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Proactive Return to Work ARC`s - Safety And Health Council Of
FROM PRE-EMPLOYMENT TO RTW: UNDERSTANDING THE CONTINUUM OF CARE 2016 SAFECONEXPO Jeff Weeks, OTR/L, CEAS Chief Operations Officer ARC Physical Therapy+ JEFF WEEKS, OTR/L, CEAS • OT for 23 years. • Industrial Rehab for 14 years with a • • • • • • focus on Industry and RTW. COO of ARC since 2007 15 clinics: KS, MO, IA 3 onsite clinics Onsite services Serviced 1,900 employers in 2015 75,000 patient visits Objectives Overview of Work Comp: Therapists Perspective Challenges Realities Opportunities Cost Drivers Case Study Objectives Continuum of Care: What is it? Why is it important? How to deploy? Work Comp Overview: My view Opportunities: Missouri and Kansas are employer directed states Picking the right provider has benefits Establish a RTW culture Work Comp Overview: My view Challenges: There are significant financial incentives to injured workers Making a mistake choosing the wrong provider can prove to be costly Injured Workers may take advantage of inefficiencies Stakeholders have different objectives Work Comp Overview: My view Realities: Most patients want to get better Patients are people Success starts at the hiring stage Work Comp Overview: My view Opportunities: Treat all patients fairly Set expectations early Use every tool possible to facilitate RTW Partner with excellent providers Cost Drivers Cost Drivers $ Surgeries: (38/123) = 30.9% $ $ DOI vs. Start of Treatment Co-Morbidities (Health of the Workforce) Confidential Cost Drivers Visits Avg. Visits in Treatment (Surgical) = 22.2 visits Avg. Visits in Treatment (Non) = 10.1visits Duration Avg. Days in Treatment (Surgical) = 56.3 days Avg. Days in Treatment (Non) = 26.8 days Confidential Cost Drivers Co-Morbidity Summary 44% Obese 22% Smoker Hypertensive 22% Osteoarthritis 20% 0% Confidential 20% 40% 60% 80% 100% Cost Drivers Co-Morbidity Summary Prev. Hx. of WC Claims 26% Failed Therapy < 6 mon. 17% 15% Attorney Involved 11% Prev. Related Surgery 0% Confidential 20% 40% 60% 80% 100% Cost Drivers Co-Morbidity Summary Patients with 1 or more co-morbidity 92% Patients with 2 or more co-morbidities 79% Patients with 3 or more co-morbidities 63% 0% Confidential 20% 40% 60% 80% 100% How Co-Morbidities Impact Outcomes Those patients who were obese (BMI>30) averaged 16.9 visits This is 3.0 visits greater than your overall average of 13.9 visits which equals approximately $600 in therapy costs What other costs are impacted? Confidential PDC Level PDC Level Why? CASE STUDY Monthly WC Cost Per Employee Includes estimated costs for open claims CPEE (Monthly) $30 $28 $25 52% Reduction in WC Cost Per Employee from 2012 - 2015 $24 $20 $14 $15 $13 $10 $5 Cause of reduction in CPEE: $2013 # Employees 4000 # Employees 3500 3274 3000 2500 145 3421 2014 2015 3538 3698 162 131 2000 119 1500 1000 500 0 2012 2013 Decrease in # of claims despite increase in # of employees Decrease in average cost per claim # Claims 2014 2015 200 180 160 140 120 100 80 60 40 20 0 # Claims 2012 2 2 Results - 2012 to 2015 # Employees Up 13% # Claims Down 18% Claim Rate Per Employee Down 27% Cost Per Claim Down 35% WC Cost Per Employee (CPEE) Down 52% 4000 200 $10,000 3000 150 $8,000 2000 100 1000 50 0 0 2012201320142015 CPEE (Monthly) Cost Per Claim # Claims # Claims # Employees # Employees $30 $25 $20 $15 $10 $5 $- $6,000 $4,000 $2,000 $2012 2013 2014 2015 2012 2013 2014 2015 Notes: 2 3 $0 claims excluded Includes estimated costs for open claims POET Return on Investment 2015 Cost of POETs: $193,000 Calculated based on if the rate of injuries and cost per claim stayed the same as 2012 • Savings of $657,283 in Direct Costs • Savings of $723,011 in Indirect Costs (Based on OSHA $afety Pays formula) • Total Savings of $1,380,294 • ROI: $1,187,294 Additional Savings: 14 of those tested never completed the tests due to medical reasons. This likely led to additional savings to the group benefit plan. Note: Not all employees have been tested (new employees only) 2 4 How? INTERVENTIONS