Value-based healthcare has proven effective in ensuring that patients receive the best quality of care. Although this innovative approach has been successfully implemented in healthcare settings throughout the U.S., injured workers being treated under workers’ compensation insurance are being left behind.

Understanding value-based care and how it could help those in workers’ compensation cases may enable the industry to get onboard with this approach to comprehensive care.

The Workers’ Compensation Issue

In the white paper, “Bringing Value-based Care to Workers’ Compensation,” Oliver Wyman Management Consulting outlines the issues:

• The pay-by-volume approach creates a high volume of services that don’t necessarily center on the patient’s well-being.
• A system of micromanagement of care that closely monitors spending puts claim adjusters in the position of deciding how best to treat a patient rather than letting care providers determine that.
• Inconsistent workers’ compensation insurance regulation, which differs state to state, gets in the way of properly treating injured workers.

How can value-based care help?

Under value-based care, doctors are paid based on the value of the services they provide rather than on volume of services. With accountable care organizations (ACOs) at work all over the country, value-based care can be highly beneficial for workers’ compensation.

Care centered on quality. With a patient-centered approach to healthcare, injured workers receive the highest quality of care while minimizing cost to insurance. Accountable care organizations create networks of care providers who collaborate to ensure patients receive the best quality of care.

Streamlined system of checks and balances. According to Oliver Wyman, because workers’ compensation cases are relatively rare, companies don’t see the point of implementing new models. In a value-based care system, however, ACOs enable a more streamlined, efficient approach to patient-centered care.

More comprehensive approach to catastrophic injury care. Particularly in cases of catastrophic injury, which often require bundled services — spinal cord treatment and therapy, for example — leveraging an ACO to implement and manage a comprehensive plan for care can be beneficial in order to ensure an injured worker and their family are cared for fully.

Paradigm Outcomes is leading the charge in the use of value-based healthcare for workers’ compensation complex catastrophic cases. With a holistic approach to care, injured workers are given the highest quality of care, all while insurers and providers work together to help those injured workers thrive in treatment.

Learn more about Paradigm Outcomes’ worker-centered approach to catastrophic injury case management by visiting our website, as well as our online communities on our blog, Facebook and Twitter.