What to Look for in Your Workforce Health Provider
In this webinar, you will learn about
- Why your workforce health provider matters
- The five characteristics of a quality workforce health provider
- How occupational medicine compares to urgent care or the emergency department
Joy Hamilton, MD, MBA
Director of Medical Operations, Concentra
Hello, everyone, and welcome to the Concentra® webinar, What to Look for in Your Workforce Health Provider. Today’s webinar will be presented by Dr. Joy Hamilton. Dr. Hamilton is director of medical operations for Concentra® medical centers in Georgia. She is board certified in physical medicine and rehabilitation, and she has extensive experience in working with employers to develop quality workforce health programs.
At the conclusion of the presentation, we will have a 10-to-15 minute Q-and-A session with Dr. Hamilton. You can submit your questions throughout the presentation to be answered during the Q and A. She will answer as many questions as possible within the time allowed. A recording of the webinar will be e-mailed to you after the presentation, as well as a copy of the slides, so you can view it again at your convenience.
Dr. Hamilton, we're ready to begin.
Dr. Joy Hamilton
Thank you very much. I appreciate everybody taking the time to join us, and I hope we have a great discussion. Please text in your questions so that we can discuss them at the end. So, we'll start with our first slide, our agenda. We're going to go over why your workforce health provider matters and the five characteristics of a quality workforce health provider. We will spend a great amount of time talking about those characteristics. Then, we'll follow up with occupational medicine versus urgent care or the emergency department, and the different benefits of using one versus the other. Again, we'll have time at the end for questions and answers.
Why Your Workforce Health Provider Matters
We want to keep patients’ lives as normal as possible during recovery while establishing treatments that allow for the fastest possible return to work. That’s the highest goal of a workforce health program. We're going to be talking about how your workforce health provider will help you prevent needless work disability, as well as all the different things that you should expect to see so that you can be sure that this is going to happen.
In a national survey about their management of workers’ compensation cases, 90 percent of the surveyed doctors said that fewer than 10 percent of the injured workers they treated needed to be off for medical reasons. And yet, U.S. Bureau of Labor Statistics’ data shows that about 25 percent of workers’ compensation cases nationally involve lost workdays. There is a costly gap between what is and what ideally could be.
A great little book called A Physician's Guide to Return to Work by Dr. Mark Melhorn noted that 60 to 80 percent of lost workdays involve medically unnecessary time off work. These days off are either discretionary or clearly unnecessary. The most common reason physicians gave for putting patients off work was an unwillingness to “force the reluctant patient back to work.” Other reasons included being ill-equipped to determine the right work restrictions, feeling caught between an employer's and an employee's version of events, and employers being unable or sometimes unwilling to provide modified duties.
The Five Characteristics of a Quality Workforce Health Provider
Now let’s turn to the five characteristics of a quality workforce health provider. We've established how important it is to work with a quality workforce health provider and what that means for your workforce, but how do you identify a quality workforce health provider? With so many options available – from urgent care clinics to emergency departments, and hospitals, and occupational medicine – how do you find the right ones?
In this next section, we will go over five characteristics to look for in a workforce health provider, including:
- Employer engagement
- Employee engagement
- Clear communication
- Quality medical outcomes
- Workforce health
As a leader in occupational medicine since 1979, Concentra has developed this list of characteristics based on our treatment of more than 18 million occupational injuries and the current state of industry practices, as identified by third-party experts. These guidelines will help your organization identify an effective provider who can help you maximize productivity and significantly lower health costs.
These five characteristics, as noted, are all critical for the success of any workforce health program. Each of the five characteristics can be broken out into a variety of sub-characteristics. For the sake of simplicity, we're only going to focus on just three of each of the five characteristics.
As you might expect from the name, employer engagement has to do with how your workforce health provider engages and collaborates with you to ensure that you get the best possible outcomes for your business and your workforce. There are times when every participant in the workers’ compensation system reports feeling powerless and as if someone else seems to be in charge. But, in fact, employees and employers have the most direct power to determine the outcome of potential injury- or health-related employment disruption. They each make discretionary decisions about how to respond to the situation. Employers decide how to manage the employee situation – either actively or passively, collaboratively or with hostility – all are possibilities. And they decide whether to provide on-the-job recovery (modified duty).
