In October, Risk & Insurance caught up with Tammy Bradly, a senior director of clinical product marketing for Enlyte. What follows is a transcript of that discussion, edited for length and clarity.

Risk & Insurance: Thanks for meeting with us Tammy. What are your primary goals and focus areas for 2025, particularly in terms of leveraging AI in clinical services?

Tammy Bradly: In my role, I handle product marketing for all our clinical services, including case management, utilization review, and our nurse triage program. This involves creating marketing collateral, refining messaging, and collaborating closely with our product development team.

For 2025, our main focus is understanding how AI can be integrated into our clinical services. As a company that directly engages with injured employees, we aim to explore how AI can assist our case managers, freeing up their time for more face-to-face or telephonic contact with the injured employees.

My goal is to be an influencer within our team, providing insights and recommendations based on my previous experience in clinical product development. By leveraging AI, we hope to enhance our clinical services, allowing our case managers to dedicate more time and attention to the individuals they serve.

R&I: What trends are you observing in the consideration of mental health in the workers’ compensation industry, and how do you predict mental health will become a more prominent topic in the future?

TB: Mental health is indeed gaining more attention in the workers’ compensation industry.  We delved into this topic in our National Comp session, “Breaking Barriers in Behavioral Health: Time to Listen, Time to Act.” I can share some insights from our perspective at Enlyte.

We are observing a growing recognition of the impact of mental health on overall employee well-being and recovery outcomes. Mental health conditions, such as depression and anxiety, can significantly influence an injured employee’s ability to return to work and achieve a full recovery.

As the industry becomes more aware of these connections, we predict that mental health will increasingly be integrated into the holistic care approach for injured employees. This may involve more comprehensive screening for mental health concerns, improved access to mental health services, and a greater emphasis on psychosocial factors in return-to-work planning.

Additionally, we anticipate that there will be more research and data analysis focused on understanding the prevalence and impact of mental health conditions in the workers’ compensation population. This research will likely drive the development of evidence-based practices and interventions tailored to the unique needs of injured employees.

Overall, the consideration of mental health in workers’ compensation is a positive trend that has the potential to improve outcomes for injured employees and reduce the long-term costs associated with complex claims. As an industry, we must continue to prioritize and address the mental health needs of the workforce.

R&I: What is the prevalence of mental health issues in workers’ compensation claims, and how does Enlyte address these issues?

TB: Our analytics team, led by Jim Harris, VP of analytics and reporting, conducted a study of over 1.5 billion bills across all of our integrated companies to determine the prevalence of mental health issues in workers’ compensation cases. We found that approximately 4.1 percent of all claims, including both medical-only and lost-time claims, had either a mental health payment or a mental health diagnosis attached.

At Enlyte, we have been passionate about addressing mental health issues in workers’ compensation for a long time. In 2012, while I was in product development, we created a training program for our clinical staff that is still in use today. We recognized that there are numerous non-medical barriers, including mental health, which can delay recovery.

Our case managers are trained to use skills such as active listening and cognitive behavioral coaching to support injured employees. While not every injured employee has a mental health illness or diagnosis, they all need support. By being an advocate for them, we often provide the necessary support to help them overcome barriers and recover promptly.

However, our case managers are also trained to recognize when an additional level of care, such as professional counseling, is needed. We partner with our clients, including carriers, TPAs, and employers, to address these issues, as attitudes towards mental health vary within the industry.

Some of our clientshave programs in place where we can roundtable and immediately refer employees to resources to deal with their mental health issues when we recognize a problem. Overall, we strive to be proactive in identifying and addressing mental health concerns to ensure the best possible outcomes for injured employees.

R&I: What steps can responsible employers take to address the mental health of their employees, especially given the sensitivity surrounding this topic?

TB: Employers can do a lot to address mental health before a claim even occurs. Mental health should be part of their risk management strategy, and risk management should partner with Human Resources to ensure the availability of services like Employee Assistance Programs (EAP) and quality mental health care providers in their network. Mentally healthy employees are less likely to experience an injury in the first place.

After an injury, employers may fear that addressing mental health will lead to endless treatment with no way to manage it. However, treatment guidelines like ODG are available for mental health diagnoses, just as they are for physical injuries. These guidelines provide guidance on appropriate treatment and expected recovery timelines.

By managing mental health treatment according to these guidelines, employers can effectively address their employees’ needs without unnecessarily prolonging treatment. The real concern for employers is not a lack of desire to help their employees, but rather the fear of opening Pandora’s box and dealing with preexisting mental health issues that may not be directly related to the on-the-job injury.

R&I: What are some signs that should prompt an early intervention for an injured worker?

TB: Early intervention is crucial when working with injured employees. There are several signs that experienced professionals look out for to initiate timely support.

One key indicator is the severity of the injury itself. More severe injuries often require prompt intervention to ensure the employee receives appropriate medical care and to manage potential complications.

Another factor is the employee’s response to the injury. If they exhibit signs of emotional distress, such as anxiety or depression, early intervention can help address these concerns and prevent them from hindering recovery.

