the 10 essential elements

The 10essential elementsof an occupational medicine program

Introduction

Each year, the costs associated with work-related injuries and disabilities impact company bottom lines. In 2013 alone, there were 3 million non-fatal workplace injuries and illnesses reported in the U.S.1 A cost-efficient, outcomes-driven occupational medicine program can reduce costs by keeping your employees healthy and your workplace safe, but not all programs are created equal.

Without an effective occupational medicine program:

• Workforce productivity goes down• Cost of care goes up• Cases go on longer• Lost-duty days increase• Employees settle for non-occupational clinicians for treatment• Reporting information is inadequate• Medically unnecessary disability cases increase

This article presents 10 essential elements to consider as you look for an occupational medicine provider, covering employer engagement, patient experience, clear communications, and clinical expertise. As a leader in occupational medicine since 1979, Concentra has developed this list based on the treatment of more than 180 million occupational injuries and the current state of industry practices as identified by third-party experts. Together, these guidelines will help your organization identify an effective provider, maximize productivity, and significantly lower health care costs.

1 Bureau of Labor and Statistics. Employer-Related Workplace Injury and Illness Summary. Accessed June 30, 2015.

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1. Established injury care processes.

Work-related injuries come with complicated regulations and requirements that can make getting your employees the care they need frustrating and confusing. An established injury care process prepares you and your workforce for work-related injuries before they even occur, so that when they do, you have a process already in place to quickly get your employee on the road to recovery. You’ll know who needs to be involved—whether that’s your risk department, human resources, insurance payor, or employee supervisor—and everyone involved will know what they need to do and how to do it quickly and efficiently.

Your occupational medicine provider should work with you to help you understand what’s involved and develop proactive plans for getting injured employees back to work and life quickly.

Questions to Ask When Selecting a Provider:

• Do you provide a standard injurymanagement process?

• Would you be able to help me developreturn-to-work policies?

• How do you track case closure andlost time?

• Do you coordinate referrals when myemployee has to see a specialist?

Established treatment plans

focused on continued activity, modified duty,

and return-to-work

Patient interviews so that you can learn

and eliminate the cause of the injury

An assessment of each injury and its urgency

Coordination of specialist referrals

when appropriate to drive recovery

A Good Injury Care Process Should Include:

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Most occupational medicine programs will provide a facility tour so that you can meet clinicians and see where your employees will be treated and how the care process works. An optimal program will take this a step further by integrating clinician involvement at every level.

In these programs2, clinicians will be actively engaged with employers so there’s an open, continuous dialogue between employer and occupational medicine experts—resulting in timely stay-at-work and return-to-work decisions. Just as importantly, clinicians will familiarize themselves with individual workplace conditions so they can create practical, effective employee treatment plans and identify ways to improve worksite safety and prevent injury.

2. Clinician relationships.


• Are your clinicians familiar with differentclients’ worksites?

• Will I be working directly with theclinicians treating my employees?

• Do you provide medical consultingservices?

2 As permitted by state law

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Likelihood of Employees Returning to Work Following a Job-related Injury

Source: Bureau of Labor Statistics

50%

3 months

20%

6 months

1%1 year

Time Away from Work

Like

lihoo

d to

Ret

urn

to W

ork

0%

10%

60%

40%

50%

30%

20%

Your employees can be reluctant to return to work after an injury. For some, there may be a psychological concern that they will be injured again or that working will increase the pain of injury. Others may view injury as an opportunity to avoid working and extend disability. These employees are often unaware that returning to work benefits them not only professionally, but also personally. Staying active and returning to work creates a positive impact on self-image, relationships with family and friends, and even speeds up recovery.

Occupational medicine clinicians are trained to treat injured employees as industrial athletes, helping them get back on the job—and in the game—as soon as appropriate. They should educate employees on the benefits of return to work and also address potential psychological or social challenges that may be delaying recovery. This speeds recovery and increases the rate of treatment plan completion, reducing medically unnecessary disability and overall lost-duty days.

3. Employee education on the benefitsof return-to-work.


• How do you encourage employees toreturn to work?

• What is your average case duration?

• How do you communicate the injurycare process to employees?

Long-term Absences Impact Physical, Mental, and Social Well-being

Source: Waddell G, Burton AK (2006) Is Work Good for Your Health and Well-Being? London: TSO.

A 2006 study found that a long-term absence from normal routines, including work, can severely impact your health, equivalent to smoking 10 packs of cigarettes a day and a 20% increased risk of death.

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4. A great patient experience.