ARC’s Continuum of Care Acute Therapy PT/OT Proactive Worksite Interventions Job Analysis POET Post Offer Employment Test STRIVE Work Conditioning Return to Work FCE Functional Capacity Evaluation Worksite Interventions Fit For Duty Testing ARC’s Continuum of Care Proactive Return to Work PT / OT • Defines the Essential Functions FFD Job Analysis Ergonomics Wellness Job Fit For Duty • Cornerstone for FUNCTIONAL TESTING Analysis POET FCE STRIVE Post Offer Programs: POETStriveand FFD Functional Consulting Work Employment Test Conditioning Capacity Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Template for RTW FFD Job Analysis Ergonomics Wellness Job Fit For Duty • Creates an end goal for treatment Analysis POET FCE STRIVE Post Offer Functional • Useful for Accommodation dialogue Consulting Strive Work Employment Capacity Test Conditioning Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Legally fits applicant to job POET FFD Job Analysis Ergonomics Wellness Fit For Duty Post Offer • National not capable rate of 7-12% Employment POET FCE STRIVE Post Offer Functional • Collects information Consulting baseline Strive Work Test Employment Capacity Test Conditioning Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Early intervention programs FFD Job Analysis Ergonomics Worksite • Stretching programs Fit For Duty Intervention POET FCE STRIVE Post Offer Functional • Ergonomics Consulting Strive Work Employment Capacity Test Conditioning Evaluation Wellness ARC’s Continuum of Care Proactive Return to Work PT / OT • Workstation evaluations FFD Job Analysis Ergonomics Worksite Fit For Duty • Body mechanics training Intervention POET STRIVE Post Offer • Workstation modifications Consulting Strive Work Employment Test Conditioning Wellness FCE Functional Capacity Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Specialization in Work Comp FFD Job Analysis Ergonomics Wellness Fit For Duty • Knowledge and experience with WC PT / OT POET FCE STRIVE Post Offer Functional care • Low patient volume=individualized Consulting Strive Work Employment Capacity Test Conditioning Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Emphasis on functional FFD RTW goals Job Analysis Ergonomics Wellness Fit For Duty • Supportive documentation PT / OT POET FCE STRIVE Post Offer Functional • Open, consistent, Consulting Strivecommunication Work Employment Capacity Test Conditioning Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Functionally based and job related FFD STRIVE Ergonomics Job Analysis Wellness Fit For Duty • Addresses total body + area of injury Work POET FCE STRIVE Conditioning Post Offer Functional • JA used plan Consultingfor RTW Strive Work and goals Employment Capacity Test Conditioning Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Lessens the need for FCEFFD STRIVE Ergonomics Job Analysis Fit For Duty • Confident RTW recommendation Work POET FCE STRIVE Conditioning Post Offer Functional • Reduces Consulting duration Striveof Workcare vs PT Employment Capacity Test Conditioning Evaluation Wellness ARC’s Continuum of Care Proactive Return to Work PT / OT • Objective assessment FFD FCE Job Analysis Fit For Duty Functional Ergonomics • Sincerity of Effort Capacity POET STRIVE Post Offer • Legally defensible Consulting Strive Work Evaluation Employment Test Conditioning Wellness FCE Functional Capacity Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • RTW: W/C or personal injury FFD Job Analysis Ergonomics Wellness FFD Fit For Duty • Internal transfers Fit For Duty POET FCE STRIVE Post Offer Functional • Annually Sensitive positions Consulting for Safety Strive Work Employment Capacity Test Conditioning Evaluation ARC’s Continuum of Care Proactive Return to Work PT / OT • Onsite Work Conditioning FFD JobWorksite Analysis Ergonomics Fit For Duty • Workstation Evaluation Interventions POET FCE STRIVE Post Offer Functional • Injury Education ConsultingPrevention Strive Work Employment Capacity Test Conditioning Evaluation Wellness Questions? Jeff Weeks, OTR/L, CEAS [email protected] www.arcpt.com