Current Perspectives in Clinical Treatment & Management in Worker's Compensation Cases

Practical Application of Outcomes-Based Networks

Author(s): Gregory Moore

Pp: 174-179 (6)

DOI: 10.2174/978160805251611101010174

* (Excluding Mailing and Handling)

Abstract

The California MPN provides an excellent legisl ative model for managing a health-care medical network in workers’ compensation. This managed care model provides payers with the control to create and certify a medical network from which all injured employees must select physicians and medical services. This containment of patient traffic ensures higher rates of compliance in the use of approved providers than typical healthcare and workers’ compensation models.

MPNs that select providers based primarily on fee discounts may generate higher total claim costs if they provide poor quality care that results in more numerous treatments and delays returns to work. Harbor Health Systems, LLC has been engaged in a nine-year effort to develop the tools, systems, and data needed to identify providers that truly reduce total claim costs by providing superior medical care which reduces the number of treatments required for recovery and enables employees to return to work more quickly. Many practical lessons have been learned about identifying, building and managing outcomes-based network of quality providers through a pilot implementation that has produced significant positive results.

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      • 12. app/Http/Controllers/ChapterController.php:1478
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
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      700μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 982 and `b`.`banner_from_date` <= 1740774922 and `b`.`banner_to_date` >= 1740774922 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.09msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 982
      • 3: 1740774922
      • 4: 1740774922
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='256e41ae0b68ac05ab79d843bb413174'
      240μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:291
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        OCC4gHOrQliCVI6bvK64iSPErrWAzqNKcPeWQx7K
        uc_cart_id
        256e41ae0b68ac05ab79d843bb413174
        _previous
        array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/2823" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/2823
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:8 [ "accept-encoding" => array:1 [ 0 => "gzip, deflate" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] "connection" => array:1 [ 0 => "keep-alive" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] ]
        request_cookies
        []
        
        response_headers
        0 of 0
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        session_attributes
        0 of 0
        array:5 [ "_token" => "OCC4gHOrQliCVI6bvK64iSPErrWAzqNKcPeWQx7K" "uc_cart_id" => "256e41ae0b68ac05ab79d843bb413174" "_previous" => array:1 [ "url" => "http://alpha.eurekaselect.com/chapter/2823" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-28 20:35:22GET/chapter/2823112182