Page 17 - 1 One Simple Question

What a carrier really wants is medically necessary home modifications (accurate scope), provided
by a qualified provider at a reasonable price. The challenge, however, is how can you know you

are paying a reasonable price? And what does reasonable price really mean?

A reasonable price should be based on fairness and equally represents the interest of the carrier,

the injured worker, and the contractor.

• The contractor is paid what is reasonable for the work performed.

• The carrier isn’t expected to pay a greater price than what is reasonable and is not
expected to pay for more than what is considered medically or functionally necessary.
• The injured worker receives what they are legally entitled to under the terms of their policy

as authorized by their insurance and medical team.

The David Corey Company established the following definition:

“To provide home modifications that are determined to be functionally necessary, and to do so in

the most cost-efficient manner without compromising the integrity of the project, the rights of the
injured worker, without expecting the contractor to complete the work for less than what is
reasonable for their services, and not expecting the carrier to pay more than what is reasonable

for the project.”

I encourage every carrier, case manager, and provider to consider this definition as an outcome
objective when involved with a home modification project. The objective is to be accurate,
reasonable, and fair and it establishes a foundational principle that equally respects all the parties.

It takes away the adversarial perceptions and creates a collaborative and cooperative
environment.

When considering the response, “Ensuring a reasonable cost”, we need to dive a little deeper and

determine what you are really trying to achieve. Are you simply wanting to ensure that the
contractor’s specific estimate is reasonable? Or are you wanting to ensure a broader cost

containment? Cost containment is looking at the big picture. The estimate is focused on a single
component.

Cost containment is one of the great mysteries of modern times found within the walls of

corporations around the world. It is a mystery not because it is so elusive, but rather it is so elusive
because we don’t really know what it is. When talking about cost containment, most people are
actually talking about cost reduction. The only time cost reduction and cost containment cross

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