Implementing Managed Care in an Industrial Rehabilitation Program

Issue title: Industrial Rehabilitation

Article type: Research Article

Authors: Niemeyer, Linda O.^; | Foto, Mary | Holmes-Enix, Debbie

Affiliations: University of California, Riverside | Rehabilitation Technology Works, San Bernardino, California

Abstract: Managed care, with all its problems and potentials, is entering the scene in workers' compensation as a way to deal with escalating costs. Though the roots of managed care lie in cost containment efforts, its future depends on a shift in emphasis to quality of care. Clinicians must become partners with insurance companies and employers to evolve a “win-win” scenario that combines efficiency with effectiveness or risk both exclusion from provider networks and loss of control over what becomes incorporated into standards of care. Steps that can be taken by clinicians include developing a sense of accountability for final functional outcome, internal utilization management, and an internal case management protocol.

Keywords: Managed care, Case management, Utilization management, Industrial rehabilitation

DOI: 10.3233/WOR-1994-4102

Journal: Work, vol. 4, no. 1, pp. 2-8, 1994