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Unbundling managed care


Third party administrators tell me employers have lost interest in unbundling their workers compensation managed care services from their contracts for TPA claims administration.

I have questions about this assertion because it obviously benefits TPAs as they derive significant revenue from bundling managed care products with their claims administration services.

An insurer TPA president I spoke with at the Risk and Insurance Management Society’s annual conference mentioned employers are no longer discussing unbundling as much as they did a few years ago.

I also noticed that Chris Mandel at TPA Sedgwick Claims Management Services Inc. recently wrote that bundled programs have become more popular. His post is available here.

However, I know several savvy risk and work comp claims managers working for employers who swear that unbundling managed care services from their TPA claims contracts is better for cost containment and control over their programs.

These are people with sophisticated work comp programs.

It makes me wonder whether TPAs are witnessing less employer interest in unbundling because employer risk management and work comp department staffing was slashed during the recession? With fewer people in-house paying attention to claims are employers opting to bundle because they don’t have the resources to unbundle?