DWC Certifies Two New Workers' Compensation Health Care Organizations
SAN FRANCISCO - The California Department of Industrial Relations' Division of Workers' Compensation (DWC) has certified two new health care organizations (HCOs) to provide medical care for workers injured on the job.
"I am pleased to welcome these two new health care plans offered by Intracorp into the HCO program," said DWC Administrative Director Richard Gannon in signing the certifications. "Use of HCOs is becoming an increasingly popular way to help employers and their workers improve medical care quality and early return to work programs while controlling rising workers' compensation costs," he said.
In addition to certifying the two new Intracorp plans, Gannon also signed the recertification of two existing HCOs, CompPartners Access and CompPartners Direct, both of Irvine, CA. Recertification is required every three years.
Intracorp is one of the oldest and largest case management companies in the country, with over 1,100 nurse case managers, 40 physicians on staff and nearly 500 physician advisors. Headquartered in Philadelphia, PA, it includes some of the largest employers, third party administrators and insurance carriers in the country among its clients.
"Our certification by DWC will allow California employers to fully leverage the benefits of an organized health care benefit delivery system through more comprehensive network utilization, occupationally focused providers, more focused medical management and increased emphasis on return to work," said Ken Ross, senior vice president, Disability Management, Intracorp. "This will strengthen Intracorp's ability to help injured workers recover and get back to work more quickly while at the same time minimize employers' medical and indemnity expenses."
The two new Intracorp HCOs are officially known as "Intracorp HCO Plan A" and "Intracorp HCO Plan B." The plans vary in the variety of choices of medical providers offered to enrolled employees. HCO applicants often request certification for two products because current law requires that employees be offered at least two plans from which to choose. Beginning in 2003, new legislation enacted earlier this year, Assembly Bill 749, will modify that requirement, and it is expected that many of the providers who operate more than one plan will combine them.
"These new certifications and recertifications will substantially
increase the options businesses have, and the choice employees have, for using
HCOs," said Gannon. He noted that new plans, as they become operational,
are reaching into different areas of the marketplace, including both public
and private sector places of employment, large and small firms, and self insured
Enrollment by employees in the programs is also growing substantially, he said, from just over 150,000 employees during the first half of 2001 to about 380,000 as of July 1, 2002.
Once an HCO is certified, employers and insurers may contract with the organization to offer their employees a medical plan for occupational injuries. Employees can opt to enroll in the plan or pre-designate their own personal physician. Depending on the overall health coverage they offer, employers gain additional time during which they control medical treatment for an enrolled employee.
Certified HCOs must provide a quality assurance and improvement
process, medical case management, coordination of return to work services
with the employer and a grievance system. They must also report preventable
health problems to the employer to improve workplace health and safety, and
must report data on medical treatment patterns, costs and outcomes for patients
receiving HCO care to the DWC annually.
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NOTE TO EDITORS:
A list of certified HCOs can be found on the DWC Web site at http://www.dir.ca.gov/dir/Workers' Compensation/DWC/HCO.htm