Workers' Comp

What is the Coventry Outcomes-Based Network Program?

June 1, 2023

Melissa McGarry

Director, Product Development

With over 15 years of historical data, the Coventry Outcomes-based Network Program (OBN) is a subset of the Coventry Integrated Network. The program provides a channeling mechanism to health care providers who demonstrate a depth of experience in treating workers’ compensation injuries and exhibit consistently better overall claim outcomes. These providers are measured on several factors such as: medical utilization, pharmacy utilization, return to work and financial outcomes when compared to their peers.

When implementing an outcomes-based network program, an employer’s strategic focus shifts from unit-cost reductions to life-of-claim disposition. Partnering with Coventry means working with an organization that is committed to identifying those providers who have been associated with effective claim outcomes. Effective claim outcomes can help your organization save money, while causing minimal distraction to your current operations.

In our current economic climate, the increasing complexity of effective work comp injury management requires an expanded group of experts to ensure multiple aspects of the claim are taken care of. Our goal is to help get injured workers back to work and back to life.

Coventry’s Outcomes-based Network Program is currently available in 46 jurisdictions. We have seen impactful results in several different areas including decreases in:

  • Treatment Duration: 35-45%
  • Claim Duration: 25-35%
  • Average Medical Spend: 40-50%
  • Average Indemnity Spend: 45-55%

Coventry invests in a provider selection methodology that encompasses an extensive provider population. Our network has proven to statistically be reliable on the threshold of workers’ comp claims for each provider. Our robust data set includes medical, clinical and pharmacy transactions, quality review information and indemnity data.

When utilizing the OBN program, you are able to shift your focus from unit costs towards overall claim outcomes.

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