Overview of the Workers’ Compensation Market
Workers’ compensation medical costs have steadily increased over the past decade and now represent more than half of all losses. While claims volume has decreased, severity has increased. This trend emphasizes the need to balance quality care with utilization and cost management strategies to minimize total losses.
Cypress Care provides innovative tools and practical experience to address the entire continuum of care through a seamless, fully-integrated workers’ compensation management program.
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The Workers' Compensation Medical Dollar
Current Challenges Facing Workers' Compensation Payers
Finding proven cost management methods and tools for controlling medical costs for injured workers is difficult due to the following factors:
- Cost management approaches are not claimant- and adjuster- centric. In order for injured workers to participate in a managed program, it must offer value. Not only must the program must be easy to use by adjusters, case managers and injured workers, it must eliminate out of pocket costs.
- Out-of-network services increase overall medical spend. A successful program must focus on prospective management of utilization and include outreach strategies to ensure program participation.
- Visibility is missing. Without visibility across the entire medical spend, it is difficult for payers to affect escalating costs and manage outcomes.
How Cypress Care Delivers Value
Cypress Care addresses these challenges by providing value-added solutions for both the payer and the injured worker through the following:
- Accelerate return to work cycles and lower indemnity costs.
- Reducing unit cost by eliminating multiple touch-points, improving access to clinical specialists and prospectively managing utilization.
- Enhancing injured worker and adjuster satisfaction through ease of access, coordination of services across the entire spectrum of care, elimination of out-of-pocket expenses, reduction of administrative burden, high-touch service, clear communication, and proactive outreach.
- Provide access to available provider organizations to assist injured workers with the management of workers' compensation related injuries and associated costs.
- Improving program outcomes with defensible clinical compliance protocols and complete program visibility.
Overview of the Auto Casualty Market
Medical costs are a significant component of auto insurance rates and a key expense driver for auto payers, but balancing cost with quality care is a great challenge for auto casualty insurers today. Similar to workers’ compensation, claims volume in the auto casualty market is decreasing while severity is increasing.
Cypress Care offers a comprehensive range of solutions to reduce costs, improve claimant outcomes and shape the future of medical management programs for auto injury claims.
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The Auto Casualty Medical Dollar
Current Challenges Facing Auto Payers
Finding proven medical cost management methods and claimant-friendly services has proven difficult in the auto casualty market for the following reasons:
- Most cost management approaches are not policyholder-centric. When choosing an insurance carrier the policyholder is a consumer. Price and service factor into the decision, but so do service and support issues. The more accommodating your cost containment strategy is, the more appealing it becomes as a selling point.
- Cost management programs must focus on increasing market share and penetration. A successful program will offer solutions that promote policyholder retention, ease of use for adjusters, and increased renewal rates through optimized program outcomes.
- Carriers must continue to enhance value to the consumer while still managing overall automobile claims costs.
How Cypress Care Delivers Value
Cypress Care addresses these challenges by providing effective solutions for both the payer and the claimant through the following:
- We increase cost savings through unit cost reductions across all services and deliver additional savings through prospective utilization management.
- We enhance claimant satisfaction by offering convenient access, coordinating services across the entire spectrum of care, eliminating out-of-pocket expenses, maximizing policy limits, and providing high-touch service with clear communication and proactive outreach.
- We offer available provider organizations to assist the claimant with management of auto-related injuries and the associated costs.
- We reduce administrative burden on adjusters through high-touch service to claimants, prospectively managing care, and consistent application of business rules and best practices.
- We create and maintain positive relationships with our network providers.