2014 NWCDC

Focusing on Results

Selecting a network of the best medical providers can result in reduced costs and better medical results for workers.
By: | November 20, 2014 • 3 min read

Partnering with medical providers that deliver top quality care leads to better results for workers while lowering claims, treatment duration, indemnity costs and incidents of permanent partial disability, according to presenters at an “Improving Claims Outcomes Using Outcomes-Based Networks” session, presented at the 2014 National Workers’ Compensation and Disability Management Conference & Expo in Las Vegas.

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“It has helped us by driving our costs down,” said Randy Triplett, manager, workers’ compensation & IDM, The Goodyear Tire & Rubber Co., who was joined on the panel by Jane Ish, national networks manager, commercial insurance, Liberty Mutual Insurance.

Instead of focusing on weeding out “bad” medical providers, it’s better to focus on attracting a medical eco-system with the best physicians, hospitals and groups, said Ish.

“We are looking to attract honey instead of vinegar,” she said.

“Physician evaluation is key to creating our networks,” she said, noting that partnering with claims and medical management professionals to get information on physicians is crucial. “We need to understand what his tools are, what his referral patterns are.”

It is not a simple task, however, she said. Sometimes, there is not enough claims data to support selection into a network and sometimes geographic limitations – such as a lack of providers or facilities – can hamper creation of an effective OBN.

But the results are impressive, said Triplett. His company’s North Carolina plant saw a 64 percent reduction in lost work days, while Goodyear’s top six plants saw a 33 percent decrease in lost work days.

In putting its network together, Goodyear needed to persuade unionized workers, who by contract have the right to choose their physicians. The company’s focus on safety and its mantra of “the right treatment at the right time” helped convince workers, he said.

“It’s taken more than seven years working hard to build confidence that what we are trying to do is in their best interests,” he said.

Even in states where the company cannot direct the care of injured workers, the employees will often ask the company for physician referrals.

“We have been a paternalistic company for our entire existence. … Our associates expect the best from us,” Triplett said.

“Any time there is a positive interaction between a network provider and an associate, it builds a stronger relationship,” he said.

Orthopedic injuries – shoulder, knee and back “in that order” – are the top employee issues, he said.

The company has onsite medical facilities staffed by physician assistants, nurse practitioners and, for two or three days a week, doctors. Initial examinations are nearly always held at the plants, Triplett said.

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The company also invites all outside medical staff to tour the facilities once a year to create a better understanding of the business and locations.

When employees are released to return to work, Goodyear puts the employees through a process of “work hardening” to ensure they are ready for full duty, he said.

One hospital group recently made the RTW transition easier by releasing injured workers to onsite physicians when they believed they were ready to return to work, he said.

“It allows us to manage that last part of that care and get our associates back to work. It’s all about outcomes and finding networks and physicians that will work with you to return your associates to work,” he said.

The late Anne Freedman is former managing editor of Risk & Insurance. Comments or questions about this article can be addressed to [email protected]

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]