The Future of Workers' Compensation Networks: Smarter, Customized & Data-Driven

​In the world of workers' compensation, the traditional one-size-fits-all approach to provider networks is no longer enough. Historically, preferred provider networks (PPOs) aimed to build broad networks capable of serving a wide range of medical needs. As the industry evolves toward more holistic, patient-centered care models, it’s clear that a tailored approach to provider networks delivers stronger outcomes for injured workers, and better value for payers.

​The Shift to Tailored Network Solutions
Today’s workers’ compensation industry is embracing a more nuanced care delivery model, one that prioritizes outcomes over network size. The old mentality of maximizing the number of providers is giving way to a smarter, outcome-driven strategy — identifying which providers consistently deliver timely, effective, and patient-centered care.

A high-performing, customized network doesn’t just focus on geographic coverage, though location remains important. It digs deeper into the types of injuries most common within an organization’s workforce and selects providers with proven expertise in treating those conditions. This includes evaluating the appropriateness of medical decisions, patient engagement practices, and whole-person care strategies.

Tailored networks also account for the critical role of ancillary services. On average, ancillary services represent about 30% of total workers’ compensation medical costs. Services like physical therapy, diagnostic imaging, home health, transportation, and translation assistance must undergo the same rigorous vetting process as medical providers to ensure quality, value, and positive outcomes.

Technology Leads to Data-Driven Network Development
One of the biggest advances fueling this transition is the use of sophisticated data analytics and AI-powered technology to guide network development. Claims data provides actionable insights into which providers and services consistently deliver the best value.

This is where ProviderDirectoryAI (PDAI), Perspecta’s channeling tool, plays a transformative role. PDAI consolidates, cleanses, and updates provider data to give payers visibility and enable better-informed decisions about which providers to include in customized networks.

Additionally, PDAI helps ensure injured workers are directed to the right providers at the right time. Integrated into claims systems and care management workflows, PDAI can enhance network steerage and improve outcomes, reducing claim duration, medical expenses, and complications. In fact, high-performing networks using strategies like these have seen results such as:

• 50% shorter treatment durations
• 35% shorter claim durations
• 30% greater data accuracy
• 43% lower medical costs
• 80% network utilization rates

Real-time data sharing, automated touch points, and claims scoring through platforms like PDAI enable payers to identify at-risk claims earlier, giving case managers and providers the ability to intervene proactively and optimize care pathways before complications arise.

The Future Is Custom
As we move deeper into 2025, workers’ compensation professionals have an unprecedented opportunity to reshape their provider networks to better serve injured workers and meet organizational goals. By prioritizing outcomes over size, leveraging tools like PDAI, and building strong specialty and ancillary networks, payers can improve care quality, control costs, and reduce claim durations.

A customized, data-driven network model delivers more than operational efficiencies, it supports injured workers through every step of their recovery journey, helping them return to health and productivity faster. In an industry where over 4 million work-related injuries occur each year and medical spend exceeds $30 billion, those improvements matter.

The future of workers' compensation care management isn’t about how many providers you can fit in your network; it’s about how many providers can consistently deliver the outcomes you need.

Learn more about Perspecta's Channeling Tool Solution

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