The jargon and terminology surrounding health care, insurance, workers' compensation, and workplace injuries can get more than a little confusing. Add abbreviations for every term plus the complex terminology of state laws, workplace policies, contracts, and regulations, and the system seems too complicated even to scratch the surface of understanding it.
One of the most common questions workers ask that does have an easy answer is this: “What's the difference between the Bureau of Workers' Compensation and Managed Care Organizations?”
The Ohio Bureau of Workers' Compensation
The Ohio Bureau of Workers' Compensation plays a critical role in ensuring Ohio's workers receive adequate care and compensation when injured. Quoting the organization's mission statement:[1]
“The Bureau of Workers' Compensation (BWC) underwrites insurance coverage for work-related injuries and illnesses for public and private sector employers conducting business in Ohio and oversees the workers' compensation programs for self-insured employers (primarily Ohio's largest companies). BWC also assists employers and employees in creating and maintaining a safe work environment. The bureau manages all medical and lost-time claims, initiates coverage, and determines premium rates and manual classifications.”
This organization is one of an employee's main points of contact in the event of a workplace injury because it is the organization in charge of helping injured workers and employers cope with workplace injuries.
Managed Care Organizations
While a state's bureau of workers' compensation will be a government-run institution operating within that state, a Managed Care Organization (MCO) is an independent group designed to reduce the cost of providing health care to Americans. An HMO insurance policy is a good example of a Managed Care Organization. An HMO health care plan closely manages the customer's care, only providing coverage at certain in-network health providers but also reducing customer costs.[2]
As a general rule, MCOs manage provider networks where patients can seek medical care. Such networks agree to certain standards and costs while also providing customers with more affordable healthcare. An MCO is generally a health plan or a health insurance company that liaisons directly with health care providers to provide low-cost care options for customers.
Knowing Your Rights, Responsibilities, and Recourse
When faced with a workplace injury, the last thing you want is to be confronted with a confusing health care and compensation network that makes it difficult to understand your rights. Don't try to navigate your workers' compensation claim alone. Contact NRS Injury Law, Ohio's largest workers' compensation law firm and the state's leading injury practice. Call 855.977.6670 for more information.
Sources:
[1] BWC. "Workers' Compensation." Ohio Bureau of Workers' Compensation, 2022. ohio.gov
[2] Medicaid "Managed Care." Medicaid.gov, 2022. medicaid.gov
