DWC Certifies Blue Cross Affiliate as the States' Newest And Largest HCO Network to Date

SAN FRANCISCO--The California Department of Industrial Relations' Division of Workers' Compensation (DWC) has certified BC Life and Health Insurance Company, an affiliate of Blue Cross of California, as the state's newest Health Care Organization (HCO). DWC's HCO program offers employers and insurers a cost effective way to provide quality medical treatment for workers injured on the job.

"The addition of BC Life and Health brings what may be the largest health care provider network in the state into the HCO program ," said DWC Administrative Director Richard Gannon in signing the certifications. The BCLH plan will be known as the Prudent Buyer HCO.

BCLH will utilize the provider network of its affiliate, Blue Cross of California, to provide workers' compensation medical services to employers and injured workers. Covering nearly 98 per cent of all zip codes in California, the Blue Cross network has over 40,000 providers, a group of which will comprise the core of BCLH's occupational health network for treating injured workers.
BCLH will begin marketing the Prudent Buyer HCO plan to its existing clients at the beginning of 2003.

"Use of HCOs is becoming an increasingly popular way to help employers and their workers improve medical care quality and early return to work programs while controlling rising workers' compensation costs," said Gannon. "This and other newly certified HCOs are substantially increasing the options businesses have, and the choice employees have, for using these plans," he said. Once an HCO is certified, employers and insurers may contract with the organization to offer their employees a medical plan for occupational injuries. Employees can opt to enroll in the plan or pre-designate their own personal physician. Depending on the overall health coverage they offer, employers gain additional time during which they control medical treatment for an enrolled employee.

Certified HCOs must provide a quality assurance and improvement process, medical case management, coordination of return to work services with the employer and a grievance system. They must also report preventable health problems to the employer to improve workplace health and safety, and must report data on medical treatment patterns, costs and outcomes for patients receiving HCO care to the DWC annually.

New regulations which go into effect on Jan. 1, 2003 will allow employers to offer only one HCO to employees. Previously they had to offer a choice of at least two.

Blue Cross of California and BC Life & Health Insurance Company are independent licensees of the Blue Cross Association.

NOTE TO EDITORS::

A list of certified HCOs can be found on the DWC Web site at http://www.dir.ca.gov/dir/Workers' Compensation/DWC/HCO.htm