TDI Report Finds WellComp’s Network Delivers Superior Results

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WellComp's managed care network delivered superior results for workers' compensation claim costs and outcomes. WellComp is one of 16 networks evaluated by the Texas Department of Insurance.

WellComp Managed Care Services

According to a report released by the Texas Department of Insurance Department (TDI), claims treated in the WellComp Managed Care network performed better and cost less than out-of-network claims. WellComp is one of 16 networks evaluated in the TDI 2016 Workers’ Compensation Network Report Card, which looked at 2014 – 2015 claims.

The annual report card evaluates the performance of certified networks with each other as well as non-network claims. WellComp was cited as a top performing network overall as well as in specific categories, including lower average medical costs, lower average medical costs for lost time claims, lower average professional costs, and lower average pharmacy costs.

Networks now represent almost half of all new workers’ compensation claims in Texas, up from 20% in 2010. The costs of network claims have been steadily decreasing while out-of-network costs have risen. For the first time since the implementation of health care networks in the Texas workers’ compensation system, the overall average medical cost per claim at six months and at eighteen months was lower for injured employees treated within a network versus injured workers treated outside of a network.

D.C. Campbell, director of the Research and Evaluation Group, which produces the report, attributes the better network results to early intervention in claims, saying “One of the strategies we've noticed is that networks provide higher levels of medical care earlier on.” Steve Nichols, workers' compensation manager for the Insurance Council of Texas, believes that the networks’ use of “cream of the crop doctors” who provide “higher quality care overall” also played a role.

“At WellComp, we believe that building and maintaining a high quality network is an essential component of our success in delivering exceptional outcomes for injured workers and their employers. By creating strong partnerships with our clients – both employers and claims administrators – we keep everyone focused on the goals of getting injured workers back to work as quickly as possible and managing costs responsibly,” said Doug Markham, President of WellComp Managed Care.

Average medical costs were not the only category in which networks outperformed non-networks. The TDI report also noted that networks provide superior results for costs of physical medicine modalities, costs of diagnostic testing, access to and satisfaction with care, overall health outcomes, and return to work rates. Another TDI finding is that there is a higher utilization of professional and pharmacy services for injured workers treated in a networks, but lower utilization of hospital services.

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Anne Ellis
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