Your workforce health provider can help with this by helping you maintain compliance with regulations, providing ongoing occupational health training and tools, and, finally, by visiting your worksite to see where your employees work to better understand what they do.
So, theoretically, at least, the patient, the physician, and the employer have the same goal: To maximize restoration of function with the least pain.
Reaching an understanding of the process of returning to work should be easy, however, the reality can be all too different. There are a lot of stakeholders involved in return-to-work decisions: Doctors, therapists, workplace supervisors, human resources and return-to-work coordinators, claims handlers, benefits administrators, union stewards, lawyers, adjudicators, case managers, consultants, state-specific workers' compensation systems. All of these are just the most obvious. Because all these people don't always realize or act as if they are on the same team, the results can be far from ideal.
In many doctors' offices across the country, physicians have too little information to make good return-to-work decisions. If the employer and the physician's office have not shared information beforehand, and the employer doesn't send any information about functional job requirements, their stay-at-work or return-to-work program and their commitment to it, the employee-as-patient may be the physician’s only source of information. The information they provide may or may not be accurate. This is why your workforce health provider should work with you to get accurate information about your workers' compensation program when you first discuss working together. That kind of outreach and knowledge will help keep everyone on the same page and ensure that your provider knows enough about your workplace to understand the patient's job demands. Do this before you even send in your first injury.
An excellent way to do this is by inviting your provider’s clinicians to visit your workplace so they can see your employees at work. Seeing your employees at work gives your provider’s clinicians a better understanding of what they do and what accommodations can or should be made in the case of a work injury. The clinicians can then help you with developing the right work injury care process and return-to-work plan for your workforce.
In addition to visiting your workplace and seeing your employees at work, your provider should offer ongoing occupational health training and tools to help you make the most of your workforce health program. This can include education about occupational health, automated tools, onboarding keys to help you get set up, and even employee education materials on the benefits of return to work.
Some employees may misunderstand an emphasis on return to work if it is not communicated well; that is, they may interpret it to mean their employer does not care about their health and recovery. This can be further exacerbated by the fears that come up after an injury.
There is a small percentage of employees who will try their hardest to get better, no matter how they are treated by their employer or doctor. And there is a small group that has their own agenda and will not cooperate no matter how they are treated. But most employees can go either way, depending on how they feel they are being treated. If they feel their employer cares about them, they are more apt to put in the effort needed to facilitate recovery. Similarly, if they feel their physician understands and cares about them, if they trust that clinician and believe he knows what is going on with them, they’re more apt to comply with the treatment plan and advisement on activity level.
Some individuals are near the end of their resilience in coping skills when they are injured. The demands of the work injury exceed their ability to cope. Getting these individuals the extra support they need early on to cope with the situation is critical to getting them on the road to functional recovery and off the road to chronic pain. Knowing how to identify these individuals and talk to them about why staying active and returning to work has a positive impact on recovery, self-image, and relationships after injury are critical skills for your workforce health provider.
Talking to employees about the benefits of return to work is just one of the ways that your workforce health providers should engage your employees. Just like employers, employees have a significant amount of power to determine the outcome of a potential injury- or health-related employment disruption. They decide how much effort to make to get well and get life back to normal. How their employer engages with them is critical. But equally important is your workforce health provider – not just how they engage with your employees, but how easy they make it for your employees to get care they need, when they need it.
Free transportation is an obvious way to make care easy to access for injured employees. Another way is keeping the necessary services, such as physical therapy, x-rays, labs, and the like, at one location so the employee doesn't have to worry about visiting multiple providers. The injured employee has only one place to go for all the visits associated with the injury. Often, workforce health providers will even call or text employees to remind them of follow-up visits. This takes away the pressure of managing multiple appointments, providers and schedules and lets employees focus on getting better.
