Abstract: A system and method are provided for determining a composition of a service provider network for providing services according to a workers' compensation insurance plan. The system and method acquires claim information, which describes workers' compensation claims and medical service providers, and determines a metric value for each of the medical service providers, adjusts the metric values, assigns scores based on the adjusted metric values, determines an average of the assigned scores, and generates results data based on the assigned scores. The results data indicates, for each of the medical service providers, whether the medical service provider should be included in the service provider network. The service provider metrics include a metric that relates to an amount paid per claim and a percentage of claims that involved lost time.

Abstract: A system and method are provided for determining a composition of a service provider network for providing services according to a workers' compensation insurance plan. The system and method acquires claim information, which describes workers' compensation claims and medical service providers, and determines a metric value for each of the medical service providers, adjusts the metric values, assigns scores based on the adjusted metric values, determines an average of the assigned scores, and generates results data based on the assigned scores. The results data indicates, for each of the medical service providers, whether the medical service provider should be included in the service provider network. The service provider metrics include a metric that relates to an amount paid per claim and a percentage of claims that involved lost time.

Abstract: Disclosed herein are technologies that may be used to determine the composition of service provider networks. Service providers may be compared based on a number of metrics related to the services they provide. As an example, medical service providers may be compared based on factors such as how quickly patients in their care recover from injuries, and how satisfied patients are with the care they receive. A service provider network may be defined as including only service providers with metrics that meet a given threshold. In the context of workers' compensation insurance, the disclosed technologies may be used to direct injured workers to medical service providers that provide superior care, thereby achieving better outcomes for injured workers.