Ventura County Businesses Join HCO to Control Workers Comp Costs
To curb the increasing cost of workers compensation coverage, about 100 Ventura County businesses have signed up with a state-certified health care organization offered through the not-for-profit Ventura County Foundation for Medical Care, the Ventura County Star reports. Nearly 400 physicians have joined the network, agreeing to provide care at 10% below the state Department of Industrial Relations' fee schedule. Employees with businesses belonging to the HCO are required to use the network's doctors for three months to one year but can switch to other network physicians. According to Darwin Hall of Coast General, a Camarillo-based insurance agency, employers joining the HCO should see a 5%-10% drop in workers' compensation premiums and a "gradual four-fold decline in cases going to litigation." Hall said that HCOs are similar to managed care networks and offer "cost efficiency and control" to employers, while workers receive "choice and improved treatment." Hall added, "A health care organization program gets an employer extended medical management of [workers' compensation] cases anywhere from three months to a year. With that length of time to get a worker back to work, the opportunity to close claims to the satisfaction of all parties without lawyers is better." However, Mark Yabrof, a workers compensation attorney, said that HCOs give employers "too much control." He said, "[Employers] are controlling and directing not only medical costs, but those costs may be based on a contract, and the pressure on the doctor to maintain the business may be to curtail treatment and release an employee back to work prematurely." HCOs have been legal in California since 1993, but have not been widely used until last year, when workers compensation premium rates "increase[d] dramatically" (McLain, Ventura County Star, 3/20).
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