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Digital Edition2024 Theo Award Winner: Kentucky Association of Counties
The Kentucky Association of Counties Workers’ Compensation Fund (KACo WCF) provides workers’ compensation coverage for county governments and political subdivisions across Kentucky.
KACo WCF struggled with extended lag times in reporting new claims and delays in initial contact with injured workers. This led to increased medical costs and longer workers’ compensation claim durations.
To address these issues, KACo WCF launched a 24/7 nurse triage program designed to provide immediate attention and guidance to injured workers.
Tackling the Problem
While implementing a nurse triage program might sound straightforward for a single organization, the challenge level goes up exponentially when you need to implement it statewide across more than 100 county governments.
“The hardest part was getting the messaging out there to our members across the state,” said Jeremy Head, claims manager for Kentucky Association of Counties. Kentucky has 120 counties, with 117 of them in the program.
“Spreading the message east to west across Kentucky and reaching every county judge, jailer, sheriff, property valuation administrator, county clerk —all the elected officials — and the supervisors who actually report the claims, is always difficult.
KaCO put together a solid marketing program to get the word out about the program’s availability and benefits. As most of us are well aware though, when people have been doing things the same way for quite some time, change is often met with hesitance.
Jeremy Head, claims manager, Kentucky Association of Counties
Buy-in is also harder when the return isn’t visible overnight: “The payoff isn’t immediate because the goal is to reduce the upfront costs of having every injured worker going to the ER. Over time, they see their loss numbers drop and their spend reduced, on top of less lost time. That’s when buy-in grows significantly,” Head said.
As the program got up and rolling, word-of-mouth became the organization’s greatest asset. Counties interact frequently, so when one county had an excellent experience, the neighboring county was more likely to try it, according to Head.
The nurse triage program aimed to reduce new claim reporting lag, expedite initial worker contact, and ensure appropriate medical care from the onset of an injury. By providing round-the-clock nurse availability, KACo WCF sought to enhance employee well-being and create a more supportive work environment.
Key components of the nurse triage program included 24-hour nurse availability for immediate injury assessment and care guidance plus follow-up calls to all injured workers, providing personalized education and support. Effective management strategies and proven managed care organization (MCO) gatekeepers helped focus on optimizing operational efficiency while minimizing disruptions to claimants’ lives.
Success to Build On
The nurse triage program yielded impressive results within its first year of implementation:
KACo WCF achieved a 50% reduction in new claim reporting lag and a 42% decrease in time to first contact with injured workers. This rapid response time ensured that employees received prompt attention and appropriate care.
The program led to a significant 72% reduction in medical bill review costs, directly contributing to lower overall medical expenses. Additionally, workers’ compensation claim open days decreased as well, facilitating faster returns to work for injured employees.
“The standard practice before implementing the nurse triage program was to send all injured employees to the ER, resulting in high average claim costs. … With our program now, roughly 30% of cases are resolved with home care, such as rest, ice, and over-the-counter medication, resulting in no cost,” Head said. “When you consider the potential savings per claim and multiply that by 100 claims per year, that significantly impacts your rates.”
The program also impacts productivity. ER visits can take hours, meaning the employees misses not just the day of the incident, but often the following day, whereas with home care, some workers return the same day.
The significant cost savings combined with the productivity benefits have been key selling points for the program, Head said.
Organization: Kentucky Association of Counties * Location: Frankfort, KY * Category: Government & Public Sector
The implementation of the nurse triage program also resulted in broader health and safety improvements. KACo WCF saw a decrease in OSHA reportable injuries and an increase in incident-only/first-aid claims. There was also a notable reduction in hospital and emergency room visits, with a corresponding rise in the use of urgent care and home care options.
“The Kentucky Association of Counties demonstrated exceptional leadership in addressing the critical issue of managing workplace injuries with their innovative 24/7 nurse triage program,” said Greg Sission, chief claims officer, Charles Taylor.
“This initiative not only significantly reduced claim reporting lag and medical costs but also fostered a supportive environment for injured workers, exemplifying a commitment to employee well-being and operational excellence.
“The strategic implementation of the nurse triage program by KACo is a testament to their dedication to enhancing injury management and employee support,” he said. “By providing immediate attention and guidance through round-the-clock nurse availability, KACo successfully reduced reporting delays and medical expenses, creating a more efficient and caring workplace.”
By providing immediate nurse triage services and follow-up support, KACo created a culture of care and efficiency in managing workplace injuries. The program not only improved injury response times and reduced costs but also established a long-term approach to employee well-being and safety.
“KACo’s 24/7 Nurse Triage program is a game-changer in reducing injury reporting delays and medical costs, exemplifying their commitment to employee well-being,” said Sission. &
The Theo Award celebrates its inaugural year, honoring 31 workers’ compensation programs for their excellence and service to workers across the nation. To learn more about the award and amazing qualities each winner possesses, visit here.
