|
 |
National Institute for Occupational Safety and Health
| Title of Project |
Performance Indicators for Workers'
Compensation Care in Managed Care |
| Category |
Quality Assurance |
| Objectives: |
Twenty-nine states now have regulations
permitting managed care organizations to deliver workers' compensation, and over 60
million workers are covered by workers' compensation via managed care networks. This
project will create a standard set of clinical performance measures with which to evaluate
the provision of managed care workers' compensation. Such measures will allow purchasers,
consumers, and policy makers to compare quality among managed care workers' compensation
providers and make informed decisions based upon those comparisons. In addition,
standardized measures will help guide managed care quality improvement efforts. The
ultimate objective of this project is to improve the quality of care delivered to injured
workers. |
| Outcomes: |
|
| External Institution/Principal
Investigator |
American Accreditation HealthCare
Commission/URAC
Liza Greenberg, RN, MPH (202) 216-9010 |
| CDC Project Officer |
NIOSH/OD/Office for Extramural Coordination and
Special Projects
Scott Deitchman, MD, MPH ( 404) 639-1534 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY: 1998-2000 $393,000 (RWJ Funding) |
| Funding Mechanism |
Robert Wood Johnson Foundation Workers'
Compensation Health Initiative Grant |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
| Title of Project |
Analysis of Capitated Payments in
Workers' Compensation |
| Category |
Research |
| Objectives and Description |
In 1993, Philadelphia moved from
fee-for-service to capitated reimbursement of medical providers participating in its
workers' compensation program covering 30,000 municipal employees. This research will
compare health-care utilization and expenditures, duration of disability and duration of
the claim for work-related injuries, and lost time at work associated with work-related
injuries -- from before and after the transition to capitation. It will also determine
whether observed changes reflect changes in the provider pool or changes in provider
behavior. Finally, capitated providers will be interviewed regarding their use of
management strategies for treatment. |
| Outcomes: |
|
| External Institution/Principal Investigatorl: |
Allegheny Universiy
David J. Tollerud, MD, MPH (215) 762-6514 |
| CDC Project Officer |
NIOSH/OD/Office for Extramural Coordination and
Special Projects
Roy Fleming, ScD (404) 639-3343 |
| Other CIOs/Agencies Involved |
|
| Annual Extramural Funding |
FY 1996: $192,173 FY 1997: $210,798
FY 1998: $195,812 |
| Funding Mechanism |
Grant |
| Project Status |
Ongoing |
| Special Populations |
|
| Published Abstracts/Articles |
|
|
