In a moment of self-serving honesty, EK Health acknowledged what providers already suspect: that MPNs are a cash-grab for “entities that provide physician network services” — and arguably do not benefit injured workers.

Unfortunately, EK Health only acknowledges this reality as part of an apparent marketing effort to paint EK Health MPNs as the exception.

A steaming pile of what looks very much like corporate propaganda published by WorkCompWire lays out why EK Health MPNs are not the greedy schemes we’ve come to know. Instead, this article attempts to convince readers that EK Health MPNs are not “your typical large, unmanned, discounted networks.” We cannot confirm — but can confidently assume — that EK Health had significant input into this article (read: EK Health’s marketing department had a hand in writing it).

Below, we break down what seems to be cringey self-praise by EK Health, and ask a few fundamental questions. Starting with “Does anyone believe this hooey?”

MPNs: A Scam for the Ages

As seemingly acknowledged in the EK Health article, MPNs exist for one purpose: to take as much money as possible from providers who treat injured workers.

California is a case study in how MPNs are used as cudgels to force doctors into discount reimbursement agreements, give cover for bogus payment denials, and otherwise muddy the waters regarding which providers are eligible to treat a given injured worker.

The result? Delayed care for injured workers, because California makes it impossible for doctors to quickly determine whether and which MPN applies to each claim.

EK Health would have us believe that they’re doing things differently. But their argument, as laid out in WorkCompWire, is far from convincing.

EK Health’s Half-Baked Propaganda

The article addresses MPNs’ “bad publicity” by acknowledging that MPNs are “seen as mere provider discounting mechanisms or profit centers.”

However, the MPN problem is not a question of perception. MPNs aren’t “seen as” profit models. It’s exactly what MPNs are. And WorkCompWire (presumably by way of EK Health’s marketing department) offers little concrete reassurance that EK Health MPNs are any different.

The article lists criteria for provider membership in EK Health MPNs that suggest a higher standard. EK Health claims its MPN provider membership is determined by a “secret sauce” that includes:

• An “outcomes-based approach” — We hope they refer to health outcomes, rather than financial outcomes.
• “...high-quality providers who are carefully vetted and credentialed…” — by whom?
• “...understanding and adherence to the expectations of the MPN and the employers…” — as in the “expectation” of paying less, we can’t help but wonder?
• “...value for all, most importantly, for the injured worker…” — Generally, injured workers aren’t looking for a “value” solution; budget shoppers are. Injured workers want to choose their doctor and receive the treatment their doctor thinks is best.

The article goes on to assert:

Using data from utilization review (UR) and bill review (BR) we can see which providers are treating within the expected guidelines and transparently examine the appropriateness of treatment requests and billing practices.

What are the “expected guidelines” for treatment? California already has “expected guidelines” — in the Medical Treatment Utilization Schedule (MTUS). Does EK Health claim its “secret sauce” includes replacing MTUS guidelines with its own — presumably budget-friendlier — treatment guidelines?

Again, it’s refreshing to read MPNs described in the article as “your typical large, unmanned, discounted networks.” If EK Health aims to reform MPNs into something beneficial, we’re all for it. But based on the vague assurances of a literally “secret” sauce-based solution, we are not optimistic.

This article is heavy on platitudes — but the silence regarding the details is deafening, and strongly suggests that EK Health is offering more of the same old MPN discount-hoarding as always.

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