The Benefits of Telemedicine

Is Telemedicine Actually Impacting Your Workers’ Comp Claims?

Telemedicine has become a 'buzzword' in workers' comp. But is it really cutting costs and creating positive results in claims?
By: | July 18, 2018 • 5 min read
women viewing patient via telemedicine

The idea of receiving precision health care from the comfort of one’s home has only grown since the inception of telemedicine. Though still not widely adopted by the general public, telehealth is making up ground in becoming a viable option for some patients and providers.

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It’s also becoming a more viable option in the workers’ compensation industry, despite regulatory obstacles.

And while telemedicine has become something of a ‘buzzword’ in workers’ comp, many industry professionals are seeing that this practice produces positive results.

Over 550 workers’ comp professionals were surveyed for a Mitchell International Inc. study on telemedicine perception. The results showed that 45 percent of respondents see promise in telemedicine when it comes to cutting costs and impacting the industry. In fact, the U.S. telemedicine market is slated to grow at an annual rate of six percent over the next few years, likely to reach nearly $7 billion in value by 2020.

So exactly how is telemedicine impacting your workers’ comp claims?

More Physicians Are Available

Fewer health care practices are accepting workers’ compensation cases due to the continuously changing health care insurance climates and the pressures a workers’ comp patient might impose. This impacts workers’ comp firsthand as employers attempt to find treating physicians who will work with their needs. Telemedicine acts as a solution.

“The beauty of telemedicine is if a clinician is licensed in the state — they can practice in that whole state and provide care where there may not be any center even open at that time,” said Ann Schnure, vice president of telemed operations, Concentra Telemedicine, and a speaker at the upcoming 2018 National Workers’ Compensation and Disability Conference held Dec. 4 through 7 at the Mandalay Bay in Las Vegas.

While telemedicine has become something of a ‘buzzword’ in workers’ comp, many industry professionals are seeing that this practice holds positive results.

This technology has made it possible for injured workers to be assessed almost immediately after injury. Of course, catastrophic cases and other serious injuries need to be treated hands-on, but minor injuries can easily be diagnosed via video chat and conferencing with a certified physician.

This is a great tool to have in rural areas where the nearest health care facility is miles away. It’s also effective in places where the available physicians specialize in areas outside of the injuries suffered (an example: a burn victim in need of a burns specialist three towns over). Telemedicine taps into the physician network, allowing access to broader health care options.

Removing Transportation Struggles

Transportation is a multi-layer problem, said Schnure.

“It’s not just the cost of transportation but the costs of management around that transportation.”

Some workers might not have any means of transport for starters. Others may take taxis and have the receipts reimbursed. Some carriers and care managers have teamed up with ride-share

Ann Schnure, vice president, Concentra Telemedicine

companies like Lyft to get workers to their appointments, while others have nurse case managers coordinate drivers for the injured workers. But all these transportation costs add up.

“If you have someone who needs transportation on every visit, and say it’s a 20-mile drive around 50 cents per mile — that’s only about $10. But times that by five for multiple appointments, you’re at $50. Now say you have a thousand cases like that; it starts to add up.”

Telemedicine, however, eliminates the need for transportation altogether and encourages injured workers to seek guidance from their providers without leaving home. Check-ups and consultations can happen within minutes using video chat and a telecommunication device, like a smartphone or tablet.

Fewer Missed Appointments

On the other hand, injured workers who can transport themselves to and from their physicians’ offices might find themselves facing time issues. Appointments at a traditional doctor’s office typically coincide with work hours, leaving an injured worker to take paid time off or schedule an appointment before or after work. Taking off work and battling city traffic is not an easy decision for some.

“It’s the number one reason why patients stop following up,” Schnure said. “When they start feeling better, they will skip appointments.”

And missed appointments lead to longer claims.

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“A missed appointment can leave a case open,” said Schnure. “An open case has an opportunity for a person to be in a gray area” if their work restrictions expire and they did not continue with their care. Because if this happens, she explained, it’s up to the employer to decide if the worker can return to their job. If it’s too early in the healing process, the worker might face reinjury and a lengthened claim.

With telemedicine, however, a worker can check in at any time.

“It’s what one of our clients coined as ‘stay-at-work-visits,’ ” added Schnure.

Telemedicine Cuts Overall Costs

Researchers at Community Health Center and the University of Connecticut Health Center found that a telemedicine consult platform specific to cardiology cases saved almost $500 per patient in Medicaid costs over in-person treatments. While this is specific to cardiology, it’s a good indicator that telemedicine is cutting costs across the board.

In workers’ compensation, telemedicine can eliminate the need for emergency room visits (and their expensive bills), cut down on transportation expenditure, provide crisis intervention due to on-the-spot care and more.

Christine Williams, managing director, Worker’s Compensation Center of Excellence, U.S. Casualty Practice, Marsh, wrote in an article that telemedicine “could be the difference between good and bad claims outcomes.”

Williams cited having that instant access to a nurse or doctor as a primary reason telemedicine works to cut costs and get injured workers what they need. This fast-paced, instant ability to connect with a medical professional enables the claim to start out right. Just as quickly as the injury occurs, the worker can be assessed and prescribed the proper care.