When you go to the doctor, you want it to be as quick and painless as possible. Whether you’re visiting your primary care clinician or an occupational medicine clinician, a convenient, welcoming experience can be the deciding factor in whether or not you continue treatment. In occupational medicine, this can mean the difference between patient disability and quick functional restoration.

A good clinician will treat patients with empathy and respect. A great one will take all aspects of their well-being—physical, social, psychological—into account when guiding them through recovery. Education on return-to-work, empathetic and welcoming patient care, and open discussion between clinician and patient result in quicker recovery and return-to-work transitions.


• Can I tour your facility so that I can seewhere my employees will be treated?

• Some of my employees have concernsabout returning to work after an injury.How do you help address them?

• Do you perform patient surveys?What is your typical score?

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A healthy mind, body, and attitude are all part of patient recovery.

We’re all busy. The more inconvenient a task or errand is, the more likely we are to find reasons to not do it. When it comes to patient treatment and recovery, convenience plays a large part in determining whether or not patients complete their treatment plans. It’s especially important to employees, who may have to leave during working hours to get the care they need.

A good occupational medicine program will make it as easy as possible for patients to get the care they need when and where they need it. They may have locations in industrial or commercial areas, near the employee’s workplace, or offer extended night and weekend hours. A prime program will take it a step further by providing multiple services at a single location—creating a “one-stop shop” experience for employees that saves time and money and eliminates the need to travel between multiple providers. A single facility also makes it easier for employers to quickly obtain authorizations from their insurance payor, making the entire care process faster and more effective.

5. One facility for multiple services.


• Can my employees get specialist careand occupational medicine in the samesystem, or will they need to travel toanother facility?

• What are your hours?

• Do you provide physical therapy?

• Do you provide DOT exams, OSHAsurveillance exams, and otherspecialized examinations?

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A one-stop shop experience makes it easy for employees to stick with treatment plans.

6. A structured communications process.

Occupational medicine is complex and can be confusing to employers and employees alike. Because so many people have to be involved, keeping everyone informed on the status of an injury is essential—but managing communications can be challenging, especially for organizations with a dispersed workforce.

Because of this, well-managed communications and reporting are integral to a successful occupational medicine program. A provider should communicate patient treatment status with all key stakeholders—whether employer, payor, employee, or fellow clinicians—and provide you with the information you need to drive engagement and program support, as well as the tools to run your business. Just as importantly, employers should have open access to the treating clinician (as allowed by state law) so that you can ask questions and discuss return-to-work strategies.


• Will I be able to easily get in contactwith the treating clinician?

• How are employers involved indeveloping return-to-work strategies?

• What type of electronic or digitalcommunications do you provide?

• Can I manage my account online?

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Communication is key to a successful occupational medicine program.

7. Clinical informatics and reporting.

Clinical informatics provides medical leaders with a way to review industry-specific medical outcomes and practice patterns so that clinicians can continuously improve their practice. In occupational medicine, clinical informatics systems enable reporting on outcomes so that employers can compare their outcomes to national benchmarks.

Put simply: it’s your doctor’s report card. Are they following best practices when performing injury care? Clinical informatics and reporting help answer this question for medical leadership—and provide employers with the information you need to know that your provider is doing well.

When it comes to your occupational medicine provider, you should have the assurance that they use clinical informatics to drive accountability with their clinicians. Just as importantly, your provider should give you regular reports on utilization and outcomes so that you know that your program is effective and your employees’ clinicians are following industry best practices.


• How often do I get utilization reports?

• What should I expect to see in my reports?

• Can I view my reports online?

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You should be able to compare your outcomes with national benchmarks.

8. Clinical expertise.

Occupational medicine providers treat employees not only as patients, but also as industrial athletes. They focus on treatment plans that get injured employees back in the game—and at work—as soon as appropriate. Because of this, an occupational medicine program should be focused on early intervention, a treatment philosophy that considers treating an injury right away to be the best way to drive recovery. Early intervention also addresses the physical, psychological, and social challenges that may impact productivity and increase cost of care by addressing potential roadblocks with employees immediately.

Clinicians who are trained in occupational medicine diagnose and treat work-related injuries and illnesses much more effectively. A good occupational medicine provider should require clinicians to go through extensive training in occupational medicine to ensure quality care for work-related injuries. A deep understanding of OSHA, DOT, and FAA guidelines should also be required so that clinicians can efficiently determine treatment plans and perform regulatory examinations.


• Are your clinicians trained inoccupational medicine?

• What percentage of cases includesoff-duty days?

• How do your clinicians stayup-to-date on industry trends?

