The Center of Occupational Health and Education, a pilot project launched in 2003 with a center here and one in Renton, Wash., has succeeded in cutting workers' compensation costs, and now its leaders are working on a plan to elevate it to a statewide program as early as mid-2012, says Daniel Hansen, project director for the Eastern Washington COHE.

COHE, which is funded by the Washington state Department of Labor and Industries, streamlines administration of workers' compensation claims by using health-service coordinators and a real-time electronic case-tracking system developed by Inland Northwest Health Services, Hansen says.

Health-service coordinators help with case management, provide employer and health-care provider training in handling workers' compensation cases, and help resolve conflicts between providers, employers, employees, and L&I, the state's workers' compensation insurance provider.

The COHE project was expanded recently to include clinics in Seattle and Everett.

The Eastern Washington COHE is sponsored by St. Luke's Rehabilitation Institute and has a staff of seven people. It occupies 1,000 square feet of space on the second floor of the Wells Fargo Financial Center, at 601 W. First.

"We're developing a work plan for transitioning into a program," Hansen says. If the plan is adopted, the program could be implemented by June 2012, and COHE's case-management practices then would become statewide policy.

The first major hurdle in turning the pilot project into a program will be finding a way to fund it permanently. Currently, COHE operates on biennial budget allocations from L&I.

The Eastern Washington COHE, which serves 16 counties, is operating under a biennial budget of $1.2 million, which is to last through June 2011, Hansen says.

Some of its work already is state policy, he says. For instance, the state has adopted a standard activity prescription form developed here by COHE. The form is the foundation for a back-to-work plan to be followed by injured workers, health-care providers, and employers, Hansen says.

"Doctors are comfortable with the form, and employers love it," he says.

Under COHE's case-management practices, participating providers are urged to enter patients promptly into an electronic case-tracking system, which was developed here by Inland Northwest Health Services, which operates St. Luke's. Through the tracking system, injured-worker cases are monitored by COHE, providers, patients, and employers, with a goal of rehabilitating and returning the injured worker to the workplace as quickly as possible.

COHE processes up to 1,400 new claims a month, Hansen says.

A study conducted by the University of Washington found that injured workers receiving care through COHE providers received benefits faster and lost fewer work days than non-COHE patients. First-year disability and medical costs for COHE patients were reduced an average of nearly $600 per claim, compared with non-COHE patients, the study showed. When tracked over three years, the average savings was nearly $1,300 for COHE patients, Hansen adds.

Providers receive financial incentives to participate in the project and use COHE case-management practices. They earn $22 from L&I for every claim they enter into the case-tracking system within two days after treating an injured worker. They also receive $19 to $56 for contacting employers to coordinate return-to-work plans. In addition, providers can earn $48 above the standard allowed office charge for follow-up visits with injured workers at two-week intervals.

Just as importantly, COHE's health-service coordinators guide providers, employers, and employees through L&I's rules and regulations, Hansen says.

"Our other currency is we've reduced the hassle factor," he says. Through COHE's case-management practices, "L&I can turn a bill around in two weeks," he says, meaning COHE providers often receive payments for services much faster in L&I cases than in cases handled through some other insurance providers.

L&I pays providers 60 percent above what Medicare pays. "That's comparable to other insurers," Hansen says.

With COHE's help, many physicians are welcoming L&I cases, as opposed to a few years ago when many who now are participating in COHE didn't want the burden of L&I red tape, he says.

Nearly 900 providers are participating in the Eastern Washington COHE. COHE isn't seeking more providers although it won't turn down those who want to participate, Hansen says. He says 25 hospitals and 578 employers in Eastern Washington are participating in the project, although he would like more employers to be aware of COHE's services.

Hansen asserts that there's no downside for employers who participate in COHE. COHE doesn't charge employers for its services, and it aims to reduce the cost of workers' compensation claims by streamlining the system so workers can return to the job sooner, he says.

"We've done a lot to eliminate intervals of wasted time," Hansen says.

Pamela Cromer, a COHE health-services coordinator here, says COHE holds quarterly seminars to inform employers about the project. COHE also provides presentations to groups of employers.

"We are recruiting employers as much as we can with the size of our staff," Cromer says.

Most employers don't realize how much a worker's comp case can cost, especially if an injured worker is off the job for an extended period of time, she says.

"A lot of mom-and-pop shops don't have human-resource departments or risk managers," Cromer says. "When they have their first injury, we help them through that L&I maze."

COHE also has produced some informational materials to inform workers about the project, Cromer says.

"We're developing outreach tools to help workers before an injury occurs," she says. "We would like to equip them with tools so that they can be more proactive in recovering."

COHE also is involved in some studies here that might help prevent worker injuries, Hansen says.

The Eastern Washington COHE is using an $88,000 grant from L&I to conduct a study on improving ergonomics in the grocery industry with the cooperation of the Spokane Valley-based Yoke's Fresh Market supermarket chain. Results of the study should be available in a few months, Hansen says.

While that effort is under way, COHE, has submitted a proposal to expand the study to look at the grocery-industry supply chain. Spokane-based URM Stores Inc., in addition to Yoke's, is committed to participate in that study, Hansen says.