“[Telemedicine] is another tool in the workers’ comp toolbox,” said Schnure. “The right injury gets directed to the right level of care. It reduces case duration and engages the employee in their return to work.” &

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at aheisler@lrp.com.

More from Risk & Insurance

More from Risk & Insurance

Risk Scenario

A Recall Nightmare: Food Product Contamination Kills Three Unborn Children

A failure to purchase product contamination insurance results in a crushing blow, not just in dollars but in lives.
By: | October 15, 2018 • 9 min read
Risk Scenarios are created by Risk & Insurance editors along with leading industry partners. The hypothetical, yet realistic stories, showcase emerging risks that can result in significant losses if not properly addressed.

Disclaimer: The events depicted in this scenario are fictitious. Any similarity to any corporation or person, living or dead, is merely coincidental.

PART ONE: THE HEAT IS ON

Reilly Sheehan, the Bethlehem, Pa., plant manager for Shamrock Foods, looks up in annoyance when he hears a tap on his office window.

Reilly has nothing against him, but seeing the face of his assistant plant operator Peter Soto right then is just a case of bad timing.

Sheehan, whose company manufactures ice cream treats for convenience stores and ice cream trucks, just got through digesting an email from his CFO, pushing for more cost cutting, when Soto knocked.

Sheehan gestures impatiently, and Soto steps in with a degree of caution.

“What?” Sheehan says.

“I’m not sure how much of an issue this will be, but I just got some safety reports back and we got a positive swipe for Listeria in one of the Market Streetside refrigeration units.”

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Sheehan gestures again, and Soto shuts the office door.

“How much of a positive?” Sheehan says more quietly.

Soto shrugs.

“I mean it’s not a big hit and that’s the only place we saw it, so, hard to know what to make of it.”

Sheehan looks out to the production floor, more as a way to focus his thoughts than for any other reason.

Sheehan is jammed. It’s April, the time of year when Shamrock begins to ramp up production for the summer season. Shamrock, which operates three plants in the Middle Atlantic, is holding its own at around $240 million in annual sales.

But the pressure is building on Sheehan. In previous cost-cutting measures, Shamrock cut risk management and safety staff.

Now there is this email from the CFO and a possible safety issue. Not much time to think; too much going on.

Sheehan takes just another moment to deliberate: It’s not a heavy hit, and Shamrock hasn’t had a product recall in more than 15 years.

“Okay, thanks for letting me know,” Sheehan says to Soto.

“Do another swipe next week and tell me what you pick up. I bet you twenty bucks there’s nothing in the product. That swipe was nowhere near the production line.”

Soto departs, closing the office door gingerly.

Then Sheehan lingers over his keyboard. He waits. So much pressure; what to do?

“Very well then,” he says to himself, and gets to work crafting an email.

His subject line to the chief risk officer and the company vice president: “Possible safety issue: Positive test for Listeria in one of the refrigeration units.”

That night, Sheehan can’t sleep. Part of Shamrock’s cost-cutting meant that Sheehan has responsibility for environmental, health and safety in addition to his operations responsibilities.

Every possible thing that could bring harmful bacteria into the plant runs through his mind.

Trucks carrying raw eggs, milk and sugar into the plant. The hoses used to shoot the main ingredients into Shamrock’s metal storage vats. On and on it goes…

In his mind’s eye, Sheehan can picture the inside of a refrigeration unit. Ice cream is chilled, never really frozen. He can almost feel the dank chill. Salmonella and Listeria love that kind of environment.

Sheehan tosses and turns. Then another thought occurs to him. He recalls a conversation, just one question at a meeting really, when one of the departed risk management staff brought up the issue of contaminated product insurance.

Sheehan’s memory is hazy, stress shortened, but he can’t remember it being mentioned again. He pushes his memory again, but nothing.

“I don’t need this,” he says to himself through clenched teeth. He punches up his pillow in an effort to find a path to sleep.

PART TWO: STRICKEN FAMILIES

“Toot toot, tuuuuurrrrreeeeeeeeettt!”

The whistles of the three lifeguards at the Bradford Community Pool in Allentown, Pa., go off in unison, two staccato notes, then a dip in pitch, then ratcheting back up together.

For Cheryl Brick, 34, the mother of two and six-months pregnant with a third, that signal for the kids to clear the pool for the adult swim is just part of a typical summer day. Right on cue, her son Henry, 8, and his sister Siobhan, 5, come running back to where she’s set up the family pool camp.

Henry, wet and shivering and reaching for a towel, eyes that big bag.

“Mom, can I?”

And Cheryl knows exactly where he’s going.

“Yes. But this time, can you please bring your mother a mint-chip ice cream bar along with whatever you get for you and Siobhan?”

Henry grabs the money, drops his towel and tears off; Siobhan drops hers just as quickly, not wanting to be left behind.

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“Wait for me!” Siobhan yells as Henry sprints for the ice cream truck parked just outside of the pool entrance.

It’s the dead of night, 3 am, two weeks later when Cheryl, slumbering deeply beside her husband Danny, is pulled from her rest by the sound of Siobhan crying in their bedroom doorway.

