We’ve been getting many questions about the Health Strategy Associates Workers’ Comp Facility Assessment Tool. One that’s come up a few times is how big a “lift” payers and injured workers can realistically expect by changing facilities.

Jay Stith

So, I put together a list of the top 10 states with the “most opportunity” to improve patient outcomes and reduce costs by making informed facility decisions.

Our definition of “most opportunity” refers to the difference between facilities in the bottom quarter of the ratings and those in the top quarter.

Put in practical terms, what is the value of being able to change care from a bottom 25% facility to a top 25% facility in a given state? "Value" is defined as better clinical outcomes and patient safety, higher patient engagement and lower cost.

The results — from our propriety database, which assesses facilities on a wide variety of measures looking at clinical outcomes, safety, efficiency, patient satisfaction and relative price with a workers’ comp focus — are:

• Montana.
• Oklahoma* (initial treating provider).
• South Carolina*.
• Wisconsin.
• Kansas*.
• Louisiana.
• Mississippi.
• California* (managed provider network).
• Massachusetts* (only in MCA).
• Arizona* (initial treating provider).

The asterisks indicate states where employers can direct care; specifics vary by state.

Just because a state is on this list does not mean its lowest-rated facilities are “the lowest rated across all states.” In fact, the state with the worst overall score for its lower-rated facilities isn’t even on this list.

Moving a patient from the lower-rated facility to the higher-rated facility, you get the most benefit.

What does this mean for you?

If your book of business includes any of these states, you have a LOT of opportunity to deliver better care at a lower cost, benefiting injured workers, your policyholders/customers and your bottom line.

Jay Stith is the chief data analyst at Health Strategy Associates, a consulting firm focused on improving medical management programs in workers’ compensation. This column is republished with permission from the Managed Care Matters blog.