New: Provider Incentives for the Best Practice Pilot Programs

What does this mean for you?

We would like your feedback about the providers that participate in the program and how the pilot incentives impact the whole workers’ compensation system. See below for information about the provider incentives pilots.

What will these incentives do?

Incentives should encourage more providers to participate in best practice programs and encourage them to adopt more of the best practices. We know that implementing occupational health best practices reduces worker disability, improves worker outcomes, and gets workers back to work as soon as medically possible. By piloting these new provider incentives we’re able to:

• Test them out
• Track any unintended consequences
• Evaluate their impact
• Refine them to prepare for state-wide rollout, and
• Gather your feedback

Do Self-Insured Employers have to participate?

L&I will direct pilot providers to bill incentives to all L&I covered employers (e.g.: excludes federal claims). These incentives aren’t currently part of the Medical Aid Rules and Fee Schedule (MARFS), but rather part of a special fee schedule. Self-insured employers aren’t required to pay them.

While self-insured business aren’t required to pay these provider incentives, we encourage them to do so. Once pilots are complete, provider incentives will be integrated into MARFS.

When will the pilots roll out?

We are preparing to launch these pilots in spring/summer of 2022. L&I will introduce and pilot new incentives for the following:

• Surgical Quality Care Program Pilot
• Centers of Occupational Health and Education (COHE) Pilot

If you’d like to know more, or have questions about these pilots, please check out our provider partnerships and best practices webpage or send an email to ProviderIncentives@lni.wa.gov.