What is an HCO?

The HCO is a comprehensive managed care program for work related illnesses and injuries covered under workers’ compensation insurance. The HCO must meet all state requirements and standards, and be certified by the California Division of Workers’ Compensation.

Self-insured employers and insurers may contract with an HCO to provide medical and disability management services to injured workers. HCOs must include a comprehensive health care delivery system, including:

Assignment of primary treating physician
Consultation and referral
Inpatient hospital care
Emergency services, diagnostic facilities, home health services
Quality assurance and medical case management system
Return to work coordination
Consultation on health and safety
Enrollment
Data reporting