Additionally, if there are indications that the employee may face challenges in returning to work, such as physical limitations or job-related barriers, early intervention can be instrumental in developing a comprehensive return-to-work plan.

By recognizing these signs and initiating early intervention, professionals can optimize the injured employee’s recovery process and improve overall outcomes.

R&I: What are some ways employers can improve their ability to intervene when an injury occurs, especially if they lack experience in this area?

TB: When an injury occurs, employers should work closely with their third-party administrator (TPA) or carrier that’s managing the claim, particularly with the adjuster and any clinical resources assigned to the file. The clinical resource is likely to be the one to identify potential issues.

At Enlyte, we’re leveraging data to recognize trends and alert our case managers when there may be a problem. As part of our early intervention strategy, we use our risk modeling tool to  identify claims that don’t have a clinical resource and assign one as early as possible. The goal is to prevent long-term, complex problems down the road by intervening early.

R&I: What strategies are proving effective at improving return to work outcomes, especially in relation to the psychosocial aspect of recovery?

TB: Several companies specialize in various approaches, such as virtual reality therapy or limited counseling programs, to address the psychosocial aspect of recovery. Most of these companies in the industry have developed structured packages, like a 12-week program that begins with an assessment.

Our clients, which include carriers and TPAs and employers are exploring these different options and partnering with these specialized companies. When our clinical staff, or the staff of our clients, identify a concern , they can refer the individual to one of these companies that specialize in addressing the psychosocial aspects of recovery.

R&I: What success stories have you observed in the industry that other groups should learn from and emulate?

TB: One notable success story is a carrier client   who has truly embraced the concept of assessing the total person, not just the injury, which aligns with my strong beliefs.

By leveraging their own data, this carrier  has helped identify claims that may have a chance of developing chronic pain syndrome or mental health issues. Beyond identification, they have  also implemented clear processes and programs to address these potential issues.

While many people in the industry are discussing this approach, they are at various stages of actually implementing it. This carrier’s  work stands out as a prime example of turning talk into action and making a real difference.

R&I: What advice would you offer to someone struggling to get buy-in from their team on a particular initiative?

TB: Getting buy-in starts with convincing the team why the initiative is important. It’s crucial to clearly communicate the rationale behind the project.

Once the team understands the significance, the focus should shift to training and equipping them with the necessary resources. For example, case management staff can be trained on active listening and identifying when an injured employee needs additional support. The same training principles can be applied to adjusters.

Ultimately, securing buy-in is about helping the team feel comfortable and confident in their ability to contribute to the initiative’s success. This is achieved through effective communication, training, and resource allocation.

R&I: What areas of the industry do you believe are underperforming, and how could they improve?

TB: I believe that many in the industry are still trailing behind, but hopefully, this will change. People are struggling because they want to see results first. They hear about various programs but want to see tangible outcomes before embracing them.

I think that once they start seeing objective results from these programs, they may be more willing to adopt them. Seeing the concrete benefits will likely encourage more widespread acceptance and implementation of these initiatives across the industry.

R&I: What are the cost benefits of early intervention, based on the data you have?

TB: Early intervention can lead to significant cost savings in workers’ compensation claims. Our data shows that when we engage with injured employees early in the claims process, we can help them access appropriate medical care and return to work more quickly.

This not only benefits the employee but also reduces overall claim costs. By addressing issues promptly and proactively, we can prevent minor injuries from escalating into more serious and expensive problems.

Furthermore, early intervention allows us to build trust and rapport with the injured employee. This open communication helps ensure they receive the support they need throughout their recovery, which can further contribute to cost containment.

R&I: How does Enlyte’s early intervention program, which uses a risk model, benefit clients and save them money?

TB: Our early intervention program, which utilizes our own risk model, has proven to be highly beneficial for our clients. When we onboard a new early intervention client, daily claim are scored by our risk model,  determine whether case management should be applied in that early intervention model.

Clients who adopt this best practice risk model in conjunction with our early intervention program save a substantial amount of money. We have observed a reduction in disability durations by 59 days in our early intervention program. Furthermore, these claims experience less litigation.

The key lies in providing support to the injured employee early on in the process. When they feel well taken care of, they are less likely to seek legal representation. Having someone guide them along the way proves to be immensely valuable.

R&I: What is the importance of advocacy and support in the context of injured employees, particularly those who may lack a strong support system at home?

TB: Advocacy and support are crucial, as it is sometimes all that people need, especially considering that many individuals lack a strong support system at home. One of the key issues we focus on is social determinants of health, which encompass factors such as living conditions, access to transportation, clean housing, healthy food, and a support network.

Unfortunately, many people lack these essential elements. That’s where we step in, focusing on being that support and advocacy for the individual. It’s a critical aspect of what we do.

A great example of this is one of our Heart of Case Management Award winners, who worked with an injured ice carver. The employee accidentally amputated three fingers, and while two were successfully reattached, she faced significant challenges as a single mother with limited support.

The case manager stepped in, assuring the injured employee that they would focus on her recovery and be with her every step of the way, offering the support she lacked from family members. Ultimately, the case manager helped the employee return to work in a better position with the same company, demonstrating the vital role of advocacy and support in the recovery process. &