Downers Grove - March 1, 2016- Coventry has expanded its Outcomes-based Network (OBN) program from 21 states to include an additional 16 states, bringing Coventry's OBN program coverage to a total of 37 states across the country.
Coventry began offering its Outcomes-based Network program in 2009 in Florida, and since then has continued its program's expansion into additional states. Coventry's expansion increases the opportunity for clients to access a more selective and focused workers' compensation managed care option. Coventry's OBN program focuses on total claim outcomes by utilizing its own proprietary methodology. Providers are measured according to stringent comparative statistical methodologies utilizing the industry's largest integrated data warehouse of medical billing, clinical and pharmacy data, alongside partnered client claim data. Additionally, Coventry incorporates benchmarks from the Official Disability Guidelines (ODG) as it relates to physical medicine treatments by injury type.
Coventry's provider measurement process has demonstrated year over year that claims being managed by an Outcomes-based Network provider tend to experience:
- 40-50% lower utilization of PT, Imaging, and major surgeries
- 55-65% lower utilization of opioids
- 55-65% lower overall pharmacy spend
- 25-35% lower claim duration
- 40-50% lower overall claim costs (including medical, indemnity and administrative costs)
"Coventry's Outcomes-based Network program aims to identify health care providers who demonstrate a depth of experience treating workers' comp injuries and have consistently better measures of clinical outcomes, medical utilization, return-to-work, and financial outcomes when compared to their peers," said Kate Farley-Agee, vice president, Network Products at Coventry. "This network program differs from others because it moves away from simply looking at billing trends and medical costs and expands provider measurement to include external client claims data sources that provide information on a providers' clinical, prescribing, utilization, return-to-work, and consistency measures, all factors essential in realizing the best overall claim outcome."
Coventry has had longstanding network relationships with our OBN clients. These clients have partnered with us and have been very satisfied with the care their injured workers receive in this program.
About Coventry
Coventry offers workers' compensation, auto and disability cost and care management solutions for employers, insurance
carriers and third-party administrators. With roots in both clinical and network services, Coventry leverages more
than 30 years of industry experience, knowledge and data analytics.
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