WorkCompWire
Full article on: workcompwire.com
Claims professionals today are facing more challenges than ever before. Realities ranging from labor shortages to workload bottlenecks mean adjusters and other professionals are regularly juggling multiple cases simultaneously—at times, well over 100. In this fast-paced environment, frontline team members are constantly working to balance financial pressures and high-performance expectations with patient-centered care that returns injured workers to a meaningful life.
The post-acute care (PAC) phase is a critical step in the recovery journey; one that can make the difference between a successful outcome and delayed return to work. Whether an injured worker needs skilled nursing, inpatient rehabilitation, or long-term care, a positive and effective post-acute care coordination solution can ensure that patients reach key recovery milestones and are supported as they transition back to their homes, jobs, and communities. To achieve this, claims professionals need to be able to quickly turn to a robust, reliable post-acute care workers’ compensation network with a proven track record of success.
The fundamentals of a quality post-acute care network
Selecting a high-quality provider that is appropriate for a specific injury and diagnosis is a time-consuming and uncertain process. Paradigm’s Post-Acute Care Network was designed to help ensure injured workers get access to the right post-acute care facility, while coordinating care throughout this phase of recovery. With decades of post-acute management experience, Paradigm excels at these key PAC components:
- Targeted network development: Using advanced analytics, we identify gaps in coverage for each geographic market, while avoiding oversaturation, to deliver the most diverse multi-specialty configuration possible.
- Best-in-class credentialing: We target top-rated facilities and facilitate an industry-leading onboarding process for all new providers. Facilities in our network consistently receive accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF). Additionally, every post-acute care facility in our network has a Medicare 3-star rating or above.
- Quality scoring: We developed an evidence-based quality scoring methodology based on outcomes plus cost- and data-driven, condition-specific ratings.
- Network integrity: Paradigm is committed to ongoing provider management to ensure contract integrity and provider performance.
- Patient satisfaction: Our proprietary platform enables patients to evaluate their experience, while our communication platform, CareLink, which offers bilingual services, allows for seamless engagement and two-way messaging with patients for scheduling and coordinating purposes. The result is a 72% opt-in rate for text communication and a 97% patient satisfaction rate.
Stress-free care coordination built with claims professionals in mind
With Paradigm’s Post-Acute Care Network, not only do we place injured workers in the hands of the best and most appropriate providers and facilities, but we also deliver an exceptional level of care coordination. For every case, Paradigm Care Coordinators are available to deliver real-time support. Each coordinator is carefully trained to match injured workers to the appropriate post-acute care facility, based on the nature and extent of their injuries, to ensure they get the right care, at the right level, and at the right time.
“Our dedicated focus to each injured worker’s experience is what makes our post-acute care program so unique,” says a veteran Paradigm Care Coordinator. “In addition to providing highly personalized and injury-specific coordination for each case, our engagement capabilities make it easy to communicate plans and ongoing updates to the injured workers we serve. Since joining Paradigm, I’ve been truly impressed by the dedication to person-centered care that I see here every day.”
From day one, our coordinators provide access to a network of 6,600 fully contracted and credentialed affiliated partner facilities, giving peace of mind that injured workers will always be admitted to the best provider for their needs. By building long-term provider relationships based on collaborative quality assurance and payment integrity through prompt reimbursement, we have built a foundation that will encourage continued network expansion within the bounds of quality provider selection.
Start your journey with Paradigm’s Post-Acute Care Network today
When working with Paradigm, claims management professionals should feel confident that high-profile and challenging cases are receiving advanced coordination that connects their injured workers with the best post-acute care providers and facilities. Paradigm’s highly trained Care Coordinators will match each case with the right post-acute care facility for the injury, while ensuring value and cost savings. Our direct contracts account for all costs involved and result in up to 30% savings below fee schedule or usual and customary allowances.
Better injured worker outcomes and cost savings have set Paradigm apart for more than 30 years. As a leading workers’ compensation managed care company, our Post-Acute Care Network plays a vital role in everything we do to help facilitate our injured workers’ road to recovery.
Learn more about Paradigm’s industry-leading Post-Acute Care Network.
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