Project Results

Public Policy Goal:

To understand the effects of the use of managed care in the treatment of injured workers.

Project Objective:

To compare the costs and quality of medical care as well as the satisfaction of injured workers who received treatment through Washington State's workers' compensation managed care plans with injured workers who received routine fee-for-service care.

Key Findings and Accomplsihments:

The results from the Managed Care Pilot suggest that substantial savings in workers' compensation medical and disability costs may be realized using the type of managed care intervention designed for this study. The occupational-medicine model of care appears to bring about improved outcomes in terms of reducing disability burden and costs. The occupational-medicine model may prove effective in developing quality improvement strategies for workers' compensation health care delivery.

Major findings of the study included:

1. Workers treated through Washington State's workers compensation managed care plans had lower medical and disability costs and returned to work earlier than did the matched injured workers in the fee for service plans in the 24 months following an injury. No meaningful differences in health outcomes were found between the managed care and fee-for-service patients.
2. The percentage of patients satisfied with overall treatment, with their attending physician, with overall access to care and with access to specialists was lower in the managed care group than in the fee-for-service group.
3. 3. Employers were more satisfied with the managed care arrangements than with the fee-for-service arrangements.

Tools Developed:

• Patient Outcome and Satisfaction Survey [future link]
• Two year patient follow up survey [future link]
• Employer Survey [future link]

Reports and Publications:

• Cheadle, Allen, PhD, Wickizer, TM, Franklin, G.  "Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project II: Medical and Disability Costs." Medical Care 37, no. 10 (1999): 982-93.
• Keyes, K, Wickizer, TM, Franklin, G, Weaver, M. "Effects on Employer Satisfaction of Managed Care in Treating Work-Related Injuries." Paper presented at the 124th Annual Meeting, American Public Health Association, New York, November 1996.
• Keyes, K, Wickizer, TM, Franklin, G. "Final Results of the Washington State Workers' Compensation Managed Care Pilot Project." Paper presented at the 125th Annual Meeting, American Public Health Association, Indianapolis, Indiana, November 1997.
• Keyes, K, Wickizer, TM, Franklin, G et.al.  "Evaluation of the Washington State Workers' Compensation Managed Care Pilot Project I: Medical Outcomes and Patient Satisfaction." Medical Care 37, no. 10 (1999): 972-81.
• Keyes, K, Wickizer, TM, Franklin, G et.al. "Employer Satisfaction with Workers' Compensation Health Care: Results of the Washington State Workers' Compensation Managed Care Pilot Project." under review by Journal of Occupational and Environmental Medicine.
• Keyes, K, Wickizer, TM, Franklin, G. "Two-Year Health and Employment Outcomes among Injured Workers Enrolled in the Washington State Workers' Compensation Managed Care Pilot Project." American Journal of Industrial Medicine 40 (2001): 619-26.
• Wickizer, TM, Franklin, G, Plaeger-Brockway, R, Mootz, R, Drylie D. "Improving the Quality of Occupational Health Care in Washington State: New Approaches to Designing Community-Based Health Care Systems." Journal of Ambulatory Care Management 25, no. 2: 1-10.
• Wickizer, TM. "Effects of Managed Care on Medical and Cost Outcomes: Results of the Washington State Managed Care Pilot Project." Paper presented at the 15th Annual Conference of the Workers' Compensation Research Institute, Boston, MA, March 1997.
• Wickizer, TM, Franklin, G, Plaeger-Brockway, R, Mootz, R. "Improving the Quality of Workers' Compensation Health Care Delivery: The Washington State Occupational Health Services Project." Millbank Quarterly 79, no. 1 (2001): 5-35.
• "Workers' Compensation Managed Care Pilot Project: Final Report to the Legislature." Washington Department of Labor and Industries and University of Washington Department of Health Services, 1997.

Presentations:

Thomas Wickizer, PhD, "Health Services Research and Workers' Compensation: Challenges and Opportunities," Robert Wood Johnson Workers' Compensation Health Initiative Annual Meeting, September 6-7, 2001, Newport, RI.