The success of the Washington Department of Labor and Industries Managed Care Pilot Project: the occupational medicine-based delivery model.

The Washington State Managed Care Pilot Project (MCP) tested the effects of experience-rated capitation on medical and disability costs, quality of care, worker satisfaction with medical care, and employer satisfaction in MCP-covered workers, compared with matched fee-for-service controls. In the MCP, medical costs were reduced by approximately 27%, functional outcomes remained the same, workers were less satisfied with their treatment and access to care initially, and employers were-much more satisfied with the quality and speed of the information received from the providers. The authors believe that it was the occupational medicine-based delivery model, working in conjunction with the method of reimbursement and the cultural context of managed care, that was the most significant innovation leading to the MCP successes. This article describes the occupational medicine-based delivery model implemented for the MCP.