – it starts with a preplan, identifying the fastest route. Then, as we receive real-time information during the journey, we coordinate between all stakeholders to make necessary adjustments that get us to the destination faster,” said Greg Nichols, president of SPNet.
Greg Nichols, PT, president of SPNet, a division of MedRisk
To leverage partnerships with companies like MedRisk and SPNet, TPAs need to get buy-in from insureds. This level of support is also key to driving better outcomes for injured workers. As Adkins explained, “Workplace support is crucial for successful return-to-work outcomes. Most of our clients are self-insured and highly engaged in the process, as it directly impacts their finances. We build trust with them.
“This trust allows us to bring in strategic partners that can help save them money. Our clients, in turn, support our initiatives and share pertinent information we provide to their employees. Effective communication and staying proactive are key to maintaining this support,” she continued.
Strategic partners can also help with cost containment and identify options for cost savings.
“For clients, about 40-50% of their bills are subject to either zero or low discounts. In this situation, we need to consider alternative solutions,” Chatterjee said. “We can explore financial audits, clinical audits, and negotiation. Our company is actively investigating a range of strategies to help our clients drive better savings on their bills in this evolving healthcare landscape.”
Leveraging Strategic Partnerships for Targeted Savings
Finding the right partners can be critical to identifying opportunities for cost savings and ensuring injured workers receive the appropriate treatment within workers’ comp. MedRisk prioritizes connecting injured workers with high-quality providers, who understand the workers’ comp system, and follow appropriate treatment guidelines. The company also uses data and analytics to track claims and ensure injured workers are on the path to a successful recovery. All of these tools can help get workers back to work sooner and reduce claims costs.
“We are working in partnership with MedRisk and SPNet to mitigate these costs and show them value in that partnership,” Adkins said.
Their tools can help even when there’s been a delay in care. “We have an integrated system that delivers scores and recommendations for physical therapy delays. Just because we have a delay in access to care or recovery doesn’t mean it will be a high-risk claim,” Nichols said.
Their team is committed to providing appropriate care for each injured worker. “Most referrals are in multiples of two or three visits, even though some cases may require five or seven,” Peers said. “Our team assesses the unique needs of each case, aiming to provide the exact care required for functional recovery and resumption of pre-injury duties – no more, no less.”
By focusing on care-first strategies and strengthening strategic partnerships, workers’ comp stakeholders can improve outcomes for injured workers while controlling costs. This collaborative, compassionate approach helps workers recover faster, supports long-term function, and creates sustainable savings in a system facing rising costs and complexity.
Also posted in: https://riskandinsurance.com/content-how-care-first-strategies-help-lower-workers-comp-costs/
Nov 7, 2023 | Uncategorized
MedRisk is sponsoring the 2023 Kids’ Chance of America Awareness Week, November 13-17, 2023.
Kids’ Chance Awareness Week is back in 2023, and it promises to be a meaningful and impactful event. This week-long campaign, running from November 13th to 19th, sheds light on the importance of providing educational opportunities for the children of workers who have been injured or fatally wounded on the job. Kids’ Chance is a nonprofit organization that strives to make a difference in the lives of these deserving young individuals, and this year, MedRisk proudly stands as one of the event’s key sponsors.
Every year, workplace accidents and injuries can have devastating consequences for families. Beyond the immediate physical and emotional toll, these incidents can disrupt a family’s financial stability, leaving children with limited access to educational opportunities. This is where Kids’ Chance steps in, ensuring that these students receive the support they need to pursue their dreams and ambitions through higher education. More information is available here.
MedRisk, a leading provider of managed care services for the workers’ compensation industry, has recognized the importance of Kids’ Chance’s mission and has joined hands as a sponsor for Kids’ Chance Awareness Week 2023. Their commitment to improving the lives of injured workers and their families aligns perfectly with the values of Kids’ Chance. By sponsoring this event, MedRisk is making a positive and lasting impact on the lives of these children, helping them access the education they deserve.
How Can You Help?
You can also be part of this noble cause during Kids’ Chance Awareness Week. By making a donation, you can contribute to providing scholarships, mentorships, and opportunities for these young individuals to secure a brighter future. Your support can help break the cycle of adversity that many of these children face and empower them to achieve their educational goals.
To make a donation and learn more about Kids’ Chance and its mission, click here.
Join us during Kids’ Chance Awareness Week 2023 as we celebrate the power of education and the unwavering commitment to improving the lives of injured workers’ children. Your involvement can make a meaningful difference in the lives of these young individuals, helping them build a better future for themselves and their families.
Together, we can create a more promising tomorrow for these deserving students. Make a difference today and support Kids’ Chance in their mission to provide opportunities for the next generation.
About Kids’ Chance of America
Kids’ Chance of America is a 501(c)(3) organization that provides a forum for state Kids’ Chance organizations to discuss best practices, share resources, and collaborate on projects at a national level. There are 43 state organizations, and collectively, Kids’ Chance organizations have awarded more than 6,500 scholarships across the country, totaling over $20 million. For more information, please see www.kidschance.org.
