Centers of Occupational Health & Education (COHE)

Accountability

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The COHE Program is working with COHE contractors to:

  • Give providers information that will help them better manage their workers’ compensation claims.
  • Measure the operations of COHEs and determine if they are meeting contractual obligations.

Provider informational measures include:

  • Claim Status and Length of Claim.
  • Claims with Time-Loss by Diagnostic Code.
  • Opioid Measures.
  • ROA Timeliness & Completeness.
  • # of APFs per Claim.

 

COHE measures include:

Measure Benchmark
  • % of APFs Completeness & Timeliness.
  • 80% of all APFs in the random (manual) review.
  • % of all claims initiated in this reporting period with at least 1 APF in the first 12 weeks.
  • 80% of all claims.
  • % of all claims with a provider/employer phone call.
  • 25% of all claims.
  • % of time-loss claims with a billed provider phone call or any HSC billed activity.
  • 80% of all time-loss claims.
  • % of all claims with an HSC billed activity.
  • 30% of all claims.
  • % of time-loss claims with an HSC billed activity.
  • 80% of all time-loss claims.
  • Median days from claim established date to first HSC billed activity.
  • 10 business days.
  • % of all claims initiated during the reporting period that have any time-loss compared to non-COHE claims in the COHE catchment area.
  • be lower than non-COHE.
  • % of all providers that are low adopters of COHE best practices.
  • less than 20% of all providers.
  • % of ROAs complete when submitted.
  • 80% of all ROAs.
  • % of ROAs submitted within 2 business days.
  • 80% of all ROAs.

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