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Published on Mar 1
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The performance of the healthcare providers that you work with in the course of a workers’ compensation claim contributes significantly to the outcome for your workers. The most successful providers are able to produce positive outcomes for injured employees while helping control indemnity costs and reducing recidivism by developing a course of treatment that fully addresses the injury incurred. With the many options available to workers, employers, and managed care organizations (MCOs), finding the right provider can be more challenging than you may think. While workers in Ohio are free to choose their healthcare provider in a workers’ compensation claim, many employees rely on referrals from their employer or their employers’ MCO. Conducting proper evaluations of potential healthcare providers prior to injuries can help you identify the best healthcare options for injured employees and develop a trusted network of quality medical providers.
Relationships built on trust
When you first begin talking to potential healthcare providers, be sure to do your homework. Be sure to look at their referrals, any history of complaints from disgruntled patients or past partners, and the outcomes for patients and partners. The health of your employees depends on the quality of care they receive after an injury, so be sure to choose healthcare providers that you can trust and depend on. Be clear with providers that the continuation of the relationship always depends on the delivery of high-value services. Talk to physicians about the outcomes that are important for injured workers, your company, the Bureau of Workers’ Compensation (BWC), and your MCO partner. When an injured employee uses the services of a provider you have a relationship with, talk to them about their experience and the quality of care they received. Creating a solid foundation of trust is important to the continued working relationship and constant evaluation allows everyone to know where that relationship stands.
Good communication skills
Communication between all parties is vital in the course of workers’ compensation claims. Be sure that your physician partners understand their role in that chain of dialogue. In addition to timely and accurate reporting of patient progress and courses of treatment, your healthcare partners should also exhibit good listening skills and spend time educating your worker and answering their questions.
Additionally, their staff should provide consistent and timely feedback to the employer, the MCO, and the BWC. Ideally, the physician’s office will designate a staff member as a liaison to handle routine issues, answer general questions, and reach out with important information throughout the duration of treatment and life of the claim.
Evidence-based treatment
The physicians you work with should use an evidence-based approach to diagnostic, treatment, and work disability prevention methods that are shown to be the most effective, safe, and economical. Your healthcare partners should evaluate patients’ progress toward recovery and adjust treatment as necessary to expedite recovery and reduce the number of lost work days for the employee. After every visit, the healthcare provider should provide updated information about work ability to the injured worker and the employer’s MCO partner.
Emphasis on recovery
Your healthcare partners should be as focused on the speedy recovery and return to work of your injured employee as you, your MCO, and the BWC are. Employees who are away from active work for extended periods become less likely to ever return to gainful employment. By identifying return to work, modified duty, or temporary duty options for injured workers, healthcare partners are able to help you limit the number of temporary total disability days on claims and, consequently, lower the overall costs of the claim. Your healthcare partner should also help your injured worker understand that returning to work does not mean that the claim is closed, but rather help them see that it is an essential component of the recovery process.
Look for best practices
When evaluating potential healthcare providers, return to work, controlling indemnity costs, and the overall medical spend costs are among the most important factors to consider. The best healthcare providers work with everyone involved in the claim to ensure the best outcomes for all involved – speedy recovery and return to work for employees, limiting total incurred expenses for the employer and MCO, and keeping the duration of the claim and TTD days in check. When you work with an MCO partner, like Sheakley UniComp, you can be sure that your injured workers have access to a network of the highest quality workers’ compensation healthcare providers to ensure the best outcomes for your injured workers.
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