Kaiser Job Opportunity

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  Questions and answers
                   ABOUT MPNs
       The following questions address some of the common
       concerns employers have about the new MPN legislation
       and how it affects them and their employees.

   Q: Are MPNs mandatory?                                      that has been developed by another organization,
   A: No. Eligible employers can choose whether to             or you can build your own network by selecting
      establish an MPN.                                        individual providers or groups of providers. If you
                                                               are insured for workers’ compensation, you can
                                                               ask your carrier to establish an MPN for you.
   Q: What happens if I don’t set up an MPN?                   If you have specific providers you would like
   A: If your company doesn’t have an MPN                      included in your MPN, you should contact your
      established, you can only direct medical care for a      insurance carrier.
      workers’ compensation injury for the first 30 days
      following the injury. Without an MPN, your injured
      employees can seek treatment from any physician       Q: What do I have to do before filing an MPN
      or facility after the first 30 days of the claim.         application?
                                                            A: First, employers must establish a provider list.
                                                               Second, the employer must enter into formal
   Q: Who can establish an MPN?                                agreements with the providers participating in
   A: A workers’ compensation insurance carrier, an            the MPN or with the entity that has arranged for
      employer self-insured for workers’ comp, or a joint      a network of providers.
      power authority can establish an MPN. Insured
      employers may choose an MPN established by
      their insurer.                                        Q: What is the deadline for applying to set up
                                                               an MPN?
                                                            A: There is no deadline for MPN applications.
   Q: Do I have to sign up with a health care plan             They may be submitted to the Division of
      as my MPN?                                               Workers’ Compensation at any time.
   A: No. If you are a self-insured employer, you have
      the ability to establish an MPN with a provider
      network of your choice. You can select a network



 Q: Must an MPN include specific types of                 Q: What is Kaiser Permanente’s background with
    physicians?                                             occupational health care?
 A: While an MPN is a network of physicians who          A: We already treat about 85,000 injured workers in
    primarily treat occupational injuries, at least         California every year through 49 occupational
    25 percent of the medical staff must be non–            health centers located in our medical centers and
    occupational health providers.                          medical offices.

 Q: If I have an MPN, can employees still                Q: How much does Kaiser Permanente charge for
    predesignate a physician?                               occupational health care?
 A: If you offer a group health plan or group health     A: Kaiser Permanente is paid on a fee-for-service
    insurance for medical conditions not related to         basis based on the State of California’s Official
    work, employees may predesignate a personal             Medical Fee Schedule.
    physician who will provide care for them if
    they are injured on the job. The predesignated
    physician does not have to be a part of your MPN.    Q: When will Kaiser Permanente be ready to
                                                            become part of my MPN?
                                                         A: Kaiser Permanente can help you build a network
 Q: Can employees switch physicians within                  for your MPN now.
    an MPN?
 A: Yes, employees can switch to a different physician
    within your MPN anytime after the first medical       Q: My company doesn’t use Kaiser Permanente as
    examination for their injury.                           a health coverage option, but we are interested
                                                            in contracting with you for occupational health
                                                            services. Do we have to use you as a main health
 Q: How long will the MPN treat my employees with           care coverage provider also?
    occupational health needs?                           A: We welcome the opportunity to meet your
 A: The MPN will treat your employees for “the life of      occupational health needs even if you do not
    the claim,” meaning all treatment required to cure      offer Kaiser Permanente as a health plan to your
    and relieve the injured employee.                       employees. In time, we think you’ll reevaluate your
                                                            health plan choices once you have a chance to
                                                            work with our physicians and staff.
 Q: Will Kaiser Permanente help me set up an MPN?
 A: Yes. Kaiser Permanente has provider networks
    that an applicant can submit to the state to be      Q: Why is Kaiser Permanente interested in the
    the only group of providers in its MPN or part          MPN program?
    of a larger MPN. The law specifies that only          A: The MPN program allows greater continuity of
    self-insured employers, workers’ compensation           care for Kaiser Permanente members who are
    insurers, and joint power authorities may submit        injured on the job. One of Kaiser Permanente’s
    MPN plans for approval. The centerpiece of Kaiser       strengths is that we use evidence-based care for
    Permanente’s network will be our Kaiser On-the-         chronic diseases and other health conditions.
    Job® physicians, who have significant experience         MPNs will enable Kaiser Permanente physicians to
    in treating injured workers.                            treat injured workers throughout the entire course
                                                            of treatment their injuries require, potentially
                                                            leading to better medical outcomes.

 Q: Can Kaiser Permanente save me money?                Q: What does Kaiser Permanente do to ensure
 A: Yes. An independent study performed by the             positive outcomes and patient satisfaction?
    California Workers’ Compensation Institute          A: We achieve patient satisfaction and positive
    (CWCI) in March 2003 demonstrated that Kaiser          outcomes through our unique integrated
    Permanente delivered workers’ compensation             approach to training, evaluating, and
    care at considerably lower cost than non–              compensating physicians. Our occupational
    Kaiser Permanente providers.                           health physicians are trained in the American
                                                           College of Occupational and Environmental
                                                           Medicine (ACOEM) guidelines, and we regularly
 Q: What are the advantages of using Kaiser                evaluate how well they incorporate these
    Permanente as my MPN provider over other               guidelines into their medical practice.
    health care plans or services?
 A: Because many injured workers are also group
    health members, having a single integrated          Q: How does Kaiser Permanente intend to handle
    medical record allows our occupational health          the increased patient volume that could result
    physicians to understand and integrate all their       from MPNs?
    medical problems from the beginning, rather         A: Right now we’re assessing the expected
    than having to wait to get medical information         additional demand under the new law and are
    from other sources. Also, physical therapy and         making plans to expand our occupational health
    diagnostic services are an integral part of the        center capacity accordingly. We believe at this
    Kaiser Permanente system, and are often in the         time that we can provide about 30 percent more
    same location as the physicians. Communication         medical treatment to injured workers through our
    is enhanced and treatment is more efficient and         current delivery system. We’ll grow to meet
    convenient for injured employees.                      additional demand.

 Q: What kind of patient outcomes has Kaiser            Q: Will all Kaiser Permanente providers be in the
    Permanente experienced with occupational               Kaiser On-the-Job network?
    health programs?                                    A: No. Not all Kaiser Permanente providers are part
 A: The March 2003 CWCI study that showed Kaiser           of the Kaiser On-the-Job network. The network is
    Permanente’s total cost per claim is 31 percent        centered around providers who specialize in
    lower than competitors’ costs also showed that         treating work injuries.
    we had fewer total temporary disability days per
    claim on average when compared to averages
    for non–Kaiser Permanente providers. The same       Q: How can I get more information about MPNs
    study indicated that only 11.7 percent of Kaiser       and Kaiser On-the-Job?
    Permanente claims required litigation, while        A: You can contact your insurance broker or a Kaiser
    17.5 percent of competitor cases required              On-the-Job sales executive at 1-888-565-9675
    attorney involvement. Higher patient satisfaction      (1-888-KOJ-WORK) toll free. Or visit us on the
    results in fewer claims requiring litigation.          Web at employers.kaiserpermanente.org for
                                                           access to our video presentation on MPNs.

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