Pilot Programs at the Division of Workers’ Compensation

The Division of Workers’ Compensation is dedicated to improving the health of the workers’ compensation population through value-based initiatives that deliver patient-centered and effective care.

What is a pilot program? 

A pilot program, also called a feasibility study or experimental trial, is a small-scale, short-term experiment that helps an organization learn how a large-scale project might work in practice.

Under Rule 18, a proposal to conduct a pilot program may be submitted to the Director for
approval. Pilot programs authorized by this Rule shall be designed to improve the quality of
care, determine the efficacy of clinic or payment models, and to provide a basis for future
development and expansion of such models.

What is quality healthcare?

The US Institute of Medicine defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”1

How do I submit my pilot program proposal?

All proposals for a pilot project must include the following information:  

  • Beginning and end date for the pilot program.
  • Population to be managed (e.g. size, specific diagnosis codes).
  • Provider group(s) participating in the program, including a payer partner.
  • Proposed codes and fees.
  • Process for evaluating the program’s success.

1. Institute of Medicine (IOM). Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, D.C: National Academy Press; 2001.