Kaiser Permanente offers managed care pilot program for injured workers in Sacramento and Santa Clara counties

Business Wire, Jan 17, 1995

OAKLAND, Calif.--(BUSINESS WIRE)--Jan. 17. 1995--Injured workers and employers in Sacramento and Santa Clara counties will benefit from Kaiser On-The-Job's 24-Hour Medical Care Pilot Program -- a new workers' compensation program to be offered by Kaiser Permanente, Northern California region, effective this January.

The State of California's Division of Workers' Compensation has approved two pilot programs which will operate out of Kaiser Permanente's medical centers in Sacramento, S. Sacramento, Santa Clara and San Jose.

Initial purchasers of the new program are Mariani Packing Co./Argonaut Insurance Co. in Santa Clara County and Winter Volvo Lincoln-Mercury/State Compensation Insurance Fund in Sacramento County. Interest has also been shown by California Departments of Personnel Administration, Motor Vehicles, CalTrans, Corrections and Youth Authority.

Unlike traditional workers' compensation medical care, which is provided on a fee for service basis, Kaiser On-The-Job's 24-Hour Medical Pilot Program will be prepaid, capitated, and run through Kaiser Permanente's occupational medicine clinics. Employers will be charged a predetermined rate per month for each employee who elects to sign up for the program. It is similar to a prototype pilot program opened in June 1994 at the Kaiser Permanente Medical Center and satellite offices in San Diego.

Advantages of Kaiser On-The-Job include:

-- For employees, the choice of a program with the convenience and continuity of 24-hour integrated health care ie both group health and occupational health care from one medical group provider. Kaiser's program will give prompt access to occupational injury treatment, prevention specialists and medical case management.

-- For employers, the benefits of predictable and controlled medical care costs and the assurance of having a single health care organization handling all medical care that might be needed for their employees' injuries.

"Kaiser On-The-Job reflects our commitment to be a leader in occupational medicine," said Douglas Benner, MD (Kaiser Permanente's Director of Occupational Medicine). "It's also an opportunity to test the ability of managed care to reduce the soaring cost of workers' compensation."

During 1992, California employers -- excluding the State of California -- spent $11 billion on workers' compensation, over 200% what it cost in 1982. One third of this went for medical costs, one third for disability payments, and the rest for the insurance companies. Over the last decade, medical costs have risen to where they now account for 50% of every claims dollar.

Earlier this year, Kaiser Permanente opened separate occupational medicine clinics to consolidate all the examination, diagnostic, rehabilitation and administration services required for workers' compensation care.

Thirteen of these clinics are now fully staffed and operating five days a week, while another seven are due to open by the end of 1995. Early results show a 22-50% reduction in the use of emergency departments as a first resort for injured workers, plus reduced wait time for routine care and physical therapy.

Enabling legislation for the pilots was AB 3757, signed in 1992, which helped bring managed care to workers' compensation, and allows Kaiser Permanente to test the effectiveness of prepaid, capitated workers' compensation coverage. -0-

Kaiser On-The-Job in Sacramento and Santa Clara

Sacramento: 2345 Fair Oaks Blvd., Sacramento, CA 95864; 916/973-5499. Chief: Peter Yip, MD.

South Sacramento: 6600 Bruceville Road, S. Sacramento, CA 95823; 916/688-2644. Chief: Mark Taylor, MD.

San Jose: 260 International Circle, San Jose, CA 95110; 408/972-6800. Chief: P.L. Estacio, MD.

Santa Clara: 900 Kiely Blvd., Santa Clara, CA 95051; 408/236-6726. Chief: Jerome Chester, MD.

CONTACT: Kaiser Permanente, Oakland

Jennifer Cross, 510/987-3852

Linda Laird (Sacramento Co.), 916/481-7410 or

916/486-5103

Randa Gnaim (Santa Clara Co.), 408/236-5338