Proving program value a must in hard times
Proving program value a must in hard times
Create a business case, demonstrate results
Proving the value of your occupational health programs is always sound business, but it’s essential when money is tight and your job might be the next victim of a cost-containment initiative. The good news is that demonstrating the worth of your programming or creating the business case for new initiatives is not as hard as it may seem.
"We clearly need to demonstrate our worth to management in a very tight business environment," says Deborah V. DiBenedetto, MBA, RN, COHN-S/CM, ABDA, president of DVDiBenedetto & Associates, Ltd., in Yonkers, NY. "At a time when occupational health nurses face the danger of being eliminated, we need to demonstrate the [return on investment] ROI for delivering business-appropriate programs."
Defining business-appropriate
Ensuring that the programs you propose and/or implement are business-appropriate is critical says DiBenedetto, who is also president of the Atlanta-based American Association of Occupational Health Nurses (AAOHN). "For example, case management is a big issue today," she offers. "But let’s say I put in a workers’ comp case management program at a bank where there are very few workers’ comp claims; that program is not going to mean very much. But in a company where there are, say, a lot of ergonomic injuries, it would be very appropriate."
Conversely, she notes, if you offered to put in a hypertension-screening program in a hospital setting where bloodborne pathogens were a key issue, "They’d laugh you out the door." In other words, DiBenedetto says, assessing needs is vital. "The occupational health professional must ask himself or herself what trends and diagnostic drivers have to align in order to reduce costs," she explains. "People can look at as many pie-in-the-sky plans as they want to, but if they’re not appropriate they won’t be successful."
Many areas to address
An occupational health professional looking to demonstrate value, or to show how improved or new programming will save money, can look at a number of different programming areas, says DiBenedetto. These include:
- Examining the total cost of benefit programs. These can include health care, employee assistance programs, work/life programs, short- and long-term disability.
- Examining the cost of risk programs, such as workers’ comp.
- Examining the cost of the occupational health and safety program.
- Examining the cost of absenteeism, or lost productivity in the workplace.
- Examining the cost of return to work programs, such as case management.
- Examining the cost of compliance. These must be segregated out, explains DiBenedetto, because they are required programs.
A key question that must be asked, says DiBenedetto, is the following: "What does the company have to do to be in business, and what does it cost them in terms of workplace productivity to have sick or injured employees?"
By the way; don’t get hung up on who actually provides the program. "When managers look to cut costs, they may decide to contract out some programs," says DiBenedetto. "But I’m not that concerned if the program is delivered on-site or if it’s contracted; there are many contracted programs where a number of occupational health nurses are used. What’s critical is for the company to see that the occ-med program brings value."
For those who are not familiar with the tools that can help quantify program value, DiBenedetto says that AAOHN has a link on the web (www.bizhealthcheck.com) that outlines several such tools. It also provides descriptions of different strategies for reducing costs, and offers six or seven "success stories" as examples.
Speaking of success
In her own consulting business, DiBenedetto herself has produced an impressive roster of success stories. For example, she recalls, a Blue-Cross organization was looking at the value of their occupational health nurse program, in order to justify the investment. "When we went to evaluate the program, we saw that they did a lot of walk-in and clinical evaluations, which were certainly valuable, but they were not used by many workers. The same was true with workers’ comp," she says.
DiBenedetto was able to demonstrate that the program would be more valuable if it added more health education initiatives, such as wellness kiosks. "They put in programs so the employees could do self-assessments and follow-up with the nurses," she explains. "They also charged the nurses with being return-to-work coordinators for program. They became gatekeepers for the insurance company, a very defined role, and were thus able to identify a direct contribution to the bottom line by documenting the number of days they saved because they facilitated employees’ return to work."
This strategy not only helped demonstrate program value, but it significantly improved processes, she notes. "There are so many good programs, but if you go in and evaluate them you always want to improve process," she asserts.
Another assignment involved the assessment of the clinical service delivery of an on-site allergy clinic. "By having the clinic available to employees after business hours, the company avoided a day away from work for each of them to go for shots," DiBenedetto explains. "The cost of having physicians and nurses available and the clinic open were easily justified by saving over $1 million in productivity."
These savings are determined by asking key questions, such as: "What would it take for the employee to seek this service outside of work? What impact would that have on his work? How many times do you have to replace the worker?"
"Little things can add up to a lot of money," says DiBenedetto. "That same company coordinated its travel health program, and saved an average of $2,500 per employee vs. having those employees go outside for medical treatment. It’s really not that hard to quantify lost time, lost productivity vs. direct costs and the need for follow-up."
Value can also be demonstrated in program compliance, notes DiBenedetto. "For example, nurses can coordinate [Family Medical Leave Act] compliance, justifying serious health conditions. This can result in early identification in a mandated program that is usually done by lay employees."
[For more information, contact: Deborah V. DiBenedetto, president, DVDiBenedetto & Associates, Ltd., P.O. Box 738, Yonkers, NY 10710-0738. Telephone: (914) 771-5152. Fax: (914) 771-9833. E-mail: [email protected]. Web: www.dvdandhaag.com.]
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