“Mom, dad!” says Henry, who is standing, pale and stricken, in the hallway behind Siobhan.

“What?” says Danny, sitting up in bed, but Cheryl’s pregnancy sharpened sense of smell knows the answer.

Siobhan, wailing and shivering, has soiled her pajamas, the victim of a severe case of diarrhea.

“I just barfed is what,” says Henry, who has to turn and run right back to the bathroom.

Cheryl steps out of bed to help Siobhan, but the room spins as she does so.

“Oh God,” she says, feeling the impact of her own attack of nausea.

A quick, grim cleanup and the entire family is off to a walk-up urgent care center.

A bolt of fear runs through Cheryl as the nurse gives her the horrible news.

“Listeriosis,” says the nurse. Sickening for children and adults but potentially fatal for the weak, especially the unborn.

And very sadly, Cheryl loses her third child. Two other mothers in the Middle Atlantic suffer the same fate and dozens more are sickened.

Product recall notices from state regulators and the FDA go out immediately.

Ice cream bars and sandwiches disappear from store coolers and vending machines on corporate campuses. The tinkly sound of “Pop Goes the Weasel” emanating from mobile ice cream vendor trucks falls silent.

Notices of intent to sue hit every link in the supply chain, from dairy cooperatives in New York State to the corporate offices of grocery store chains in Atlanta, Philadelphia and Baltimore.

The three major contract manufacturers that make ice cream bars distributed in the eight states where residents were sickened are shut down, pending a further investigation.

FDA inspectors eventually tie the outbreak to Shamrock.

Evidence exists that a good faith effort was underway internally to determine if any of Shamrock’s products were contaminated. Shamrock had still not produced a positive hit on any of its products when the summer tragedy struck. They just weren’t looking in the right place.

PART THREE: AN INSURANCE TANGLE

Banking on rock-solid relationships with its carrier and brokers, Shamrock, through its attorneys, is able to salvage indemnification on its general liability policy that affords it $20 million to defray the business losses of its retail customers.

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But that one comment from a risk manager that went unheeded many months ago comes back to haunt the company.

All three of Shamrock’s plants were shuttered from August 2017 until March 2018, until the source of the contamination could be run down and the federal and state inspectors were assured the company put into place the necessary protocols to avoid a repeat of the disaster that killed 3 unborn children and sickened dozens more.

Shamrock carried no contaminated product coverage, which is known as product recall coverage outside of the food business. The production shutdown of all three of its plants cost Shamrock $120 million. As a result of the shutdown, Shamrock also lost customers.

The $20 million payout from Shamrock’s general liability policy is welcome and was well-earned by a good history with its carrier and brokers. Without the backstop of contaminated products insurance, though, Shamrock blew a hole in its bottom line that forces the company to change, perhaps forever, the way it does business.

Management has a gun to its head. Two of Shamrock’s plants, including Bethlehem, are permanently shuttered, as the company shrinks in an effort to stave off bankruptcy.

Reilly Sheehan is among those terminated. In the end, he was the wrong person in the wrong place at the wrong time.

Burdened by the guilt, rational or not, over the fatalities and the horrendous damage to Shamrock’s business. Reilly Sheehan is a broken man. Leaning on the compassion of a cousin, he takes a job as a maintenance worker at the Bethlehem sewage treatment plant.

“Maybe I can keep this place clean,” he mutters to himself one night, as he swabs a sewage overflow with a mop in the early morning hours of a dark, cold February.

Bar-Lessons-Learned---Partner's-Content-V1b

Risk & Insurance® partnered with Swiss Re Corporate Solutions to produce this scenario. Below are their recommendations on how to prevent the losses presented in the scenario. This perspective is not an editorial opinion of Risk & Insurance.®.

Shamrock Food’s story is not an isolated incident. Contaminations happen, and when they do they can cause a domino effect of loss and disruption for vendors and suppliers. Without Product Recall Insurance, Shamrock sustained large monetary losses, lost customers and ultimately two of their facilities. While the company’s liability coverage helped with the business losses of their retail customers, the lack of Product Recall and Contamination Insurance left them exposed to a litany of risks.

Risk Managers in the Food & Beverage industry should consider Product Recall Insurance because it can protect your company from:

  • Accidental contamination
  • Malicious product tampering
  • Government recall
  • Product extortion
  • Adverse publicity
  • Intentionally impaired ingredients
  • Product refusal
  • First and third party recall costs

Ultimately, choosing the right partner is key. Finding an insurer who offers comprehensive coverage and claims support will be of the utmost importance should disaster strike. Not only is cover needed to provide balance sheet protection for lost revenues, extra expense, cleaning, disposal, storage and replacing the contaminated products, but coverage should go even further in providing the following additional services:

  • Pre-incident risk mitigation advocacy
  • Incident investigation
  • Brand rehabilitation
  • Third party advisory services

A strong contamination insurance program can fill gaps between other P&C lines, but more importantly it can provide needed risk management resources when companies need them most: during a crisis.



Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at dreynolds@lrp.com.