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New Network Offers Improved
Return-to-Work Outcomes,
Potential Discount 
When you pay more than the next guy for a product or service, you expect to get more in return. That has not always been the experience of employers, injured workers and insurance carriers in the Texas workers’ compensation system. Medical costs in our system are among the highest in the nation. Furthermore, injured workers in Texas are less likely to return to work than their counterparts in other states, and they are less satisfied with the quality of their care, according to a study released by the Workers’ Compensation Research Institute in February. The new Texas Star NetworkSM option gives Texas Mutual Insurance Company another powerful tool to get injured workers back on the job and help control medical costs. The network received certification from the Texas Department of Insurance on March 29th. Eligible policyholders can start taking advantage of the network option and its associated benefits immediately. Most policyholders who choose to participate in the network will receive a 12 percent annual network premium discount. They will all benefit from the network’s focus on returning injured workers to productive employment. Employers are often surprised to hear that injured workers who go back to work feel more productive, and they often recover faster. Timely return-to-work also benefits employers by reducing the effects of lost productivity, paying overtime to other workers, hiring extra help, and other costs associated with workplace accidents. “On-the-job injuries carry both human and financial costs,” said Lisa Corless, senior vice president of claim and information services at Texas Mutual Insurance Company. “We designed this network with one goal in mind: to get injured workers well and back on the job, which should ultimately reduce costs.” Texas Mutual Insurance Company partnered with Concentra to build the Texas Star NetworkSM option. Concentra has a proven track record for establishing occupationally focused medical provider networks. The network provides access to Concentra clinics and other occupational health care providers committed to treating work-related injuries. They have unique expertise, and they rely on nationally recognized, evidence-based treatment and return-to-work guidelines in delivering care. If a policyholder selects the network option, injured workers who live in a network service area select their treating doctor from the network’s list of providers. The network designates which specialties serve as treating doctors, and injured workers have access to other specialists on a referral basis. In that sense, the network system represents a departure from the “any willing provider” model historically seen in the Texas workers’ comp system. The focus is on matching injured workers with the right doctor to treat their specific injuries. The network supplements medical treatment with a case management program designed to identify and resolve return-to-work barriers early in the life of a claim. Certified Texas Star NetworkSM case managers work with health care providers, employees, and employers to reduce lost time. “Texas Mutual Insurance Company has always believed in a coordinated, team approach to helping injured workers get back to productive employment,” added Corless. “The Texas Star NetworkSM option is a synchronized approach to that philosophy.” Get more information Texas Mutual Insurance Company reminds employers that network participation comes with responsibilities. If employers do not fulfill their responsibilities, the network discount may be revoked. Employers can visit the Health Care Network section for a list of network responsibilities. The section includes information that answers the most commonly asked questions about the Texas Star NetworkSM option.
COMPNEWS - SPRING 2006 Texas Mutual® is a registered service mark of |
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Spring 2006