As a quality-focused network, the Alliance is committed to matching injured employees with top-notch providers who will get them back to health, back to work, and back to their lives. Our members are known for their service to their local communities — at city hall, the county courthouse, in schools, community centers, public utility facilities, and as first responders. If they get hurt on the job, the Alliance is here to make sure these dedicated public servants have access to top-quality healthcare providers.

The Alliance is different than your typical healthcare network and does not sell its services for a profit, nor is it commercially available. As a result of 2005 workers’ compensation reforms, Texas public entities have the opportunity to directly contract with healthcare providers in order to deliver the best medical care possible to injured employees. The Alliance was established under Chapter 504.053 of the Texas Labor Code to perform the direct contracting and credentialing of healthcare providers on behalf of its members (the pools.)

The Texas Department of Insurance (TDI) oversees certified networks, and the TDI Workers’ Compensation Research and Evaluation Group (REG) publishes an annual Network Report Card that evaluates workers’ compensation certified networks and Chapter 504 political subdivision networks. The criteria include:

• Healthcare Costs
• Utilization
• Satisfaction with care
• Access to care
• Return to work
• Health Outcomes

The Alliance remains one of the highest-ranked networks in the state. The REG uses data supplied by each network/provider panel for more than 100 data elements, denial codes, medical procedures and healthcare provider types. The REG also conducts a survey of injured workers by the Public Policy Research Institute at Texas A&M University. The time period for the 2018 network report card was for injuries occurring between June 1, 2016 and May 31, 2017 and evaluates 16 individual networks and groups. The data used included information for 219,000 injured employees, 5 million medical services, $400 million in medical payments to healthcare providers, and 3,200 completed injured employee surveys.

Among the more noteworthy findings of the report that compares the 15 networks, the Alliance had:

• the highest satisfaction of care of any of the networks in the survey
• the third highest rating for getting needed care and second highest rating for getting care quickly
• the second lowest average duration from date of injury to first non-emergency treatment
• the third highest return-to-work results
• the second highest physical and mental functioning scores
• the second lowest average medical cost increase between six months and 18 months among all networks
• the second lowest average professional costs
• the third lowest average hospital costs and pharmacy costs
• the lowest average number of prescriptions per injured employee
• 21 percent of all workers’ compensation claims, the second highest of any network in the report

The Alliance is a consistent top performer since the REG began publishing network report card results. As a result, the Alliance continues to ensure that the best quality doctors treat our injured workers and return them to work in a timely manner with a high level of satisfaction of care. The complete report can be viewed at https://www.tdi.texas.gov/reports/wcreg/documents/netrc2018.pdf.