MANAGED CARE COULD CUT COMP COSTS, EXPERTS SAY

MANAGED CARE COULD CUT COMP COSTS, EXPERTS SAY

Experts say managed health care may be the vehicle to drive workers' compensation rates back to earth, because the force behind rising rates are costs associated with medical treatment and overuse.

"I think about one-third of all the medical payments to claimants probably fall into the over-utilization category," said Raymond Neff, president of Florida Employer Insurance Service Corp. in Sarasota.In Florida, 55 percent of all the workers' compensation premiums went to pay for medical treatment in 1991, Neff said. Nationwide, medical benefits account for about 40 percent of all premium dollars.

Although most workers' compensation claims are valid, a small percentage of abuse can be very expensive to the system, he said.

The problem with the medical end of the workers' compensation issue is that it's not regulated and scrutinized, said State Rep. Mark Ogles, R- Bradenton. "Let's say I hurt my leg. I go to see one therapist, who refers me to a chiropractor, who will then refer me to another doctor. There are no controls on how to manage the treatment."

Mr. Ogles said the idea of having a super doctor, or a gate keeper, to watch over the treatment could be the right prescription for the problem.

"No one wants to destroy the ability of the injured to get therapy," he said. "But we also need to have a system that monitors the treatment."

There appears to be a consensus among lawmakers that workers' compensation care must be managed so that costs can come down, said Tim Watson, staff director of the state House Committee on Commerce.

"Everyone seems to be on the same level on this issue." A "gate keeper" for the system will help quantify some of the injuries, and set the treatment parameters, he said.