The Partnership is directed by Ohio’s leading Occupational Healthcare Providers. (An insurance company or a third party administrator does not own our MCO.) Rather, The Partnership is owned and operated by a representative group of Ohio’s leading hospitals, physician specialists and research organizations.
As the nation watched in 1997, Ohio threw the switch on a radical change in its workers' compensation system. Fifty-six (56) MCOs began the process of transitioning the medical management of workers’ compensation claims from the State run BWC to the private sector. Year one focused on the process and the system, building the foundation that was essential to support the new system. The payment structure for MCO services was one that included an administrative payment. But, 50% of an MCO's possible revenue was not guaranteed and was earned through performance measured against BWC standards and benchmarks. The Partnership was one of ten MCOs that received full performance and incentive bonuses in Year One. Year Two added satisfaction results from both employers and injured workers to the system and performance payment measurements. Again, The Partnership scored in the top 5% of the MCO industry.
As the journey continued into Year Three, the standards have been shifted from one of process implementation to one of measurement of medical outcomes. An incentive payment, 43% of MCO revenue is tied to one outcome measure, safe return to work. The BWC engaged Milliman & Robertson, (M&R), a nationally recognized health-care consulting firm, to evaluate the performance of the MCOs in the first two years of the HPP system and to develop a system of measuring successful return to work. The BWC recertified The Partnership as an MCO when M&R completed its evaluation.
As part of its engagement, M&R completed a two-year Degree of Disability Management (DoDM) Evaluation. Preliminary results of the return-to-work measurement showed The Partnership to be the NUMBER ONE statewide MCO in return-to-work rates as of December 1998. In fact, the Partnership was almost twice what the BWC deemed as an acceptable percentage. Now that BWC has incorporated DoDM into the MCO contract as THE determiner of incentive performance payments, employers will soon have the opportunity to measure their MCO’s performance in this critical measure. While those final figures are being compiled now for 1999 and the Employer Report Card, The Partnership has again surpassed the BWC requirements for earning 100% of its performance incentive payments.