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Blue Cross Launches Care Management Program for Workers' Comp and Auto Insurance Claims

25 October 2000

Blue Cross Launches Care Management Program for Workers' Comp and Auto Insurance Claims

ExpertChoice(SM) Allows Consumers to Access Their Preferred Doctor Regardless
                          of Where They are Injured

    ST. PAUL, Minn., Oct. 25 Care Delivery Management, Inc.
(CDMI), an affiliate of Blue Cross and Blue Shield of Minnesota (Blue Cross),
announced today the launch of ExpertChoice(SM), an injury care management
program offered to workers' compensation and automobile insurers.
ExpertChoice was developed over the last year in response to customer requests
for integrating the health care delivery needs of their members.
    "Consumers don't care if they are injured at home, at work or in a car --
they care about being able to see doctors they know and trust regardless of
where they were injured," said Gregg Larson, President of CDMI.  "ExpertChoice
offers employers and auto insurers some of the best expertise in managing
health care and the largest, most geographically diverse provider network in
the state.  The result is quality, accessible care for injured individuals at
the lowest price with fewer administrative burdens."
    Currently workers' compensation medical claims cost Minnesota employers
$400 million each year and health care costs as a result of automobile
accidents cost $210 million.  Through ExpertChoice, Blue Cross is able to
demonstrate immediate benefits not only to purchasers of workers' compensation
and auto insurance through the prices negotiated with providers, but also to
the injured person who has a large choice of quality providers.
"Implementation of this product in other markets has resulted in significantly
reduced litigation and improved overall care coordination," said Larson.
    ExpertChoice will begin to provide injury care management services to its
clients November 1, 2000.
    From the date the injury is reported until the final claims are processed,
ExpertChoice is designed to fully integrate the health care needs of the
injured person along with the financial processing needs of the insurance
carrier.  When an injury occurs, the ExpertChoice program establishes a team
approach to achieve the best care for the injured person through appropriate
use of available resources and return to work programs.
    After a person is injured, they have the option to choose from a
comprehensive, statewide network of providers that can best meet their medical
needs, including medical doctors, chiropractors, physical therapists,
podiatrists, osteopaths, hospitals and urgent care/emergency facilities. Nurse
case managers and other providers help evaluate cases for management of
medical issues and to facilitate return to work.  Providers, not the injured
person, submit their claims directly to ExpertChoice for payment.
ExpertChoice may issue payment directly to providers, or generate an
explanation of benefits to be paid by the insurer.
    Xcel Energy, formerly Northern States Power (NSP), is just one of the
companies that sees the merits of the ExpertChoice program in managing its
workers' compensation costs.  "The advantages to Xcel Energy and our employees
are the reduction in workers' comp costs while maintaining choice and quality
medical care," said Mike McCallum, workers' compensation consultant at Xcel
Energy.  Recently signed clients for this product include Farmers Insurance
Group and the Minnesota School Boards Association Insurance Trust.
    The ExpertChoice program is also advantageous for health care providers
because they can see their patients for all their health care needs.  It also
simplifies their administrative processes by using the same claim submission
criteria as for its health business.
    All Blue Cross participating providers have the opportunity to participate
in the ExpertChoice program; more than 80 percent are expected to participate.
Consistent with new state law, providers' decisions on ExpertChoice will not
affect their ability to serve Blue Cross health plan members.
    Blue Cross and Blue Shield of Minnesota, with headquarters in the St. Paul
suburb of Eagan, covers more than 2 million members through its health plans
or plans administered by its affiliated companies.  Blue Cross is Minnesota's
oldest and largest health plan and began operations in 1933.  Blue Cross and
Blue Shield of Minnesota and Care Delivery Management, Inc. are an independent
licensee of the Blue Cross and Blue Shield Association, headquartered in
Chicago.