TY - BOOK ID - 143046028 TI - Alternative Payment Models for California's Workers' Compensation System: A Review of Issues and Possible Next Steps AU - Quigley, Denise D. AU - Dworsky, Michael AU - Qureshi, Nabeel AU - Rasmussen, Petra W. AU - Sorbero, Melony E. PY - 2023 PB - RAND Corporation DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:143046028 AB - In California's workers' compensation (WC) system, there have been long-standing concerns about the costs and quality of medical care provided to injured workers and the ability of workers to access care. These challenges are not unique to WC and in part reflect the limitations of fee-for-service payment. Alternative payment models (APMs) have been implemented outside WC to rein in costs, discourage overtreatment, and incentivize quality improvement. The California State Legislature has expressed interest in developing pilot programs that could bring APMs into WC in California, and the California Department of Industrial Relations, Division of Workers' Compensation (DWC), asked the RAND Corporation to study alternatives to using the California Official Medical Fee Schedule (OMFS). The authors of this report sought to (1) evaluate potential APMs for use in California WC, (2) examine advantages and disadvantages of each, and (3) make recommendations to the California Legislature on pilot programs for APMs. To do so, the authors conducted a scoping review and an environmental scan of literature on APMs and conducted interviews and focus groups with key WC stakeholders (providers, unions, applicant attorneys, employers, and insurers). The authors considered four APMs: quality incentive programs (such as pay-for-performance and value-based payment programs), bundled payments, accountable care organizations, and global budgets. Stakeholders most consistently supported exploring the implementation of a pay-for-performance pilot program for California WC. The authors recommend that DWC use a two-stage process to develop a pilot pay-for-performance program that aims to increase provider participation in WC and improve injured worker's access to WC care. ER -