• Cost Containment and Mitigation

  • Apr 29 2024
  • Length: 15 mins
  • Podcast

Cost Containment and Mitigation

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  • Summary

  • Hosts Matt Yehling and Patty Reinecke are joined by Marianne Reed, Senior Claims Analyst at MEC, to discuss strategies for containing and mitigating costs in complex workers compensation claims. Marianne shares her expertise on identifying cost drivers, collaborating with stakeholders, and implementing targeted interventions to improve outcomes and reduce expenses.

    Discussion Points:

    1. Cost Drivers in Complex Claims: Marianne outlines the medical treatments that tend to be the biggest cost drivers in complex claims, such as injections, brand name medications, spinal cord stimulators, and failed surgeries. She also describes the typical features of these claims, including multiple surgeries, psychological issues, and long-term opioid use.

    2. Strategies for Cost Containment: Marianne shares her approach to mitigating costs, which involves reviewing medical records, engaging MEC's resources, collaborating with stakeholders, and implementing targeted interventions like medication reviews and negotiated rates.

    3. Successful Claim Intervention Case Study: Marianne provides an example of a catastrophic claim where early intervention by MEC led to a successful outcome.
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