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Outcomes-based Network Program

When implementing an outcomes-based network program, an employer’s strategic focus shifts from unit-cost reductions to life-of-claim disposition including clinical, utilization, and return-to-work outcomes.

 

A philosophical shift

We understand the key differences between access-focused and outcomes-focused network models. Expansive provider selection criteria including medical, pharmacy, and indemnity financials, as well as return-to-work and clinical outcomes.

  • Shift from individual transactions to entire claim outcomes
  • Collaborative program design, data submission, and shared expectations that differ from traditional access-focused models
  • Active channeling to OBN providers vs. pre-program channeling rates

 

 

A philosophical shift

We understand the key differences between access-focused and outcomes-focused network models. Expansive provider selection criteria including medical, pharmacy, and indemnity financials, as well as return-to-work and clinical outcomes.

  • Shift from individual transactions to entire claim outcomes
  • Collaborative program design, data submission, and shared expectations that differ from traditional access-focused models
  • Active channeling to OBN providers vs. pre-program channeling rates

 

 

A philosophical shift

We understand the key differences between access-focused and outcomes-focused network models. Expansive provider selection criteria including medical, pharmacy, and indemnity financials, as well as return-to-work and clinical outcomes.

  • Shift from individual transactions to entire claim outcomes
  • Collaborative program design, data submission, and shared expectations that differ from traditional access-focused models
  • Active channeling to OBN providers vs. pre-program channeling rates

 

Network Solutions

Network Solutions

The OBN is a subset of the largest national provider network in the workers’ compensation industry.

Nurse Triage  (NT24) 

Channeling is the driving force behind a successful OBN program. Telephonic nurse triage at the point of injury means employees will be directed to your OBN providers.

Find a Provider 

It's easy to find Coventry providers in the OBN program.

 

Coventry Connect: Informed decisions lead to better outcomes

The more information claims adjusters have, the better decisions they can make. With Coventry Connect, you can see all activity on a claim and receive customizable alerts. Our secure web and mobile technology supports Bill Review, First Script® Pharmacy Benefit Management, DMEplus®, Case Management, Utilization Review, IME services, and Coventry’s extensive national network of providers and pharmacies.

    

 

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