October 1996 Bulletin

Managed Care in Workers Compensation

Medical care of injured workers should be of high quality, at a reasonable cost, and provided in a timely manner in order to achieve maximum medical recovery and a safe, prompt return to the work force. The integration of managed care programs into workers compensation health care is increasing rapidly.

The American Academy of Orthopaedic Surgeons believes that properly designed and efficiently run workers compensation managed care programs can provide high-quality health care to injured workers and minimize their disabilities.

Effective managed care workers compensation programs can be recognized by the following characteristics:

Providing prompt access to medical care

Furnishing beneficial services to the employee

Returning the employee to work

Using quality assurance measures

Establishing effective communication among all parties

Encouraging safety and prevention measures

The American Academy of Orthopaedic Surgeons believes that managed care workers compensation programs that meet at least these basic standards deserve public and/or legislative support.

As managed care workers compensation systems evolve, all parties-the physician, the employer, the employee, the insurer and governmental agencies-will share opportunities to introduce and encourage changes in how care is viewed and delivered. By helping to redesign managed care workers compensation systems with safety and prevention as high priorities and by establishing positive incentives for early return to work, employee health and productivity will increase and the number of injuries that occur on the job will decrease.

The American Academy of Orthopaedic Surgeons supports changes in managed care workers compensation programs that establish measures for safety and prevention and improve the timely delivery of high-quality, cost-effective medical care to workers who are injured on the job.

September, 1996


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