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4.2. SR 03-18-1996ITEH 4.2. ity of iver FROM: DATE: MEMORANDUM Mayor & City Council Lori Johnson, Asst. City Administrator~ ~ March 26, 1996 SUBJECT: Managed Care Provider for Worker's Compensation When the city renewed its worker's compensation coverage in October, the City Council agreed that staff should proceed with instituting a managed care program. As you may recall, having a managed care program will decrease the premium by 5 percent until renewal in October when it will decrease by 10 percent. In addition, it will hopefully assist injured employees in working through the worker's compensation process by directing them to the appropriate medical facilities, and in returning employees to work as soon as possible after an injury. After reviewing five managed care companies, the field was narrowed to the two companies that include Elk River clinics in their provider network. The two companies which were reviewed in depth were Medica Worker's Compensation Services and CorVel. The companies both include the Mork Clinic and other Elk River clinics in their provider list. The Fairview Clinic in Elk River is not included. However, all employees who have a previously existing relationship with a health care provider (an existing relationship means that they have seen the physician at least once in the last two years) are allowed to go out of the network. The main difference between Medica and CorVel is their method of billing and the training they provide to employees and supervisors. CorVel bills strictly on a per case basis. Each injury must be registered and a case file is opened at a cost of $30. Following that, if time is lost an additional charge of $345 is assessed. If there is no time lost, and it is a medical only case, there is no charge unless the city, the adjuster, or CorVel requests that a file be opened, at which time a per hour charge of $75 is made with a maximum of $150 per case. CorVel charges $2 per employee for on- site training and $25 for a training video. Medica offers two choices of billing. One is a monthly fee based on the number of employees covered. There is then no fee for medical or lost time case review. The second option is a per case fee which is $360 for lost time 13065 Orono Parkway · P.O. Box 490 · Elk River, MN 55330 ° (612) 441-7420 · Fax: (612) 441-7425 cases and $50 for medical only cases. Medica offers free on-site training for employees and supervisors, including distribution of all materials and handouts so that employees know what to expect in case of an injury. Estimated costs under each of the providers are listed on the attachment. As you can see, the per month savings far exceed the estimated cost for participating in the managed care program. Recommendation It is recommended that the City Council approve entering into a managed care provider agreement with Medica. Following approval by the City Council, employees will be notified of this change and the appropriate training will be held. s:XcouncilXmngdcare.doc MANAGED CARE PROVIDER COST ANALYSIS Actual Work Comp. Claims Lost Medical No Total Year Time Only Cost Claims 1994-1995 1 8 7 16 The following estimates what the cost for managed care would have been based on the actual claims experience for 1993-1995. This assumes that only two of the medical only claims would require managed care intervention. CorVel $30/each case $75/hr med only $345/Iost time $ 375 $ 54O $ 210 Total Cost $ 1,125 1994-1995 Medica Case Fee Option SOO/each case $50/med. only $360/Iost time Monthly Fee Option $1.35/employee (ESTIMATED. Total Cost $ 360 $ 400 $ $ 760 1994-1995 Total Cost $ 1,215 1994-1995 The actual fee is based on an audit of hours and FTE positions) Estimated MONTHLY premium credit is $465. Estimated ANNUAL premium credit is $5,588. (Approximately $3,700 of the annual credit would be realized in the General fund.) Effective with renewal the premium credit increases from five to ten percent which will double our credit. 3/15/96 CARE.XLS