News Briefs
News Briefs
Why UM might not save money
Are you really saving money from utilization management of worker’s compensation cases? Only if you focus your UM on care that is costly and has a higher than average denial rate, according to a study published in the Journal of Occupa-tional and Environmental Medicine.1
Researchers at the University of Washington in Seattle analyzed almost 12,000 workers’ compensation cases and found that only 2% to 3% are denied overall — and many of those denials are later reversed.
Some procedures had markedly higher denial rates, such as spinal surgery (5.5%) and carpal tunnel syndrome (8.6%). In some cases, the UM program required a procedure to be performed on an outpatient basis. For example, one in three patients reviewed for hernia repair or arthroscopy were directed to an outpatient setting.
The study suggests employers target efforts on those procedures that have a higher rate of unnecessary use. It found that UM reviews of spinal surgery with and without fusion produced savings of almost $2 million, or 37.4% of the total cost savings. Rehabilitation care ($268,000 or 6.2%) and carpal tunnel release ($212,200 or 4.9%) accounted for the next greatest savings.
Reference
1. Wickizer TM, Lessler D, Franklin G. Controlling workers’ compensation medical care use and costs through utilization management. JOEM 1999; 41:625-631.
Heart attack video available
"When Seconds Count," a 30-minute educational video that emphasizes the importance of early symptom recognition, quick action, and quality of care in heart attack survival, is now available to Chicago-area employers through the CCN/EPIQual Healthcare Program’s "Wellness Works" program.
First aired on local cable channels, the video has also been used by the city of Portage, IN, to raise heart attack awareness. The city adopted the project after city clerk-treasurer Felix Kimbrough and firefighters Tim Sosby and Mike Brown attended the video’s premiere, hosted by Genentech Inc., the Chicago Business Group on Health, and CCN/EPIQual.
Attendees were given promotional packets to take back to their work sites to encourage employees to watch the program.
"When we learned that the City of Portage was outside of the viewing area, we decided to bring this important message to our community," Kimbrough explains.
For more information, contact: Terry Merryman, CCN, 5251 Viewridge Court, San Diego, CA 92123. Telephone: (858) 654-2202. Web site: www.ccnusa. com.
NIOSH provides needlestick alert
The National Institute for Occupational Safety and Health (NIOSH) has published an alert, "Preventing Needlestick Injuries in Health Care Settings." This is the first document by a federal agency to provide broad guidance and assistance to employers, workers, and others in reducing needlestick injuries.
Some 600,000 to 800,000 occupational needlestick injuries occur every year, exposing workers to the risk of serious and potentially fatal infections from HIV, hepatitis B and C, and other bloodborne diseases.
NIOSH recommends that the use of needles be eliminated where possible, where safe and effective alternatives are not available, and that devices with safety features, such as shields and sheaths, be used.
The NIOSH alert is available on the NIOSH Web page: www.cdc.gov/niosh/2000-108.html. Additional copies can be obtained by calling NIOSH at (800) 356-4674. For additional information, contact: Fred Blosser, NIOSH Public Affairs Office, 200 Independence Ave. S.W., Washington, DC 20201. Telephone: (202) 260-8519.
DaimlerChrysler/UAW garners awards
The DaimlerChrysler/UAW national wellness program received six more Well Workplace Gold Awards last November, pushing its record-setting total to 29 during the last two years.
The Wellness Councils of America’s Gold Award, considered one of the most prestigious in the worksite health promotion industry, recognizes DaimlerChrysler/UAW’s commitment to developing and implementing comprehensive health promotion into the fabric of their organizations.
The StayWell Company in San Bruno, CA, is the health promotion management partner with DaimlerChrysler and the UAW at 25 of the 29 Gold Award sites, and two of the six 1999 winners are managed by StayWell. "Winning six more Gold Awards is further proof of DaimlerChrysler’s and the UAW’s continued commitment toward improving the health and well-being of their employees," notes David Anderson, vice president of programs and services at StayWell.
For more information, contact: The StayWell Company, 1100 Grundy Lane, San Bruno, CA 94066-3030. Telephone: (800) 333-3032.
Weight loss study planned
Houston-based Baylor College of Medicine has joined several institutions in a nine-year, nationwide "Study of Health Outcomes of Weight Loss." Researchers are seeking to obtain long- term evidence that weight loss actually results in health benefits, and to determine if interventions designed to produce sustained weight loss will improve the health of obese individuals with Type 2 diabetes.
"We know that being heavy is a problem. However, we need to know if lowering weight decreases the chances of dying and increases health," says John Foreyt, MD, a professor of medicine at Baylor and the study’s principal investigator. "We have short-term data that says yes, but not long-term data."
The study, funded by the National Institutes of Health, will enroll 6,000 individuals nationwide. Baylor will enroll 400 participants next year. Individuals will receive counseling and drug intervention to lose weight and maintain it throughout the study.
For more information, contact: Angela Mendoza, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. Telephone: (713) 798-4712. E-mail: [email protected].
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