MetraComp will issue provider 'report cards'; Physician profiling aims at improving care in workers' compensation cases.
TAMPA, Fla.--(BUSINESS WIRE)--Sept. 7, 1995--MetraComp, the workers' compensation workers' compensation, payment by employers for some part of the cost of injuries, or in some cases of occupational diseases, received by employees in the course of their work. managed care subsidiary of The MetraHealth Companies, Inc., is building a national provider profiling system that will be among the first in the industry to focus specifically on medical care for injured in·jure
tr.v. in·jured, in·jur·ing, in·jures
1. To cause physical harm to; hurt.
2. To cause damage to; impair.
Designed by participating providers in the MetraComp Network and network management, the Provider Performance Profile (PPP (Point-to-Point Protocol) The most popular method for transporting IP packets over a serial link between the user and the ISP. Developed in 1994 by the IETF and superseding the SLIP protocol, PPP establishes the session between the user's computer and the ISP using ) will analyze performance parameters and profile its network providers. MetraComp plans to complete the PPP system by mid- mid-
Middle: midbrain. 1996, using comprehensive data on workers' compensation treatment experience.
"Monitoring provider activities will enable us to apply the principles of continuous quality improvement to our networks," said Steven Ste´ven
n. 1. Voice; speech; language.
Ye have as merry a steven
As any angel hath that is in heaven.
2. An outcry; a loud call; a clamor.
To set steven
to make an appointment. Rosen Ros´en
a. 1. Consisting of roses; rosy. , M.D., medical director for MetraComp and the project's leader. "By identifying sub-optimal performance, we can customize and target our educational programs to help improve future outcomes. It is also important to note that physicians were instrumental in creating this system, and it will evolve into a sophisticated peer review process in the near future."
The goal of the PPP program is to gauge the ability of physicians to provide access to efficient and effective medical care, the outcomes resulting from that care and the provider's adherence adherence /ad·her·ence/ (ad-her´ens) the act or condition of sticking to something.
immune adherence to MetraComp's Return-to-Work System. The Return-to-Work system is a coordinated treatment effort involving the patient, employer, providers, insurance adjusters and MetraComp's managed care staff, dedicated to providing appropriate care to aid in recovery.
To create the profiling system, MetraComp is building a comprehensive workers' compensation experience database. This will include diagnoses and procedures, disability duration and medical charges, cost comparisons by providers and procedures, and geographic and demographic factors. The database also will target other outcomes data, such as return-to-work dates, availability of modified positions, lost-time cases versus medical only, average cost per claim, litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute.
When a person begins a civil lawsuit, the person enters into a process called litigation. rates and other essential information.
While many employee benefits networks have had provider report cards for a few years, it is a relatively new concept in workers' compensation.
"In the future, profiling workers' compensation network providers will be as common as the networks themselves," said Lawrence Dorman, president of MetraComp. "Many states are beginning to require peer review/profiling as part of the managed care certification process. With the PPP, MetraComp will be several steps ahead of the legislative requirements, and, even more importantly, we will be able to respond to market demand for `real results,' such as reduced loss ratios."
With the performance experience data, MetraComp also will be able to offer its services under risk arrangement contracts, Dorman said. MetraComp's long-term Long-term
Three or more years. In the context of accounting, more than 1 year.
1. Of or relating to a gain or loss in the value of a security that has been held over a specific length of time. Compare short-term. goal is to overlay (1) A preprinted, precut form placed over a screen, key or tablet for identification purposes. See keyboard template.
(2) A program segment called into memory when required. its workers' compensation experience database with experience data from customer group health and non-occupational disability claims to provide outcomes analysis of medical pay out, whether a patient is hurt on, or off, the job.
The MetraHealth Companies, Inc.-- formed Jan. 3, 1995 through the combination of the group medical businesses of Metropolitan Life Insurance Company and the Travelers Insurance Company-- finances, manages and administers health insurance plans and delivers managed care services for its customers. The company serves millions of Americans with health care plans and operates in all 50 states.
CONTACT: Metra Health
Dennis C. Milewski, 203/277-3476