Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project I

Kyes, Kelly B.; Wickizer, Thomas M.; Franklin, Gary M.; Cain, Kevin C.; Cheadle, Allen; Madden, Carolyn W.; Murphy, Linda; Plaeger-Brockway, Roy; Weaver, Marcia R.

doi:10.1097/00005650-199910000-00002

Cited by 36 publications

(26 citation statements)

References 15 publications

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“…We found no evidence to suggest that early return to work, observed for managed care patients relative to fee-for-service patients, had any important effect on long-term health or employment outcomes (Kyes, Wickizer, and Franklin, 2001). At two years postinjury, the functional status, level of employment, and wages among managed care and fee-for-service patients were similar.…”

Section: Long-term Follow-up Of Patients Treated In the Mcpmentioning

confidence: 62%

“…The evaluation found no meaningful differences between managed care and fee-for-service patients in health outcomes (Kyes, Wickizer, Franklin, et al 1999). However, it did find important and statistically significant differences favoring managed care patients (see figure 1) in medical and disability costs (Cheadle, Wickizer, Franklin, et al 1999).…”

Section: Washington State Workers' Compensation Managed Care Pilot Prmentioning

confidence: 91%

“…Washington State managed care pilot project: differences in satisfaction among managed care and FFS patients. Source: Adapted from Kyes, Wickizer, Franklin, et al 1999. by the insurance company or the employer, and the nurse case manager was the patient's advocate. The success of the care coordination and the employers' perceived improved quality of communication was, in part, dependent on the skills and personality of the nurse case manager.…”

Section: Washington State Workers' Compensation Managed Care Pilot Prmentioning

confidence: 99%

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Improving the Quality of Workers' Compensation Health Care Delivery: The Washington State Occupational Health Services Project

et al. 2001

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Researchers and health policy analysts in Washington State set out to determine the extent to which administrative process changes and delivery system interventions within workers' compensation affect quality and health outcomes for injured workers. This research included a pilot project to study the effects of providing occupationally focused health care through managed care arrangements on health outcomes, worker and employer satisfaction, and medical and disability costs. Based on the results, a new initiative was developed to incorporate several key delivery system components. The Washington State experience in developing a quality improvement initiative may have relevance for health care clinicians, administrators, policymakers, and researchers engaged in similar pursuits within the general medical care arena.

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Section: Long-term Follow-up Of Patients Treated In the Mcpmentioning

confidence: 62%

Section: Washington State Workers' Compensation Managed Care Pilot Prmentioning

confidence: 91%

Section: Washington State Workers' Compensation Managed Care Pilot Prmentioning

confidence: 99%

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Improving the Quality of Workers' Compensation Health Care Delivery: The Washington State Occupational Health Services Project

et al. 2001

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“…23 We have described some of the policy studies conducted to date on the health care delivered through the system. Other important studies involving evaluation of a major managed care demonstration initiative, 24 -27 outcome assessment of a multi-year drug-free workplace initiative, 28 evaluation of an ongoing quality improvement initiative, 24,29 and patient satisfaction surveys 30,31 have been conducted and reported elsewhere. Most importantly, we believe that the structural capacity built here has had a long-term beneficial effect on both quality of care and cost.…”

Section: Discussionmentioning

confidence: 99%

Policy-relevant research: When does it matter?

Franklin¹,

Wickizer²,

Fulton‐Kehoe³

et al. 2004

Neurotherapeutics

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Summary:Evidence-based medicine is most meaningful to policy makers when research questions are clearly informed by strategic health policy questions. In Washington State workers' compensation, key structural characteristics allow for the conduct of effective policy-relevant research. These include clear authority and a stable funding stream, a formal relationship between a policy agency and a University, development of appropriate research capacity, development of research questions related to strategic goals, and a robust data source. The research conducted relies on computerized medical bills and work disability records, medical records, structured telephone surveys to collect data on pain, functional status, quality of life, and computerized data on employment status. The types of policy-relevant research include identification of factors leading to preventable disability, outcomes research of specific procedures, technology assessment, and "real-time" research that addresses rapidly emerging questions. Health policy changes implemented from research have been substantial in Washington State workers' compensation, including: 1) noncoverage or partial coverage decisions for emerging technologies not proven to be of value to injured workers, 2) formal treatment guidelines and utilization review criteria for invasive, expensive, or marginally effective procedures, 3) disability prevention efforts, and 4) relatively rapid changes in policy as emerging patterns suggest harmful outcomes from existing treatments (e.g., schedule II opioids). Key structural characteristics must be in place to conduct policy-relevant research effectively. The workers' compensation system in Washington State is a single-payer system with other unique properties that have allowed the emergence of these structural characteristics and the conduct of research linked to the strategic goals of policy makers.

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“…Even when the network has adequate numbers of qualified providers, patient satisfaction may decline if patients are denied access to providers of their choice. Evaluations of WC managed care plans in Florida, Oregon, and Washington state that use restricted networks found that injured workers are significantly and persistently less satisfied than similar workers in traditional workers' compensation plans, even though treatment outcomes for those in restricted provider networks were similar to those for patients in unrestricted networks (11,4). Dissatisfaction was mainly attributed to a lack of provider choice.…”

Section: Restricted Provider Networkmentioning

confidence: 99%

Managed Care in Workers' Compensation Plans

Peele

Tollerud²

2001

Annu. Rev. Public Health

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Key Words insurance, employment, occupational health, employment benefits, health services s Abstract Workers' compensation plans have lagged behind most public and private health care plans in the adoption of managed care techniques. This is largely attributable to the underlying differences between workers' compensation and group health plans. Managed care techniques were developed within group health plans with the objective of health at the lowest cost. In workers' compensation, managed care must address a different objective-restoring a worker to health and productivity at the lowest cost. It is this fundamental difference that makes the application of managed care techniques to workers' compensation plans contentious and at times inappropriate. Research on the impact of managed care on the health and welfare of injured workers is sparse, and important questions remain about the appropriateness of care delivered under workers' compensation managed care plans. In this paper, we discuss the application of managed care to workers' compensation, and highlight the barriers to effective implementation.

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Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project I

Cited by 36 publications

References 15 publications

Improving the Quality of Workers' Compensation Health Care Delivery: The Washington State Occupational Health Services Project

Improving the Quality of Workers' Compensation Health Care Delivery: The Washington State Occupational Health Services Project

Policy-relevant research: When does it matter?

Managed Care in Workers' Compensation Plans

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