Coventry’s workers comp business appears to be going through some interesting changes, especially in case management.
In what can only be described as a “back to the future” move, the Concentra telephonic case management operation now reports up to the field case management folks. Insiders claim this is due to the company’s desire to increase the volume of field case management. If so, the Coventry strategy is an attempt to reverse history; for the last several years TCM has overtaken FCM as the CM model of choice. Field has long been seen as an expensive, difficult-to-control, inefficient use of resources on all but the most problematic cases.
In all of the audits my firm has conducted over the last few years, FCM has been assigned to fewer than 10% of lost time cases. This will bear watching.
The other interesting angle here is competitive. Prior to the Concentra acquisition, Coventry did very little CM of any type, and essentially no FCM. This worked out fine for two of their larger customers – Genex and Intracorp. That’s all changed: at least in the TCM and FCM product lines, the new Coventry WC managed care entity is directly competing with two of their larger customers.
One wonders how Intracorp and Genex will deal with this rather delicate competitive situation.
What does this mean for you?
If the new reporting structure is an attempt to get more FCM cases flowing, Coventry’s customers would do well to (very) carefully monitor the TCM – FCM referral process.
Joe,
I agree that FCM is too expensive, somewhat outdated and often out of control. The problem at Concentra was that TCM and FCM were in direct competition and as a result they spent considerable time trying to convince customers that one had more value over the other. I think Coventry is now in a position to sell customers what they need, rather than convince them that one product is more beneficial than the other. With more than 800 FCMs there might be a chance to thin the heard by using TCM in a broader application and get FCM focused primarily on task assignments. If done right this could be very good.
I know for a fact that there are companies that are seeing substantial ROI’s using FCM. Also just heard of a company that is integrating a Med legal product into their FCM and it is generating astronomical ROI’s. Yes FCM is expensive but after a FCM Nurse closes a couple of really old unmanaged claims for a client the FCM is paid for. We all know about those old claims and how pricey they are.
Joe:
Not sure this is any real news, in fact one could wonder why this hasn’t happened sooner pre the Coventry acquistion.
Case management has often been wrongfully the claims professionals “tool” of last resort.
The concept of having one case management product that can be delivered in a unified manner seems to make sense.The implementation of how these resources come together could make for a more powerful product offering and enhance customer appreciation and value for these services.
Certainly this bears watching as it maybe redefining case management’s true value
Coventry currently has 75 + positions for “Field Case Mgr-Med” on their career opportunities site @ this moment… all over the country.