PMSI’s Clinically Based Home Health Care Solution Delivers Significant Cost Savings for Customers

Share Article

Innovative Utilization Management Focus Drives Average Savings of 12% - 18%

PMSI is recognized for our industry-leading clinical capabilities. Our Home Health Care program involves the application of evidence-based guidelines which eliminates the guesswork from the care management process.

PMSI, one of the nation’s largest and most experienced companies focused solely on workers’ compensation cost containment, today announced that the integration of evidence-based medical guidelines into its Home Health Care program is already delivering measureable results. PMSI’s program, originally launched in November 2010, focuses on identifying inappropriate care and aggressively managing utilization—driving average savings of 12% - 18% on the total cost of home health care services.

“PMSI is recognized for our industry-leading clinical capabilities. Our Home Health Care program involves the application of evidence-based guidelines which eliminates the guesswork from the care management process—objectively defining the level and frequency of care based on the compensable injury and diagnosis,” explains Brian Bell, Vice President, PMSI Medical Services and Equipment. “The end result is a program that delivers administrative efficiency and utilization control, both resulting in measurable cost savings for our customers.”

PMSI’s approach employs sophisticated, clinically based utilization controls and careful monitoring of the progression of care. Detailed reports are provided to support effective decision-making by adjusters, claims examiners and nurse case managers and to drive increased management efficiencies. The combination of PMSI’s clinical oversight, broad national network of home health care providers and outcomes-based reporting tools have enabled clients to achieve up to 18% savings over traditional transactional approaches.

A recent case study of a major client with an injured worker requiring a total hip replacement illustrates the benefits of PMSI’s approach. A comprehensive review of the injured worker’s home care treatment found prescriptions for nursing care, physical and occupational therapy evaluation and treatment, and durable medical equipment. PMSI’s clinical staff evaluated the care plan and found that the care being recommended was not directly related to the compensable injury. In addition, the length of treatment was managed through careful monitoring of Physical Therapy, which resulted in a change to the original prescription. Collaborative and objective clinical management resulted in an immediate $1,200 savings to the client and an injured worker returning to work faster.

The PMSI Home Health Care program uses nationally recognized clinical protocols embedded in PMSI’s clinical management program, MedAssess(TM). All Home Health Care services are reviewed prospectively, concurrently and retrospectively to ensure positive health outcomes for the injured worker and optimum cost containment for clients. “The focus on improving clinical outcomes and driving administrative efficiency is a major priority for PMSI,” stated Pat Sullivan, President of PMSI’s Ancillary Services Division. “The outcomes we have achieved in the area of home health care are consistent with PMSI’s tagline—Proven Solutions for Cost Containment.”

About PMSI
Founded in 1976, PMSI is a leader in developing solutions to control the growth of medical costs in workers’ compensation. As one of the nation’s largest and most experienced companies focused solely on workers’ compensation, we deliver proven solutions for cost containment across the claims lifecycle. PMSI’s Pharmacy, Medical Services and Equipment, and Settlement Solutions products deliver quantifiable results and improve the quality of care for injured workers. We provide our customers with the innovation, focus, expertise, analytics and technology needed to successfully deliver workers’ compensation benefits. For more information, visit http://www.pmsionline.com or call 877.ASK.PMSI.

# # #

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Jay McGee
PMSI
877-275-7674
Email >
Visit website