A little earlier, we covered how critical it is that your workforce health provider’s clinicians know how to talk to employees about their recovery and the importance of staying active and engaged throughout their treatment. This approach is employee-centric, meaning that the clinicians aren't only addressing the injured employee’s physical health, but also the social and psychological effects of getting injured on the job and returning to work. When these conversations are handled well by the clinician, they result in a positive employee experience and high employee satisfaction. Your workforce health provider should track employee satisfaction to ensure a positive employee experience.
Much of what we've covered in employee engagement and employer engagement has emphasized the importance of communication, so why highlight it as a separate characteristic? The answer is because while communication is vital in every step of the return-to-work process and workforce health program, there is a difference between the collaborative communication between employer and clinician and clinician and employee. Clear communication also is important for the other parties involved in a workers' compensation case, including workers' compensation carriers.
You'll note that clear communication is in the very middle of the five characteristics, and that's not by accident. Automated communications, outcomes reporting, and good payor relationships are critical, both to employer and employee engagement, and to the last two characteristics – quality medical outcomes and workforce health. So clear communication should start with automation and a structured communication plan that ensures everyone with a part in the workers' compensation process stays informed every step of the way. When everyone is in the know, everything goes more smoothly. Payors can more quickly complete treatment authorizations, enabling employees to get care and return to work sooner.
But keeping everyone in the loop isn't just about a structured communication plan. It's also having access to the treating clinician so you can discuss your employee’s treatment plan, referrals, and functional job descriptions to ensure that your clinician has the information needed to make appropriate return-to-work or stay-at-work recommendations.
Finally, clear communication should also include reporting and employee engagement. Your workforce health provider should be able to report out on injury trends, recordable injuries, and utilization to show how your business compares with others in your industry and how things change over time. Reporting on utilization can also show you how effective your employee engagement has been and if employees are getting care with when they need it. Your provider should be able to give you educational messaging that supports employee engagement and encourages them to get care and follow your injury care process when hurt on the job.
Quality Medical Outcomes
We've talked about why employers and employees have the most direct power to determine the outcome of potential injury- or health-related employment disruption. They each make discretionary decisions about how to respond to the situation. Clinicians primarily influence the situation by providing factual information and advice that either encourages and supports staying at work, returning to work or, in some cases – but not at Concentra! – discouraging and obstructing efforts to return the patient to work in the mistaken belief that, by doing so, they are being “an advocate for the patient.”
Multiple studies have shown how returning to work and staying active after injury can benefit employees, and it's critical that your workforce health provider takes this approach with your employees when providing care. Their treatment guidelines should be focused on early intervention or enabling the employee to get treatment as soon as possible and activity to encourage that return to work mindset. Faster return to work leads to positive medical outcomes, but the clinician engaging directly with the employee or patient to encourage them in their recovery and explain why returning to work benefits them is also a key driver.
As mentioned before, employees play a large role in their own recovery. How much of a positive impact they play relies on the employee feeling satisfied with their care and their employer. Both the knowledge of the treating clinician and the employer's own approach to employee recovery are critical to driving positive outcomes.
Medical expert panels – or groups of clinicians within your provider's organization who are focused on a specific topic – are an excellent way to ensure ongoing clinical education. To maintain clinical knowledge, your workforce health provider should encourage and require ongoing clinical education and occupational medicine. This will ensure clinicians are up-to-date on regulations and best practices and help drive quality medical outcomes. Ongoing education also bolsters regulatory expertise, which is especially important in workforce health. With the Occupational Health and Safety Administration, the Federal Motor Carrier Safety Administration, the Department of Transportation and more regulating work injury and workplace safety, you need your workforce provider to know and understand the regulations and how they apply to your workforce.
As with clear communication, you may wonder why Concentra would call out workforce health as a key characteristic of quality workforce health provider. After all, workforce health is right there in the name. Doesn't that pretty much cover it? Just like clear communication, certain aspects of being a workforce health provider are so important that they do deserve to be pulled out and emphasized. In today's presentation, I will cover COVID-19, occupational exposure screenings, and preventive care.
