The Growing Surge in Specialty Service Costs
As specialty services become a major driver of rising expenses, effective management of medical costs requires a thoughtful, strategic approach. Based on data from internal calculations, these services now account for an astounding $6.4 billion annually in workers’ compensation medical spend, representing over 22% of total medical costs for many organizations.
The challenge is further compounded by the steady increase in hospital expenses. According to NCCI data, hospital inpatient paid cost per claim has been growing at a constant rate of 1.6% per year since 2012. This persistent upward trend highlights the urgent need for proactive cost containment strategies. Without careful oversight, these rising expenses can place a heavy burden on both payers and injured employees, creating challenges that require progressive solutions.
Obstacles to Cost Control
Fragmented processes within specialty services create obstacles that inflate claims costs and disrupt operational efficiency, including out-of-network expenses, cost leakage and limited visibility across disconnected data systems.
To take control of rising specialty service costs, payers must unify systems, data analytics and clinical expertise to enable better claim decision making. These tools not only help contain costs but also elevate claims accuracy and operational performance.
Three Ways Apricus Tackles Costs Head-On
- Deep Network Penetration
Apricus’ extensive specialty provider network delivers results, achieving 85-90% in-network penetration for DME services, which significantly reduces out-of-network referrals and associated costs. - Comprehensive Cost-Saving Strategies
Apricus achieves an average of 36% savings on home health services and reduces claim costs by up to 30% through optimized physical therapy management. Our approach aligns case management, utilization and bill review to ensure accurate pricing, eliminate errors, prevent unnecessary services and balance cost containment with care quality. - Actionable Data Analytics
Advanced analytic tools, including predictive risk modeling, empower your team to make smarter, data-driven decisions. By analyzing historical data, current trends and monitoring cost trends by geography, injury type or service category, our system forecasts potential outcomes and costs, enabling better planning, faster responses and more accurate resource allocation.
Not all change creates measurable impact. At Apricus, we deliver both—with proven outcomes and deep industry expertise to back it up. Our partners count on us for results that go beyond promises:
- Elimination of Leakage
By ensuring every service aligns with clinically recommended care guidelines, only necessary services are paid for, eliminating inappropriate service costs. - Cost Reductions of 30% or More
Strong network discounts combined with utilization management tools significantly lower claim costs, resulting in substantial savings. - Smarter Decision-Making
Apricus combines data-driven insights with clinical oversight to not only control costs but also strengthen claims management with clear, confident decision-making and precise care determination.
Unleash Your Path to Success
The future of specialty service management requires proactive, unified solutions to simplify processes and eliminate inefficiencies. Apricus equips you with the tools to achieve clarity, control and confidence, empowering you to overcome challenges, uncover cost-saving opportunities and boost operational efficiency.
With a results-driven approach, we don’t just make promises—we deliver. One example: a recent complex injury case saw over $170,000 in total savings with streamlined coordination—while also improving the injured employee’s quality of life and independence.
If rising specialty service costs are impacting your organization, it’s time to act. Contact Apricus today!