It's a changing world in the workers' compensation arena. The Affordable Care Act is transforming the health care industry. Opioid use and abuse is a national epidemic that can impact workers' comp outcomes. And rising medical costs often create incentives to move non-work-related conditions into the workers' comp space.
In nearly 38 years of medicine, I have never seen a time with more change at such a pace, and with so many external factors impacting the care of injured employees.
[Dr. Will Gaines on current trends affecting workers compensation and why effective claims management is so important.]
Amid these trends, how can employers control workers' compensation costs and ensure their employees receive appropriate care and effectively return to work? By partnering with a knowledgeable insurance company that understands the evolving workers' comp market and how these changes can affect the care of injured workers and claims costs.
Here are six areas to consider when selecting your workers' compensation partner to help ensure that even in a changing environment, your company and employees are getting the best possible outcomes.
Preventing injuries
Employers should look for an insurer with a long history of understanding, independently researching, and successfully preventing workplace injuries. What's also critical is the insurer's ability to translate that knowledge into practice through risk control professionals and services that help employers to identify and implement steps to improve workplace safety. As a first step, the insurer can help an employer understand the top reasons employees get hurt and specific ways to keep them safe.
Early and accurate information
When workplace injuries do occur, it's critical to gather accurate information about the injury as soon as possible. Sometimes, a medical provider will classify an injury as work-related based solely on conversations with the injured worker. An insurer with the medical and industry expertise to initiate meaningful discussions with the primary treating physician and employer can offer an objective review of the work situation and help the provider make a valid causation assessment using an evidence-based approach.
[Key ways an insurer can control workers compensation costs and deliver better outcomes]
Matching injuries with providers
In states where employers are able to direct care, a knowledgeable insurer can match employers with medical providers that specialize in work-related injuries and ensure that jurisdictionally appropriate work injury treatment guidelines are followed. An insurer that knows how to leverage data and analytics can evaluate medical providers, identify those that deliver the best outcomes, build networks of the most effective providers, and tailor those networks to a worker's home or work location.
Return to work
A strong insurance partner will have a good understanding of the employer's operation and industry to help injured employees return to work. For example, the insurer can help employers identify temporary jobs for injured workers, make medical providers aware of opportunities for injured employees to return to work in less physically demanding roles, and help identify and address medical or social conditions that could delay an injured worker's recovery.
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