April 22, 2013 – Excerpt from Business Insurance Magazine:

By Roberto Ceniceros

“Managed care’s promise to control medical utilization and reduce workers compensation claims costs is undercut when employers pay for excessive services that don’t improve claims outcomes, experts say.

Furthermore, workers comp service providers, such as managed care companies and third-party administrators, can benefit from applying additional products — such as utilization review, nurse case management, and bill review — when helping resolve claims, they add.

“Don’t let this be a money maker for the managed care company when there is no impact on a case,” warned David Donn, president of David Donn Consulting Inc. in San Francisco. “Anytime you are dealing with products where utilization drives the revenue of the managed care company, you have to be very mindful of overutilization.”

http://www.businessinsurance.com/article/20130421/NEWS08/304219949