Managing Workplace Safety and Health

Managing Workplace Safety and Healthy

Managed care initiatives are becoming increasingly popular as cost control strategies for managing work-related injuries in the workers' compensation system. A comprehensive “managed” occupational health program was implemented at a large hospital in an effort to reduce workers' compensation costs. The present study compared a “managed care” treatment approach to “traditional care” for workplace injuries and illnesses among 1300 total and part time employees. Significant differences in claim costs, lost-time frequency, and total lost-time days were observed.

The “managed” occupational health treatment approach substantially reduced medical and indemnity costs of workplace injuries and illnesses. The average claim cost for the “traditional care” group was $4,580 compared to $664 for the “managed care” group. The “traditional care” group was 15 times more likely to result in a lost-time injury claim and averaged 4.13 days per lost-time claim compared to the “managed” care group with 1.21 days. Additionally, claim costs and lost-time frequency comparisons were made to other hospitals within the state as well as national affiliates. The hospital utilizing the “managed care” model demonstrated substantial savings in overall claim costs and fewer incidences of lost-time injuries (Nelson, 1996).

A patient satisfaction survey was also mailed to participants in the managed care group. Results of the patient satisfaction survey found that participants were satisfied with the quality of care. It was concluded that significant cost savings are achievable without compromising patient satisfaction when a “managed” occupational health program is implemented in the workers' compensation system for healthcare workers. Managing care for healthcare workers poses a significant challenge. These employees have detailed knowledge about health care, ready access to treatment, and little prior exposure to managed care, all of which leads to high utilization rates and soaring benefits costs. Traditionally, hospitals have not had many managed care controls in place.

The traditional injury treatment approach to workers' compensation is an “unmanaged” system in which insurance carriers and employers assume a passive role leaving decisions as to the appropriate type, frequency, and cost of treatment up to the health care provider. Within this traditional approach, as depicted in the Figure, the coordination of care is left to the medical provider and/or the patient. The assumption has been that health care interventions facilitate recovery, return function, and return the employee to work. Instead, fragmented services and poorly coordinated care leave injured workers lost in a maze of the ...