Workers' Compensation Medical Cost Containment: Updated National Inventory

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Table 16  Details of Quality Assurance Requirements in Workers' Compensation Managed Care as of January 1, 2008

States are always concerned about both access and quality of medical care to workers. When they authorize the use of managed care arrangements, they often also require some measure of the access, timeliness, satisfaction and outcomes of care for workers. This table indicates which states require such measures in their managed care regulations and how they are enforced.
State	Quality Assurance Requirements within Managed Care										Enforcement
	Measurement of Accessibility of Services	Measurement of Availability of Services	Measurement of Adequacy of Services	Measurement of Appropriateness of Services	Measurement of Effectiveness of Services	Measurement of Timeliness of Services	Measurement of Injured Worker Satisfaction with Care	Measurement of the Cost of Treatment	Measurement of the Outcomes of Treatment for the Worker	Other
Sample State 1	No Managed Care Regulations									However, see studies on COHEs at www.xxxxx
Sample State 2	No	No	No	No	No	No	Yes	No	No		On site surveys or audits; examination of the financial records of a managed care organization; investigation of complaints about a managed care organization
Notes: