The opportunity to channel care in Illinois through the use of a preferred provider program (PPP) is ready for implementation. This legislation was enacted as one of many efforts to allow for better direction of care and care delivery for employers and their employees.
Having been involved for a number of years with the process and the changes the state has seen, I wanted to point out a few key areas of the PPP to think about:
- The legislation was hard-fought and is not perfect, but does allow employers to create an opportunity up front for the best quality care for their injured workers. Getting them to the right doctor the first time will help keep them in-network and get them back to work more quickly.
- Some will argue it’s “too easy” to opt out; the fact is, this is our first chance in Illinois to direct care. To maintain momentum in the state in terms of change – and to offer the best opportunity for success – adoption of the PPP is critical.
- Savings to employers will come from consistently applying the process and continuing to implement each new change with rigor.
- Implementation will be simple, but there is a requirement to notify employees about the PPP at the time of injury. Sedgwick is providing the appropriate documentation to our clients.
- Sedgwick claims examiners and nurses utilizing our provider benchmarking and search tool are provided visibility to the highest quality network physicians when assisting injured employees to find a network provider. As we have seen in California, we believe that helping injured workers identify those providers associated with the best outcomes consistently improves the quality of healthcare and helps to ensure optimal recovery and return to work.
Sedgwick’s care management team has been building our approach and providing opportunities for clients to learn more about the Illinois PPP legislation through informational webinars. Learn how to apply this new tool to get quality healthcare for injured workers and ensure timely return to work – and lower costs. Listen to a recorded webinar here.
The more consistent we are across the state, the better our results! Do you have thoughts or questions about the Illinois PPP? Please post them in the comments to continue the dialogue with us.
James Harvey, SVP Managed Care Products & Products Development