Leaders Speak

Jeffrey Saffle, MD, Paradigm Medical Director, Paradigm Catastrophic Care Management My colleagues and I who specialize in caring for people with burn injuries are often asked, “Why does burn rehabilitation take so long?” The answer is that burn injury and recovery are uniquely difficult for patients, their families, employers, and care providers. Burn injuries require… [Read more]

By Jean Brajuha, MHS, CRC, CCM – VP, Field Case Management, Paradigm Complex Care Solutions A little-known case management service makes a huge difference for employers whose employees have experienced a traumatic incident in the workplace. Case managers with specialized education and certifications in critical incident stress management can be deployed to the workplace after… [Read more]

By: Michelle Despres, VP and National Product Leader for Physical Therapy, One Call People respond to injuries physically, emotionally and socially in many different ways, with every response playing a vital role in the recovery process. If a patient suffers from anxiety, depression, post-traumatic stress disorder or any other psychosocial condition due to their injury,… [Read more]

By Kent Spafford, Company Advisor and Board Member, One Call The U.S. Healthcare market employs approximately 950,000 physicians today. In developing the appropriate treatment plan for their patients, these physicians routinely request diagnostic imaging for their patients, which now accounts for $100 billion dollars in healthcare spend annually according to American College of Radiology statistics1.… [Read more]

By Lisa Anne Bickford, Director, Government Relations, Coventry Major natural disasters tend to spin off countless smaller crises and problems. These challenges can test the ability of workers’ compensation systems to care for injured workers. In recent years, some of these trials have grown more onerous as the calamities themselves have increased in scale. Last… [Read more]

By Lisa Anne Bickford, Director, Government Relations, Coventry In workers’ compensation, we study frequency and severity for insights into injury trends. Understanding how often injuries occur and how bad they are can help us find better ways to help injured workers. This same methodology can be applied when examining overall setbacks to the workers’ compensation… [Read more]

By Daniel M. Anders, Esq., Chief Compliance Officer, Tower MSA Partners The concept of not submitting a Medicare Set-Aside (MSA) for approval from the Centers for Medicare and Medicaid Services has become an increasingly popular topic in workers’ compensation. Since the MSA review process is voluntary, “non-submit” is an option for settling parties in workers’… [Read more]

By Rita Wilson, CEO, Tower MSA Partners In today’s data-driven business environment, employers, carriers, third-party administrators, and other payers are inundated with data, both internally via claim analytics as well as external data received from vendor partners. Pharmacy alone with its drug interactions, duplicate therapy warnings, opioid utilization reports and polypharmacy alerts provides a plethora… [Read more]

By Mariellen Blue, National Director of Case Management at Genex Services Workers’ comp professionals are seeing delayed recovery as an increased challenge in claims – as injured employees may not be progressing along a medically reasonable and expected time frame. However, it can be difficult to pinpoint exactly why the delay is occurring in order… [Read more]

By Deborah Robinson Stewart, National Manager of Medicare Set-Asides, Genex Services In its simplest form, the Medicare Set-Aside (MSA) is a pool of funding reserved for future accident‑related treatment once a workers’ compensation case is settled. However, because of its complex nature, some employers will go the MSA route when there are better options available,… [Read more]