Vaccine administration and exposure screenings are critical to workforce health, especially relevant for maintaining regulatory compliance. After COVID-19, these services have taken on an additional level of importance: Ensuring your employees are safe on the job. Whether through random drug tests, personal protective equipment, respirator fit testing, specialized physicals or COVID-19 testing, taking steps to keep employees safe on the job is more important today than ever. Services like medical surveillance can help you maintain regulatory compliance and protect your employees to ensure a safe, productive workplace.
In addition to screenings and testing, your workforce health provider should help you with workplace injury prevention and worker health protection. This can come in several forms, but the most well-known are workplace risk assessments, which can tie in with the clinician visiting your worksite that we talked about in employee engagement, and injury prevention programs and training, including ergonomics. Your provider’s clinicians should take a hands-on, consultative approach to educating and training your employees on how to be safe on the job and protect themselves from injury.
Occupational Medicine vs. Urgent Care or the Emergency Department
Now that we've covered the five characteristics of a quality workforce health provider, where can you find one? Urgent care clinics and hospital emergency departments are quick and convenient, but do they provide the services required to demonstrate the five characteristics of a quality workforce health provider? Or is more specialized care needed?
Occupational medicine is designed for workforce health. Occupational medicine providers are more likely to provide the services required to demonstrate the five characteristics of a quality workforce health provider. Let’s use Concentra as an example and compare what the company – an occupational health provider – offers versus what most urgent care clinics and emergency departments deliver.
Looking at employer engagement, we can see that only occupational medicine providers, like Concentra, offer what we covered earlier in the presentation. Emergency departments are intended for emergencies and a limited interaction window. Urgent care typically doesn't offer occupational health training or the expertise needed to help employers maintain regulatory compliance.
When it comes to onsite evaluations, most urgent care and emergency department clinicians would be out of place. Again, their interaction with the employee is typically limited and not intended as a long-term workforce health program.
When we look at employee engagement, again, your workforce health provider offers injured employees maybe free transportation to and from the medical centers, calls the employees for injury care follow-ups, and encourages injured employees to actively participate in their own recovery. In most cases, those three offerings are not available in the emergency department, and possibly only calling employees or patients for injury care follow ups may be offered at an urgent care setting.
In clear communication, we discussed providing automated communications regarding the case status, offering quarterly reporting to measure injury outcomes, and ensuring payors have required information to quickly complete treatment authorizations. Those programs and processes are most definitely not established in an emergency department because that is not their focus and their care. And most urgent care situations would not have these things set up, as well, because, again, they are just focusing on short-term or acute injuries and not focusing on the establishment of a relationship with the employer or the employee.
Quality medical outcomes: Utilizing an early intervention, and an outcomes-focused medical care philosophy, maintaining medical expert panels that update clinical protocols continuously for optimal care and licensed healthcare professionals, and providing a written medical opinion post-exam are definitely all characteristics in a workforce health provider scenario. Emergency departments, because they do have to stay up-to-date with current medical treatment and technology, may have medical expert panels available. And because they do have to give written statements about the acute care that was given, they may be able to provide written medical opinions post-exam. But urgent care center scenarios don't usually have that. Again, they're not focusing on the work-related injuries, just that acute episode.
Workforce health: Conduct COVID-19 return-to-work assessments and testing services, administering vaccines series, screenings for occupational exposures, and offering workplace injury prevention and worker health protection definitely will be provided by a quality workforce health provider. As for emergency departments, that is not their scope or focus. An urgent care setting may administer vaccine series because they will do that for the general public. They will be able to help with screenings for possible occupational exposures, but again, not always in every urgent care setting. That is not always a focus, but it definitely is at a workforce health provider.
So, when you look at the five keys, you'll see that Concentra, a workforce health provider, does provide all of those and many things more. Urgent care and emergency departments only provide two of the many characteristics that we have discussed.