Content updated: January 2023

Catastrophic workplace injury care management put Paradigm on the map more than 30 years ago. Today, our Systematic Care Management Model^SM has decades of proven results to demonstrate the effectiveness of a data-driven, expert-guided approach to injury recovery. HERO Severe^SM leverages the full power of Paradigm’s Catastrophic model for a wider range of injuries—to improve the lives of more injured workers and families.

Severe, non-catastrophic injuries can still have a devastating impact on the workers, families, and employers they affect. These diagnoses require a level of managed care similar to catastrophic injuries—including multidisciplinary treatment from a range of specialists, addressing behavioral health obstacles, and meeting long-term needs that elevate risk over the life of a claim.

HERO Severe incorporates the critical elements from Paradigm’s established catastrophic care management model, and applies it to provide guaranteed outcomes and financial certainty for severe workplace injuries. The overriding goal is to guide injured workers back to their jobs and families through coordinated services specifically calibrated for guaranteed release to return to work. HERO Severe is a solution our clients specifically asked for and is designed to help change more lives for the better.

Here are five specific ways HERO Severe is equipped to achieve the same superior outcomes—including 32% lower lifetime medical costs and nearly six times higher return-to-work rates—as HERO Catastrophic^SM:

1. Deep clinical expertise behind every successful outcome
Just like our catastrophic product, each HERO Severe case leverages a highly specialized care management team. This includes a Network Manager who is a nurse case manager carefully selected and trained to handle the needs of seriously injured workers and their families. Alongside each Network Manager is a Paradigm Medical Director—an experienced physician specifically matched to each worker’s injuries to ensure comprehensive and consistent care; a Clinical Director who provides expert oversight on every file; and Clinical Specialists available for consultation as needed, with training and expertise across a wide swath of catastrophic and behavioral health conditions.

This team coordinates care and supports recovery with their deep experience and access to proprietary data from tens of thousands of completed Paradigm cases. Just like our catastrophic model, we have the expertise to connect injured workers and their families with the best available treatment for each unique situation.

2. Treatment for a wide range of severe injuries
Severe workplace injuries can take many forms. The injury types that can benefit from HERO Severe are often from the same major categories as our catastrophic product. Serious diagnoses of this nature still involve major risk and care needs over the life of a claim. They include:

• Multiple trauma: Including uncomplicated limb and/or joint fractures, ligament injuries, thoracic or ribcage injuries, as well as internal injuries, such as ruptured spleen, renal laceration, or hernia
• Limb loss: Including amputation of fingers, toes, non-dominant hand/foot, and uncomplicated single-limb amputations
• Burns: Severe, but not involving extensive total body surface area or sensitive/complex body parts (e.g., face, hands)
• Brain injury: Including mild traumatic brain injuries and post-concussion syndrome
• Spinal cord injury: Incomplete spinal cord injuries (SCIs) with no anticipated permanent neurological deficits; or complete SCIs resulting in paraplegia with no secondary issues or significant comorbidities

3. Care coordination with best-in-class providers
HERO Severe leverages Paradigm’s carefully curated network of leading medical, rehabilitation, and behavioral health care delivery providers. Paradigm has spent decades building relationships across the care and injury spectrum—which now benefit a large number of injured workers. We interface with these partners to build our guaranteed Outcome Plans from day one, ensuring seamless transitions of care.

With every Severe Outcome Plan, Paradigm ensures provider accountability according to our own high standards. HERO Severe leverages Paradigm’s signature value-based and outcomes-focused approach, doing whatever is necessary to return workers back to their communities and productive activity, with an emphasis on vocational reintegration.

4. Expanded resources, from behavioral health to vocational rehabilitation
Injuries of any severity can result in psychological trauma or adjustment challenges. Additionally, effective care management includes identifying potential preexisting psychosocial barriers to recovery. Paradigm Management Teams handling severe injuries maintain the same focus on working with injured workers and family members to identify and address any existing or emergent behavioral care issues. A dedicated Paradigm Community Support Specialist may be assigned to the case to help overcome obstacles to recovery. By identifying resources to help with a wide range of biopsychosocial factors, we help severely injured workers and their families get the whole-person support they need for a positive outcome.

Vocational services are another key step on the return-to-work path. Each individual with a HERO Severe Outcome Plan has access to a vocational clinical specialist. From assisting with learning or re-learning key job-related skills to facilitating light duty or transitional return to work if needed, HERO Severe empowers injured workers with the tools they need to achieve a return to meaningful work.

5. Full medical risk transfer and workers’ comp fixed-cost outcomes—laser-focused on return to work
The Paradigm care management model is built to establish an up-front guaranteed maximum functional outcome, with an emphasis on release to return to work. HERO Severe Outcome Plans are designed to get injured workers back to their homes and jobs using the same successful concept we have been using for decades to manage catastrophic injuries. Our workers’ comp fixed-cost Outcome Plan includes all compensable medical costs from the date of the injury until the guaranteed outcome is achieved, relieving clients of significant risk.

The effectiveness of this approach is backed by more than a decade of independent research. A 2020 independent study from a leading actuarial firm showed that among Paradigm cases, 65% of patients were released to return to work, and of those, 40% did. This is a nearly six times higher return-to-work rate than comparable industry benchmarks. What’s more, Paradigm achieved lifetime medical savings of 32% against the comparison group, indicating significant financial certainty and workers’ comp cost control for our clients. These results are consistent with the results of studies conducted in 2008 and 2013, which utilized data covering 20 years of Paradigm cases.

Discover more about Paradigm’s innovative HERO Severe product and connect with us to learn more about our growing portfolio of product innovations that are dedicated to changing even more lives for the better.