About MedRisk
Based in King of Prussia, Pennsylvania, MedRisk is the largest managed care organization dedicated to the physical rehabilitation of injured workers. One of the Inc. 5,000 fastest growing companies, MedRisk counts over 162,000 providers in its network and serves over one-half million injured workers every year. The company holds direct contracts with more than 90 percent of the nation’s top workers’ compensation insurers and third-party administrators. MedRisk, which has successfully completed a SSAE 16 Type II examination, ensures high quality care and delivers outstanding customer service. To that end, all customer service professionals, healthcare advocates and physical therapists are based in the U.S. For more information, visit www.medrisknet.com or call 800-225-9675.
Apr 6, 2023 | Uncategorized
MedRisk is sponsoring the 2023 Kids’ Chance of America National Conference, May 4-6, 2023.
At the 2023 Kids’ Chance of America National Conference, representatives of state Kids’ Chance organizations will learn best practices and strategies for raising scholarship funds, increasing student engagement, managing a non-profit, marketing, and establishing corporate partnerships. Attendees will also meet scholarship recipients and hear their stories.
The 2023 Kids’ Chance of America National Conference will be held at The Alexander Hotel in Indianapolis, Indiana on May 4-6. More information is available here.
About Kids’ Chance of America
Kids’ Chance of America is a 501(c)(3) organization that provides a forum for state Kids’ Chance organizations to discuss best practices, share resources, and collaborate on projects at a national level. There are 43 state organizations, and collectively, Kids’ Chance organizations have awarded more than 6,500 scholarships across the country, totaling over $20 million. For more information, please see www.kidschance.org.
About MedRisk
Based in King of Prussia, Pennsylvania, MedRisk is the largest managed care organization dedicated to the physical rehabilitation of injured workers. One of the Inc. 5,000 fastest growing companies, MedRisk counts over 162,000 providers in its network and serves over one-half million injured workers every year. The company holds direct contracts with more than 90 percent of the nation’s top workers’ compensation insurers and third-party administrators. MedRisk, which has successfully completed a SSAE 16 Type II examination, ensures high quality care and delivers outstanding customer service. To that end, all customer service professionals, healthcare advocates and physical therapists are based in the U.S. For more information, visit www.medrisknet.com or call 800-225-9675.
Sep 22, 2022 | Uncategorized
As Hurricane Ian makes landfall and continues into the state of Florida and other states over the next few days, MedRisk continues to prioritize the safety and well-being of patients, customers, providers and team members affected. While we monitor the path of the storm, be assured that MedRisk maintains operations without service disruptions and will continue monitoring provider and patient scheduling, rescheduling and accessibility to physical therapy services.
Needless to say, MedRisk remains committed to our customers and patients to ensure delivery of care as appropriate.
Please contact your MedRisk representative with any questions or concerns.
Jul 8, 2021 | Uncategorized
MedRisk, the leader in physical rehabilitation in workers’ compensation, has appointed John Jakovcic Senior Vice President of Technology.
Responsible for project management and client solutions and working alongside the technology leadership on strategic technology solutions, he will focus on cybersecurity, business continuity, and automation strategies. Jakovcic, who has managed large technology staffs, will collaborate with the infrastructure and development teams to expand MedRisk’s technology strategy while continuing to support leadership development and growth through the organization.
“We are excited to have John bring his range of skills and industry knowledge to help further MedRisk’s growth,” said President Danielle Lisenbey. “His contributions and our continued investment in modern technology and innovation will help MedRisk maintain the highest clinical and customer service standards in the workers’ comp industry.”
Jakovcic has 25 years of information technology experience with disability and group health insurance companies and worker’s compensation third-party administrators. Most recently, he was Vice President of Information Technology, Premier Life, Absence and Disability Solutions for Aflac.
During his prior nine-year tenure at Broadspire, he served as Senior Vice President of Global Strategy and Global Management, and Senior Vice President of Information Technology, where he developed an overall technology strategy to collapse multiple claims systems, enhance the managed care process and automate key processes to drive overall operational efficiencies. Earlier in his career, he worked for Broadspire Services in application software development and for Aetna as an implementation manager.
Jakovcic holds a Bachelor of Science degree in Biomedical Engineering from Case Western Reserve University in Cleveland, Ohio.
About MedRisk
Based in King of Prussia, Pennsylvania, MedRisk is the largest managed care organization dedicated to the physical rehabilitation of injured workers. Clinically driven since its inception, the company has an International Scientific Advisory Board that developed and maintains physical medicine-specific, evidence-based guidelines for workers’ compensation. MedRisk, which has successfully completed SSAE 18 SOC Type 1 and 2 examinations, ensures high quality care and delivers outstanding customer service. For more information, visit www.medrisknet.com or call 800-225-9675.
Media Contacts:
Helen King Patterson, APR, King Knight Communications, 813-690-4787, helen@kingknight.com
