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健康维护组织(HMO)管理工伤赔偿申请的策略。

HMO strategies for managing workers' compensation claims.

作者信息

Gallagher P A

机构信息

Milliman & Robertson, Inc., Radnor, PA, USA.

出版信息

Healthc Financ Manage. 1996 Mar;50(3):40-4.

Abstract

Health maintenance organizations (HMOs) have become very active in managing workers' compensation medical expense benefits. A survey of 316 HMOs shows that this activity takes the form of various network models and a range of services--such as utilization review and case management--that may not be linked to a provider network. Of the HMOs surveyed, 78 reported that, by using managed care services and provider discounts, they were able to save from 20 percent to 30 percent on occupational health claim costs.

摘要

健康维护组织(HMOs)在管理工伤补偿医疗费用福利方面已变得非常活跃。一项对316家健康维护组织的调查显示,这种活动采取了各种网络模式以及一系列服务的形式,如利用审查和病例管理,这些服务可能与供应商网络没有关联。在接受调查的健康维护组织中,78家报告称,通过使用管理式医疗服务和供应商折扣,它们能够在职业健康索赔成本上节省20%至30%。

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