Disease management a 'fit' for workers' comp
Disease management a 'fit' for workers' comp
Early identification limits long-term costs
The same characteristics that have made disease management strategies so successful in health promotion can be equally effective in workers' compensation, say experts. As in health promotion, the ultimate benefit would be the prevention of high-cost "complications."
The main difference, of course, is that workers' compensation does not address "diseases," per se. "On the 'comp' side, it's not really a disease, but an injury that occurs that's a long-term, high-dollar situation," explains Barb Robinette, MPH, vice president of marketing for CCN, a San Diego-based health care management company. "We're talking about work-related back injuries, knee injuries, carpal tunnel [syndrome] - things that tend to go on and on."
"Our thought is that because on the comp side you can have disease management programs that start pre-injury, like safety and awareness programs for employees to help prevent injuries, you have a better opportunity to avoid chronic, high-dollar cases."
A fit on two levels
Lissa Smith, MA, national accounts executive with Richmond, VA-based Health Management Corp., says a disease management approach to workers' compensation makes sense on two levels. "First, you know there are key components to a successful disease management program that can be adapted to workers' comp," she says. These include:
· Early identification and assessment: Identifying the physical demands of the job and whether the employee meets those demands.
· A strong education component: if you can teach someone to better perform their job by using various techniques, you can proactively attack workers' comp.
· Compliance: You have to do more than just tell an employee he needs to wear safety glasses while performing certain tasks; you must do all you can to make sure he actually wears them. (For more keys to a successful workers' comp disease management program, see the box below.)
"There's also a possibility of trying to link chronic diseases to workers' comp," adds Smith. "If you can lessen the severity of diabetes, or arthritis, does that lead to lower workers' comp costs? Here, functionality is the key. If, for example, I have arthritis, and my range of motion reduced or the amount of weight I can carry is restricted, the chances are perhaps greater that I may be injured."
Several advantages cited
Robinette says that the disease management approach offers several advantages on the workers' comp side. "It's easier to implement," she says. "As a managed care company working with carriers and employers, we can begin early identification/notification programs at the start of the renewal period. Then, as soon as an injury occurs, you are notified. Right then you make the determination as to whether this injury should be handled through the disease management process. In a group insurance environment, the employee may decide go to a doctor, 30 days later you get the bill, and the employee is already in the midst of the care process."
In addition, she says, the disease management approach may lead to more appropriate treatment and better outcomes. "Plus, the sooner you become involved with an injured person, and show them they have someone who cares about their care and their case, you can help avoid litigation and care from inappropriate provider types. The employee gets better medical care, they return to maximum productivity at work, and through that the employer realizes improved cost savings."
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