321 - Keeping Patients at the Center: Aligning Payor, Accreditation, and Provider Goals to Achieve the Triple Aim of High Quality Outcomes, Low Costs of Care, and Improved Population Health

Session Description: This presentation explores how State Compensation Insurance Fund's (SCIF) efficient treatment approval process and outcome metrics were scaled and monitored across a broader network of care allowing for meaningful insights into long-term patient recovery trajectories and resource utilization, and aligned with the attainment of Commission on Accreditation of Rehabilitation Facilities' (CARF) accreditation, to catalyze data-driven, patient-centered transformation within Pain & Rehabilitative Medical Group (PRCMG). The integration of standardized performance indicators and patient-reported outcomes enabled all teams to strategically align care delivery with value-based goals.
By aligning clinical and business practices with CARF standards, PRCMG established a rigorous framework for continuous quality improvement, outcome measurement, and individualized care planning. PRCMG demonstrated improvements in functional outcomes, patient satisfaction, and operational efficiency. This model achieved the Triple

Aim: enhanced patient experience, improving the health of the injured worker population, and reducing the cost of care.

Educational Gaps: This offers actionable insights into how physicians can align payor goals w/ accreditation standards to build a culture of accountability, support transparent data reporting, and sustain measurable improvements in rehab outcomes. Attendees will understand how provider-payor partnerships, and accreditation, enabling population-level impact, and position organizations for value-driven healthcare.

Is this session being sponsored by an ACOEM Section or Component?: No

Has this session previously been presented?: It has been accepted to the American College of Healthcare Executives annual conference in Houston in March 2026.

The AOHC 2026 theme is Healthy workers. Healthy world: Our proposed session supports the AOHC 2026 theme “Healthy workers. Healthy world” by showing how collaborative models in occupational health can achieve broad impact beyond individual patient encounters.

At Pain & Rehabilitative Consultants Medical Group (PRCMG), alignment with the State Compensation Insurance Fund (SCIF) and CARF International created a framework that integrates payer priorities, accreditation standards, and provider practices. This model leverages outcome measurement, patient-reported data, and rigorous quality benchmarks to ensure injured workers receive care that is personalized, efficient, and accountable. By demonstrating measurable improvements in patient satisfaction, functional recovery, and cost reduction, the session highlights how data-driven, patient-centered strategies advance the Triple Aim and strengthen workforce resilience.

The session emphasizes that worker health is not isolated—it directly influences families, organizations, and communities. When injured workers recover more effectively and sustainably, the benefits ripple outward: employers experience improved productivity, families regain stability, and healthcare systems achieve greater equity and efficiency. In this way, strengthening the health of workers contributes to healthier societies, economies, and global well-being.

Finally, this program underscores the importance of collaboration across stakeholders. Payor-provider partnerships and accreditation not only drive value-based care but also foster a culture of continuous improvement and transparency. By aligning incentives and focusing on outcomes, healthcare leaders can scale these strategies across diverse care settings, from medical groups to post-acute rehabilitation.

In essence, our session advances the AOHC theme by illustrating that building healthier systems for workers—through data, accountability, and partnership—creates a foundation for a healthier world.