Because WorkWell manages cases from start to finish, PPO network penetration can be greatly increased. Across the country the average PPO network penetration rates range from 30% to 60% for major PPO networks. These penetration rates are a result of what we call the blind network failure. In most PPO networks, patients go to a provider with no knowledge of whether the provider is in a PPO or not. Sometimes the provider is in the PPO, and sometimes they are not; hence the low penetration rate. It's like playing catch with your eyes closed. You have no idea where you partner is and you can only hope they catch the ball. This failure is compounded as treatment continues. In fact, lost savings can grow exponentially as patients continue to treat outside the network for more expensive treatments like surgeries.
In contrast to the blind network, WorkWell’s care management system drives much higher PPO network penetration rates by actively guiding the patients into and through the PPO network system. For example, a worker injured in Virginia must treat with a list of three providers produced by the employer at the time of injury. WorkWell populates this list with approved PPO network providers, thereby insuring that the injured worker will see a discount provider. After this initial appointment WorkWell schedules any follow up care with participating PPO providers. Throughout the injury treatment process, WorkWell monitors and directs care to maximize savings. WorkWell can achieve PPO penetrations of 95% or greater. This increase has an immediate and dramatic effect on retained savings.
