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Network Synergy Group Data Shows 25% of PT Cases Completely Unmanaged

April 28, 2014 - WorkCompWire

Tampa, FL – Network Synergy Group, a national physical therapy management company, recently announced findings from an in-depth analysis of data showing that only 18% of workers’ compensation claims incorporate comprehensively managed solutions for injuries requiring physical therapy (PT) and occupational therapy (OT). The company estimates that by utilizing networks that simply employ discounts, instead of a comprehensive and coordinated physical therapy management program, U.S. employers lost about $500 million in 2013 alone.

The results were obtained from an analysis of more than 47,000 PT and OT claims nationally, representing a wide cross section of industries. The analysis showed that 25% of PT cases were completely unmanaged, using non-network providers and undergoing little quality or cost containment review. The vast majority of PT and OT claims today – approximately 57% – are in networks that passively apply discounts after treatment has occurred.

“In order to maximize impact, there needs to be an emphasis on channeling to quality providers, employing treatment plans that are evidence based, as well as fostering collaboration with all stakeholders throughout the entire course of therapy,” notes Pat Chavanu, President of Network Synergy Group.

Chavanu also states that the key cost driver in physical therapy spend is not necessarily the cost per service, but the utilization of those services. A comprehensive and fully managed PT program can help ensure the highest quality of treatment is delivered. These programs include:

  • The ability to direct injured workers to a defined network of credentialed providers with proven track records of providing superior results.
  • Utilization of best practices and proven standards of care, with robust clinical controls to ensure consistent results for every injured worker.
  • Processes to screen, credential and educate providers to ensure they possess the knowledge, tools, and, importantly, the commitment to meet the injured worker’s treatment goals.

With many injuries today requiring PT, and with effective management of PT offering the ability to improve outcomes, costs, return to work and even employee satisfaction, Chavanu and his colleagues believe that employers are looking for ways to get more value from their PT and OT programs.

“The problem is not that employers are unaware of the importance of optimal PT programs and networks in the management of injuries,” says Chavanu. “It is simply that many of the PT cases that employers thought were managed, were not. We believe this analysis highlights to employers the importance of ensuring PT and OT claims are fully managed and of working with partners such as Network Synergy Group that have the experience, the people and the tools to help deliver the best result.”

Source: Network Synergy Group

Filed Under: Claims, Legal, & Compliance News, Industry News, Top Stories, Workers' Compensation

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