Integration of workers' compensation and health insurance prescription drug programs: How does it work and do employees use it?

摘要

BACKGROUND: In 1998, New York State designed and developed an integrated workers' compensation (WC)/health plan prescription drug program, ONECARD Rx, in response to cost inefficiencies within the then current system and in an attempt to improve the quality of care provided to WC claimants. This paper describes the benefit's design and development process and factors related to its use. METHODS: Users and non-users of the program were surveyed through a mailed questionnaire with appropriate telephone follow-up. RESULTS: Eight steps were followed in the development of the benefit. Results obtained from the assessment of ONECARD Rx suggest that factors affecting use mainly relate to the knowledge of both, employees and pharmacists, of the program. The two main differences detected between users and non-users included the state agency the employee works for and the site of residence. CONCLUSIONS: Innovative strategies that couple private and public agencies should aim at reducing the costs and eliminatinginefficiencies while improving the quality of care, of which satisfaction is an important component. Am. J. Ind. Med. 45:103-112, 2004.