Focus on Change: Advancing Workers’ Compensation Medical Management and Access to Care
Posted on 10.26.15
The 2015 Medical Directors Meeting combined frank and insightful discussions, new data on results in medical management and indemnity costs, and ideas for continuing to improve the system’s efficiency and patient outcomes.
“I always look forward to our annual meeting because I get the opportunity to connect with some of the most forward-thinking individuals in the workers’ compensation industry,” reflected Gregory Moore, MPH, Senior Vice President of Innovation for One Call Care Management.
“This year, we took a deep dive into how we can accelerate the rapid rate of change in our industry for better outcomes and a more positive experience for injured workers. Harbor Health Systems’ mission is to maximize the impact of top-performing physicians. However, it’s not enough to find out who the best doctors are; we also have to get the injured worker to them successfully through programs like our Care Concierge service. As we improve the experience of the injured worker, we’re seeing not only lower costs but also a decrease in indemnity costs related to litigation.”
During the event, Moore provided proprietary Harbor data showing lowered medical costs across all claims in the Harbor MPN network by 7.7 percent. Moore also noted indemnity related costs were reduced, achieving:
- 12.5 percent lower indemnity costs.
- 11.2 percent fewer indemnity claims.
- 12.5 percent fewer days off work.
David North, President and CEO of Sedgwick Claims Management Services, Inc., noted in his keynote speech that “We should be identifying the medical providers who produce the best outcomes for injured workers and incentivize these physicians to treat our workers by compensating providers fairly. When we find these superior physicians, we need to get out of their way and let them practice medicine. Workers’ compensation cannot evolve if we are unwilling to take risks and become innovators. If we are not the agents of change for the workers’ compensation industry, then change will not happen.”
Speakers at the conference included:
- Greg Moore, MPH, Senior Vice President of Innovation for One Call Care Management, addressed the current state of the California workers’ compensation system as well as the status of the Medical Provider Network (MPN).
- David North, President and CEO, Sedgwick CMS, spoke about the need for innovation in medical management for injured workers, and making access to the healthcare and disability system easier for injured workers. He recommended closely examining the changing healthcare delivery system in order to anticipate and design the next steps needed in workers’ compensation.
- Theodore Blatt, M.D., FAAOS, Medical Director, Harbor Health Systems, spoke about best practices for physicians in the workers’ compensation system, how outcomes-based networks are changing workers’ compensation and key objective measures of claim outcomes.
- John Robinton, M.D., Medical Director of Neurodiagnostics, One Call Care Management, shared best practices in neurodiagnostic studies to ensure accurate test results to guide workers’ compensation care decisions.
Agents of change identified in workers’ compensation include the advancement of technology to improve timely access to best providers and regulatory initiatives like California’s SB 863 which is helping to improve access and efficiency, reduce costs and lower the administrative burdens for payers.
To learn more about how Harbor Health Systems can help lower claims costs for your organization, contact us today at (949) 273-7020.