Early Intervention Returns Employees to Work Sooner

Source: Early workplace intervention for employees with musculoskeletal-related absenteeism: a prospective controlled intervention study. Journal of Occupational & Environmental Medicine 2003;45(5):499-506.

144 days sick leave with early

intervention

198 days sick leave without early intervention

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It seems simple: if you have a question about your employees’ care, you should be able to pick up the phone and talk to the treating clinician. Yet for many providers, connecting employer and clinician can require round after round of calendar roulette—and in the end, the house always wins.

An effective occupational medicine program should prioritize clinician involvement and collaboration with the employer to the extent permitted by law. Effective return-to-work plans, functional job descriptions, capacity examinations, and ergonomic evaluations require collaboration between employer and clinician or physical therapist. When employer and clinician and physical therapist collaborate on return-to-work plans, employees recover more quickly.

It’s just good business. As the employer, you should be able to connect with the treating clinician so that you can ask questions about your employees’ care and increase your understanding and comfort level with return-to-work plans. Maintaining clear communication among clinicians, patient, employer, insurance payor, and everyone else involved drives good decisions on patient treatment and how and when to return to work.

9. Easily accessible clinicians.


• If my employee needs specialist care,will I be able to talk to the specialistif I have questions?

• How can I get in contact with thetreating clinician?

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The best return-to-work plans come from collaboration between clinician and employer.

10. Quality medical outcomes.

Successful occupational medicine programs are built upon thorough, accurate data and objective insights regarding where your outcomes are today and where they need to be. Your occupational medicine provider should be able to give you verifiable data on program utilization, return-to-work, patient satisfaction, and clinical outcomes for your workforce so that you can know if the program is having an impact. You should be able to see what your statistical outcomes look like by center, state, and nationally. Just as importantly, they should automatically provide you with reporting comparing your data to national benchmarks so that you can measure how your workforce is doing and what may need to change.

But ultimately, the best measure for a quality outcome is seen through a timely and effective employee return-to-work program that does exactly that. Is your employee back to function in a limited amount of time, following the proper amount of medical care and treatment that allowed for healing and participation in the process? Did the limited amount of down time and quick case closure help to reduce the cost of claim and limit the financial impact to your business? Were you aware of what was happening throughout the process and your employee also kept informed and engaged? More valuable than any report or statistic is a quality outcome by all vested parties. It’s also known as a job well done — and something Concentra has been doing consistently for the past 35 years.


• Are your clinicians required to completeoccupational medicine training?

• How do you report on outcomes?

• If I have multiple work locations, willyou offer the data I need to compareoutcomes between locations andagainst national benchmarks?

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1

Concentra average cost per claimNon-Concentra average cost per claim

$6,205 $4,159

0%

10%

30%

20%

Non-Concentra lost-time claims Concentra lost time claims

Reduced Average Claim Cost

Fewer Average Lost Time Claims

Aggressive process management of cases yeilds better outcomes. Concentra’s ability to reduce lost time cases and shortening case duration results in lower total case costs. Concentra saves an average of 44 days per case duration.

reduction 233%

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1 Validation study of 2.1M occupational injury cases from 2009 through 2011. (Excludes catastrophic cases.) 2 Primary care KPI for services provided within Concentra clinics.

Conclusion

As you look for an occupational medicine program, make sure that you’re considering the essential elements required for success. Without them, workforce productivity goes down, cost of care goes up, cases take longer, off-duty days increase, and profits drop. Settling for non-occupational medicine specialists for employee treatment and workers’ compensation cases often results in inadequate reporting information and an increased in medically unnecessary disability. An effective occupational medicine program or provider will be able to demonstrate all 10 essential elements that you need to keep your workforce healthy and productive now and in the years to come.

About Concentra

Concentra is a national health care company focused on improving the health of America’s workers, one patient at a time. Through its affiliated clinicians, the company provides occupational medicine, urgent care, physical therapy, and wellness services from more than 520 retail and work-site facilities in 44 states. Through this complement of services, Concentra intends to raise the standard of health by putting individuals first, treating them with clinical excellence, and focusing on their ongoing well-being. To learn more about Concentra, visit www.concentra.com.

Contact an Expert

Talk to us if you have questions about your current occupational medicine program, need to discuss how to get a new one, or just want to understand best practices.

i ,ii Many states have laws regulating the manner and extent of communication regarding patient care. Concentra strives to provide the fullest communication under applicable laws to maximize employer information while protecting patients’ rights. The communications as described here may be altered to adhere to these laws.

13©2019 Concentra®. All rights reserved. 11/15

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