Stretching dollars through partnerships
Case managers, PT, safety officers can help
In health care every dollar spent must be justified in some way. Hospital occupational health departments and clinics might find this to be especially true since they are considered non-revenue producing departments.
One effective strategy for enhancing the department’s return on investment is to partner with other organizations and other departments within a health system, says Barb Maxwell, RN, MHA, COHN-S, CCM, FAAOHN, division director of company care in occupational health services at HCA — West Florida Division in St. Petersburg, FL.
"When you can control costs on workers’ compensation claims it will affect the organization’s bottom line," Maxwell says.
Partnerships that bring important services to employee health’s mission will help with costs containment, she adds.
This isn’t the same as outsourcing occupational health services, she notes.
"If organizations start outsourcing to other companies to perform occupational health services then senior teams must understand there’s a cost for administration of the program, along with the full time equivalents they want to outsource for," Maxwell explains.
Instead, occupational health departments should develop a plan that outlines each service the department provides and see if there are in-house or community partners that could provide value for any of these additional services.
For example, vocational case management services could be provided by a partner.
"Vocational case management is one of our partners," Maxwell says. "They bring value, job searches, knowledge of transferrable skill sets, and they actually do an assessment on the injured worker."
Vocational case managers also confirm labor market opportunities and look for suitable job placement, she says.
"Another partner we utilize are the safety officers," she adds.
"The value they bring is they do the thorough accident investigations, the follow-through for corrective action, providing trending data," Maxwell says. "And they can collaborate with the medical case manager and link case management services with prevention activities."
Other partnerships are intuitive and might be expected to occur naturally, although that’s not always the case. For instance, injured employee’s managers or supervisors can be on the employee health team.
"We educate them on their role in handling that injured worker’s medical plan of treatment," Maxwell says. "We tell them how important it is to stay in contact with the injured employee and bring the employee back to a transitional duty program, which transitions the person from the injury phase to getting back physically to the way they were."
Senior hospital leaders also play a role in partnering with employee health.
The case managers are the hub of the employee health department when it comes to managing workers’ compensation claims, Maxwell notes.
"We look to them to do appointments with the authority level of your injury coordinators and to provide adequate resources," she says.
"They support monthly allocation reports that are delivered to our senior teams," Maxwell adds. "I hold all my occupational health nurses responsible for managing their monthly allocation reports, entailing how many lost-time days and restrictive/transitional duty time they monitor."
Maxwell offers these additional tips on how to develop effective partnerships:
Make use of free partners: In-house medical case management, supervisors, and safety officers are examples of partners that could help at no charge to employee health. Others, such as vocational case management might come at a contracted cost, but the price likely would be less than if a case manager were hired to work fulltime on staff.
Health care systems also could contract with insurers to provide these services, Maxwell notes.
Various hospitals have physical therapists (PT) on staff, and PT services also could be available at an affordable rate.
Identify weaknesses: Conduct an opportunity analysis, looking at strengths, weaknesses, and opportunities for enhancing employee health services, Maxwell suggests.
"If a service is outsourced, how do we provide continuity? Will it impact employee morale?" she adds. "These are things you can’t put a dollar to, and this is a fluid type of process that needs to be re-examined constantly."
Consider partnerships in light of all aspects of care: Injured or ill employees might need a variety of services, including psychosocial and ergonomic, Maxwell says.
"Is there symptom magnification?" she says. "Whenever there’s a reduction in the workforce, people end up with no job, and [may be tempted] to claim a workers’ compensation than to have no income at all."
Physical therapists can assist with ergonomic issues, and the health system’s legal department might be needed for any claims reviews, she adds.