In a small business, having just one employee miss work often has a great impact on overall efficiency and production. When this occurs due to an injury on the job, costs incurred from medical care and lost time can be as unpredictable as the injury itself. When employers are spending increasingly large amounts on workers' compensation, integrating workers' compensation with managed health care makes good sense.
Studies show that managed care integration reduces the ultimate cost of workers' compensation by 25 to 49 percent over traditional fee-for-service systems. With an integrated approach to medical care and claims handling, employers also benefit from increased communication regarding work injuries and decreases in lost productivity. And litigation rates tend to be lower overall.
Through an integrated workers' compensation system, an employee who becomes injured on the job receives treatment from physicians and other health care professionals who are specially trained and experienced in occupational care. Claim misclassification and the tendency for providers to over-treat work-related injuries are greatly reduced through the process, as opposed to a non-integrated approach that allows injured employees to visit any physician for treatment. Throughout the U.S., intense interest exists among policy makers and insurers to use managed care to control medical and related disability cost inflation in workers' compensation. According to John Ireland, the occupational health business line manager at the Kaiser Permanente Medical Care Program, "One approach that is working in California is the State Compensation Insurance Fund-Kaiser Permanente Alliance program. It is offered by State Fund and features Kaiser Permanente occupational medicine professionals who provide medical care for work-related injuries."
With the Alliance, occupational medicine physicians, physical and occupational therapists, rehabilitation specialists and other health care professionals work together to speed employee recovery. These teams work closely with the State Fund claims adjusters and return-to-work coordinators to assure proper treatment and foster early return to work for valued employees.
In an independent study, Ernst & Young analyzed treatment patterns on both Alliance and non-Alliance workers' compensation claims over a nine-monthperiod. Within the first stages, the Alliance program reduced costs in all areas of medical service. The length of employee disability was also reduced from an average of 63.9 days to only 42.2 days.
"The Alliance is providing quality care to injured workers faster and at less cost to their employers. It exemplifies State Fund's leadership in bringing beneficial change to California's workers' compensation insurance system," reports State Fund Vice President Arnis Tubelis.
Additional services such as injury prevention services, pre-placement examinations, immunizations, screening programs, ergonomic consulting and health education can help reduce the potential for occupational injury and illness. Be sure to ask your health care provider if it offers these services when considering integrated health care and workers' compensation medical care for your employees. Kaiser Permanente has more than 70 convenient occupational medicine facilities in California.
To learn more about the program, you may call 1-888-KOJ-WORK. To discuss small business health plan needs, call your broker or 1-800-730-4661.
Excerpted with permission from Small Business Success magazine, Volume XI, produced by Pacific Bell Directory in partnership with the U.S. Small Business Administration and the Partners for Small Business Excellence.