The value of treatment guidelines in improving outcomes for patients and controlling costs is significantly enhanced in Washington by incorporating guidelines into a structured UR program. This article describes: (1) how the Washington Department of Labor and Industries (L&I) UR program uses guidelines; and (2) the impact of the UR program on costs and outcomes. The impact of guideline implementation in the Washington program is considerable. In 2014, the L&I program produced net savings of $7,519,823, and the return on investment was approximately $2.00. The impact on clinical outcomes includes an overarching effect from use of best practices.
Keywords: Clinical outcomes; Clinical practice guideline; Cost containment; Quality of care; Treatment guideline; Utilization management; Utilization review; Workers’ compensation.
Published by Elsevier Inc.