Paradigm Introduces New Program to Reduce Volatility and Cost of Legacy Cases
Complex Large Loss Plan Proven to Reduce Lifetime Medical Costs and Reserves by 29%
CONCORD, CA--(Marketwire - November 4, 2009) - Paradigm Management Services today introduced a
new medical management program for cases with persisting conditions
stemming from catastrophic and complex injuries. Unlike traditional
approaches to claims with ongoing volatility, the Complex Large Loss Plan
uniquely quantifies the financial savings and functional improvements,
guarantees performance, and assumes the risk for a client's entire claim
"Our clients often ask for help managing cases beyond the acute period of
care, even years from the initial date of injury," said Kevin Fleming,
Paradigm's President. "Naturally, they're concerned by ongoing
complications and expenses and feel like all they can do is adjust case
reserves as needed. We listened and designed a new offering that lowers
costs by ensuring the injured worker receives the right care. This
approach gets to the root causes of legacy cases and proves its value."
The Complex Large Loss Plan provides independent analysis and estimates by
Milliman, Inc. of specific lifetime case reserves at the beginning and end
of each contract. Recent analysis by Milliman indicated that Paradigm
reduced lifetime medical costs and reserves by 29% for large loss claims
during the multi-year pilot.
"I am not aware of any other analysis quantifying the lowering of case
reserves via medical management for the types of catastrophic and complex
injuries studied," said Bob Briscoe, the senior Milliman claims consultant
who conducted the analysis.
Built in medical impact scales make it easy to measure and quantify the
functional improvements Paradigm achieves. The Complex Large Loss Plan
also delivers customized performance guarantees based on specific portfolio
The Complex Large Loss Plan's risk-bearing contract structure transfers
responsibility for paying all medical expenses to Paradigm for a specified
period of time. This locks in a single rate, and eliminates financial
volatility and medical cost inflation during the contract period.
Methodology & Eligibility
The Complex Large Loss Plan leverages Paradigm's Systematic Care
Management(SM) methodology to improve care, reduce volatility and manage
costs in each case of a portfolio. A comprehensive medical, social,
psychological and vocational course correction plan stabilizes and improves
the injured worker's condition. An expert Paradigm Medical Director,
onsite nurse case manager and clinical management team oversee all aspects
Cases eligible for the Complex Large Loss Plan exceed $15,000 per month in
medical costs and project $500,000 or more in remaining lifetime costs.
Paradigm's performance managing these persisting conditions averages 50%
improvement in physician costs, 28% improvement in attendant care costs and
22% improvement in pharmacy costs.
About Paradigm Management Services, LLC
Paradigm Management Services provides catastrophic and complex case
management services for traumatic brain injuries, spinal cord injuries,
amputations, burns, wounds and chronic pain. As the nation's leading
provider of complex and catastrophic medical management in the workers'
compensation industry, Paradigm achieves 5x better medical outcomes and
lowers total costs by 36%. Paradigm accomplishes this by bringing together
nationally recognized doctors and specialists, the best network of care
facilities in the country, and nearly 20 years of clinical data to guide
decisions. For more information, visit www.paradigmcorp.com.
Contact Information: Media Contact