Bundled care programs – an alternative care model emphasizing quality over quantity – has gained significant adoption amongst Medicare and group health providers. Robert Evans, VP of Repricing Solutions, shares Rising’s experience as one of the first organizations to bring bundled arrangements to the workers’ comp market.
July 21, 2016 – Chicago, IL – Rising Medical Solutions is broadening its bundled payment, surgical program in the southeast with the addition of North Carolina and Georgia. The states join Florida, as well as New Jersey and Illinois in Rising’s Surgical Care Program (SCP) – one of the first value-based, bundled reimbursement programs in workers’ compensation that has provided all-inclusive case rates for orthopedic surgical procedures since 2013.
Compound prescription growth in workers’ compensation is a striking example of how the lack of consumer involvement can cause treatment to expand from reasonable to rampant care. In his Risk & Insurance Risk Insider column, Rising CEO Jason Beans outlines how state oversight and inroads from within claims payer and managed care organizations can help rein in compounding.
June 21, 2016 — Cranston, RI & Chicago, IL — Updated Rhode Island Workers’ Compensation Fee Schedules have been released. The new Hospital Fee Schedule will go into effect on July 1, 2016, and the new Medical Fee Schedule will go into effect on July 15, 2016, for services on or after those dates.
This article features thoughts from Mark Walls, Vice President of Communications and Strategic Analysis for Safety National and an Advisory Council member for the Workers’ Compensation Benchmarking Study, on why the study matters and its value to the workers’ compensation community.
June 17, 2016 – Boston, MA – Rising Chief Compliance Officer and Vice President of Care Management Anne Kirby presented at the 2016 Nurse Innovation & Entrepreneurship Summit in Boston at Northeastern University. The three-day event attracted nursing students and expert speakers with diverse backgrounds in clinical care, academic research, engineering, and game design.
As California officials are calling for a review of workers’ comp fraud fighting practices in the state, some cost containment providers are saying that bill review can be an effective tool for detecting fraud. Jason Beans, Rising’s Chief Executive Officer, shares some of the company’s bill review practices for detecting fraud.
Polling Claims Leaders to Deliver Collective Intelligence, Practical Research/
June 7, 2016 — Chicago, IL — The Workers’ Compensation Benchmarking Study’s 2016 claims leader survey is now underway, advancing its collaborative investigation of issues most impacting claims organizations today.
“Claims Advocacy” is fast getting the attention of workers’ comp claims leaders as a powerful approach to better claims outcomes. The on-demand economy has created cultural and multi-generational expectations around service, speed and simplicity – expectations that raise the bar for engaging injured workers. We found some claims leaders – from Starbucks, Albertsons Safeway, Nationwide Insurance, and Sedgwick – who have already figured out what to do. This article, co-authored by Rising’s Work Comp Benchmarking Study Program Director Rachel Fikes and industry journalist/consultant Peter Rousmaniere, uses interviews and study insights to describe the advocacy concept and how to walk the walk. Four minutes to read.
Study Evolution Focuses on Practical Claims Management Research/
May 2, 2016 — Chicago, IL — Distilling the many challenges confronting claims organizations today to a critical few is a challenge unto itself. In its fourth annual study, the Workers’ Compensation Benchmarking Study program will do just that.