2015 Teddy Award Winner

Revitalizing the Program

In three years, the Columbus Consolidated Government was able to substantially reduce workers’ compensation claims costs, revamp return-to-work and enhance safety training. 
By: | November 2, 2015 • 7 min read

Anne-Marie Amiel assumed her post at Columbus Consolidated Government in Georgia three years ago, becoming the first risk manager for the consolidated City of Columbus and the County of Muscogee government in over a decade.

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Since then, she and a colleague have been successfully reconfiguring the government’s workers’ compensation, liability claims and safety programs.

Given the short amount of time she’s been working there and her limited resources, it’s uncanny how many accomplishments the first consolidated city-county in Georgia has produced.

Amiel has not only substantially reduced the time spent by employees on leave by revamping the return-to-work program, but she has reduced costs per claim, enhanced the workers’ comp process and begun overhauling safety and training procedures.

The reduced volume of lost-time days experienced by the public entity and its 3,000 employees has been a great benefit to Columbus — in more than just fewer days off the job.

In 2011, the average number of days out of work for government employees was about 109, Amiel said, noting that she took oversight of the program for the entire year in 2013, when the number dropped to 53.

In 2014, the number was 28, nearly half of the 59-day figure projected by the Department of Labor’s National Disability Guidelines for that year, Amiel said.

So how did she do it?

An enhanced return-to-work program for employees with limited capacity played a big role.

“Often the doctor says that an employee can come back to work but cannot do all

Anne-Marie Amiel, risk manager, Columbus Consolidated Government, Georgia

Anne-Marie Amiel, risk manager, Columbus Consolidated Government, Georgia

the essential functions of their job,” said Amiel. ”If someone has a knee injury, for instance, they often can’t be driving heavy equipment but could be driving something smaller.”

Amiel understood that offering light duty to more employees was not only good for the company and its self-insured workers’ comp program, but was also psychologically beneficial to workers.

“If someone is injured and out of work for more than 12 weeks, psychologically they tend to start thinking of themselves as disabled, and it gets to be harder and harder to bring them back to work,” Amiel said.

To make the process more effective, she centralized the return-to-work program instead of leaving it to various government divisions to handle their own employees.

In the past, Amiel said, many of Columbus’ departments would provide only as much light or transitional duty as could be absorbed within their own divisions, meaning that large numbers of employees unable to take on full duties had no choice but to stay at home and collect workers’ compensation checks.

Under Amiel’s supervision, that has changed.

“I have worked with all of our departments to allow their employees to be provided light duty in another department when there is none available in their own.”

One striking example of the new policy resulted in additional monetary benefits to the government.

A police officer who was not able to perform her normal duties was placed in the public works department, where she helped create a database of addresses for Columbus, and identified a cross-referencing system failure with a local utility’s database.

“I have worked with all of our departments to allow their employees to be provided light duty in another department when there is none available in their own.” — Anne-Marie Amiel, risk manager, Columbus Consolidated Government, Georgia

As it turned out, a local water utility was using an outdated address list, meaning that Columbus’ water bill mistakenly included trash collection charges for several new addresses, while Columbus was collecting trash at those locations without pay.

Now able to collect accurate fees for services provided, “the increase in Columbus’ revenue due to that one light-duty assignment between 2013 and 2014 has been approximately $100,000,” Amiel said.

“I am still assigning people from other departments to public works duty to help them with the water department database,” said Amiel.

“Like most employers these days, we have a lot of tasks that need to be completed but insufficient personnel to perform them,” she said. “Utilizing light-duty employees to accomplish these tasks is beneficial to both employer and employee.”

Lower Costs Per Claim

That was only the beginning. Through Amiel’s efforts, the government’s total incurred cost per claim (the sum of medical and indemnity benefits and other incurred costs for all claims, divided by the total number of all claims) has dropped dramatically.

Costs per claim dropped by more than 60 percent over three years, from $9,971 in 2011 to $3,641 in 2014.

After Amiel began exercising oversight of the program, the organization’s total medical costs per indemnity claim dropped from $6,307 in 2011 to $2,014 in 2014. An indemnity claim is paid when the employee is out of work and is receiving the wage benefit from workers’ compensation.

One key step leading to these improvements was a change in Columbus’ third-party administrator and a move to managed care in early 2014. Today, Columbus is using USIS/AmeriSys as its TPA and managed care organization (MCO).

The shift was transformational, said Amiel.

CCG's lost days dropped sharply from 2011 to 2014 — from 109 to 28.

