Network Innovation Drives Quality and Performance
Outcomes-Focused-Network (OFN) and new provider excellence programs offer the best possible care pathways for claimants, ensuing administrative and clinical quality.
HCS continues to build its network to provide quality care for claimants, the lowest cost for employers and carriers, and smooth administration for providers. Coordinated, evidence-based care rendered by workers’ compensation-savvy providers is the key to meeting each stakeholder’s needs and requires effective partnership among all parties.
Providers enroll in our OFN specifically to treat injured claimants in the EOC programs. Providers treat claimants within the programs’ guidelines, work with in-network resources, such as ambulatory surgery centers and in-network anesthesiologists, and understand workers’ compensation guidelines, including prompt return of medical documentation.
Partnership with OFN providers benefits all stakeholders:
- Claimants consistently receive prompt evidence-based care.
- Providers understand case management expectations, which leads to simplified authorizations and fewer delays in care.
- Carriers and employers reduce their costs by maximizing the use of in-network resources.
Provider Excellence Programs
HCS has provider excellence programs in place to ensure claimants are following optimal care pathways. For instance, some providers stand out for their prompt return of medical documentation or use of in-network resources for surgery, anesthesiology, and physical therapy, therefore reducing the cost of care.
Enhanced analytics allow HCS to identify high-performing providers for deeper partnerships and target clinical and administrative improvement efforts. Deeper partnerships drive superior claimant outcomes at lower cost for employers with less administrative overhead for providers. The combination of these efforts will enable HCS to continue delivering the best workers’ compensation network in New Jersey for claimants, providers, employers and carriers.