Paradigm Complex Care

Kenji Watanabe
Cohort 9 Cardinal
 Goal Definition

Data Collection
Business
Analytics
Data Analysis and
Framework
Modeling
Interpretation, Action,
and Feedback
 Understand the relationships between a variety
of variables to be able to accurately predict
claims outcomes and claims costs.

 Utilize prior claim experience to increase

Goal
probability of best case scenarios.
Definition
 Pair claims statistical data with clinical medical
data to streamline claims decision make.
 Paradigm has developed a claim
database with the past 30 years of
working within the Workers’
Compensation industry.

Significant data points pulled from prior

claim experiences.

Data
Collection Paradigm utilizes historical and real-
time data collection.

Paradigm Case Study database for

unique claims.
 Number of
body parts
injured.
Prior Claims
State Statutes
history.

Personal
Life

Data
medical
expectancy
history

Analysis
Family
Initial costs
medical
summary
history

Psycho-Social Industry
Risks trends
 Case Management

24/7 Nurse Triage and Telemedicine

Tailored
Product Transitional Return to Work

Offering Complex Pain Solutions

Physician Advisory Services

 Cross reference data
analyzed with other
standardized medical
outcomes.

Interpretatio Suggested decisions based

n, Action, on prior claim decision
experience.
Feedback
Real-Time data collection to
check decision outcomes
with immediate feedback.
 5:1 average ROI on field
case management files.

Key statistics 41% reduction in lifetime

with Paradigm cost for complex pain files.

93% of field case

management field closed
with a medical return to
work.
 Sources

 Paradigm. “Paradigm Introduces New Outcomes-Based

Platform to Support Catastrophic Care Management
Plans.” PR Newswire: Press Release Distribution, Targeting,
Monitoring and Marketing, 6 Nov. 2019,
https://www.prnewswire.com/news-releases/paradigm-intro
duces-new-outcomes-based-platform-to-support-catastroph
ic-care-management-plans-300952779.html
.
 Paradigm. “Paradigm Introduces New Outcomes-Based
Platform to Support Catastrophic Care Management
Plans.” PR Newswire: Press Release Distribution, Targeting,
Monitoring and Marketing, 6 Nov. 2019,
https://www.prnewswire.com/news-releases/paradigm-intro
duces-new-outcomes-based-platform-to-support-catastroph
ic-care-management-plans-300952779.html
.