Karen Conger on MCOs

What kind of information needs to be laid out for the relationship between the MCO and employer to be successful?

Be aware that MCOs can also help you create a safer environment to prevent injuries. MCOs can educate your supervisors and employees. MCOs can review injury records and track trends in your work environment. For example, if one department tends to have a lot of specific injuries on a certain day, you can work with the MCO to investigate possible causes and solutions.

You can also work with the MCO to set up an aggressive but safe return-to-work program. With workers’ compensation you have both medical and indemnity (lost wage replacement) expenses. Working with your MCO to make sure the injured worker is back with modified duty will impact your indemnity expense. It’s also medically better for the injured worker to be at work instead of at home, worrying about paying bills and wondering about whether he or she still has a job. Develop your return-to-work program with your MCO’s help prior to a claim occurring.

You can also work with your MCO to find a quality health provider to suggest to injured workers. An employee is able to go to any physician who is BWC certified, but many times your employee will not know where to go right after an injury has occurred. Working together with the MCO on this can make a big difference in the quality of care your injured workers receive.

Make sure that your MCO is one of your first touch points once an injury happens. The sooner you let the MCO know that the injury has occurred, and get on top of it, the better it is for everyone.

What should you look for in a good MCO?

You should ask yourself four questions when choosing an MCO:

  • Does the MCO understand my company and what I do?
  • Does the MCO give me timely information when an employee is injured? You should choose an MCO that will communicate with you in whatever format is best for you, whether that be through the Internet, on paper, or by phone.
  • Can the MCO case manager meet with you in person and come out to your site to see exactly what your employees do?
  • Does the MCO put an emphasis on safe and timely return to work for the injured worker?

Karen Conger is the CEO of Ohio Employee Health Partnership.