CCG’s lost days dropped sharply from 2011 to 2014 — from 109 to 28.

“Under the old system, the people managing our claims were not medical professionals,” she said. “I really wanted a medical professional who could triage with our employees when they were hurt and help guide them to the correct treatment.”

At AmeriSys, a nurse case manager handles the medical side of all claims — and only Columbus’ claims. That makes a difference, Amiel said.

“With a workforce of over 3,000 employees, we need people who understand our culture and who get to know our employees,” she said.

Also instrumental to Columbus’ improvements was moving away from the state’s so-called “panel system.”

“In Georgia, the law says that if you use that system you need a list of six unique medical providers your employees can tap when they are injured,” Amiel said.

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“The panel needs to include one minority member, for instance, one orthopedic specialist, and one walk-in provider, among others.

“The problem has increasingly become we have larger practices buying out smaller ones so it can be difficult to find six quality providers.”

Managed care acts as an alternative to the panel system for Columbus, she said.

“Under managed care, what happens is the MCO gets approval from the state workers’ comp board for a whole network of providers and we now have access to over 200 providers,” Amiel said.

“Our MCO system provides both 24/7 coverage and medical management of claims, plus a larger network of available medical providers than does the panel system.

“I have visited all of our regular medical providers so that I could make sure they know the city has a ‘face’ and someone on whom they could call if they need more information on an employee or if they want to discuss potential light duty work.”

The new system’s utilization review is also “one of the keys to cost control of injury claims.”

She noted that under the panel system “any dispute brought before the State Board of Workers’ Compensation would essentially have a doctor’s opinion on one side and a professional adjuster’s on the other. If you were a judge, would you not take the opinion of the doctor over the adjuster? I know I would,” she said.

With the MCO system, there is a peer review system at an earlier stage than a court hearing. That peer review can result in medical professionals talking to other medical professionals and coming to a consensus on the appropriate course of treatment.

That works to the benefit of the employee and gives the employer a greater confidence on the treatment plan being implemented, she said.

“When one utilizes an MCO system there is a much more robust peer review system,” Amiel said.

Loss Control Strategies

Since bringing on the new TPA, Amiel said, she has been tracking accident trends and using that information to discuss potential safety improvements to work environments with Columbus’ department heads.

“For instance, we have stepped up employee training and workplace inspections provided to our employees, including different forms of driver training to include not only standard vehicles, but also vans and larger trucks,” she said.

“I have also rewritten our accident review policy to bring it more in line with national standards,” she said. “We have adopted a system that is widely in place nationally, whereby employees are assigned points for various types of at-fault accidents according to the degree of severity.

For example, a trash truck that hit a mailbox would be assigned fewer points than the driver of a city vehicle that hit a stopped car at an intersection.

“Disciplinary actions are given in a progressive manner,” she said.

Among those who are impressed by Amiel’s efforts is Columbus, Ga. Mayor Teresa Tomlinson.

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“We have seen a transformation in our workers’ comp claims system through a more engaged management effort and best practices techniques,” Tomlinson told Risk and Insurance®.

“In three years, we are down from [roughly] $10,000 per claim to $4,000 per claim. That comes from having diligent in-house workers’ comp personnel and a systematic approach to deal with the injuries and claims of our employees expeditiously.

“We are better able to assess their needs and get them healthy and confident to return in just 28 days on average.”

“Of course,” she said, “the best investment we can make for taxpayers is education and training through our safety plan. If the injury never happens, we are all better off and that’s our goal.

“In the event of an injury, our efforts turn to investing in a system that gets our valued employees healthy and safely back to work.”

_______________________________________________________

Read more about all of the 2015 Teddy Award winners:

AA LAX TuesdayRevamped Program Takes Flight: The American Airlines and U.S. Airways merger meant integrating workers’ compensation programs for a massive workforce. The results are stellar.

 

112015_03_stater 150X150Checking Out Solutions: From celebrating safety success to aggressively rooting out fraud and abuse, Stater Bros. Markets is making workers’ comp risk management gains on multiple fronts.

 

112015_04_columbus 150X150Revitalizing the Program: In three years, the Columbus Consolidated Government was able to substantially reduce workers’ compensation claims costs, revamp return-to-work and enhance safety training.

 

112015_05_barnabas 150X150Spreading Success: Barnabas Health wins a Teddy Award for pushing one hospital’s success in workers’ comp systemwide.

 

Janet Aschkenasy is a freelance financial writer based in New York. She can be reached at [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]