Onsite Clinics for ALL Care: The Erickson Living Experience

Transcription

1 Onsite Clinics for ALL Care: The Erickson Living Experience Craig D. Thorne, M.D. VP/Medical Director, Employee Health and Wellness Joselle Bamford, R.N., C.O.H.N. Sr. Occupational Health Nurse

2 Today s Objectives 1. Overview of Erickson Living s integrated health, safety and well-being program 2. Onsite Employee Health and Wellness Centers: Personal and work-related services Improved reporting and compliance Return-to-work process Provider performance management 3. Impact on reducing Workers Compensation costs 4. Q&A

3 Erickson Living at a Glance Third-largest independent living provider in U.S. 23,000+ residents served 14,000+ staff; 8,500 full-time 96% occupancy; industry standard is 90%

4 Erickson Living Locations 19 communities, 11states Colorado Wind Crest Florida Devonshire at PGA National Chatsworth at PGA National Kansas Tallgrass Creek Maryland Charlestown Oak Crest Riderwood Massachusetts Brooksby Village Linden Ponds Michigan Fox Run New Jersey Cedar Crest Lantern Hill Seabrook North Carolina Windsor Run Pennsylvania Ann s Choice Maris Grove Texas Eagle s Trace Highland Springs Virginia Ashby Ponds Greenspring

5 Greenspring Village, Springfield, Virginia

6 Vision, Mission and Values Erickson Living helps people live better lives. We strive to be the most valued and trusted leader in senior housing and services through operational excellence, integrated senior health and wellness and a commitment to the Erickson Way culture and values. Respect & Caring Diversity Friendliness & Enthusiasm Integrity Responsibility Excellence Teamwork We share our gifts to create communities that celebrate life

7 Person-Centered Approach Caring enough to understand the individual and customizing our approach to recognize the person s gifts, their needs, their preferences, and their goals

8 Integrated Employee Health, Safety, and Well- Being at Erickson Living Personal health & wellness Health advocacy Work-related services & safety promotion Workers compensation care and management

9 Employee Health and Wellness Center Brochure

10 Our EHWC Provider Team

11 Our Journey:

12 Evidence-based workers compensation management U.S.: : National health care costs increased 10% annually; workers comp costs increased nearly 15%. JHMI: (Bernacki et al, JOEM, Vol. 45, No. 5, May 2002) Patient advocacy & customer service, preferred provider network using sports medicine model, close follow-up, continuous dialogue between parties & injured employee, & in-house legal services to settle certain cases. 73% decrease in lost time & medical claims; 54% decrease in all costs (incl. admin costs). 77% decrease in temporary/total days paid. Hospital of the University of PA: (Green- McKenzie at al, JOEM, Vol. 44, No. 12, Dec. 2002) 46% decrease in lost time mainly due to modified duty. 10% decrease in total claims.

13 Lean Six Sigma Methodology to Improve Workers Compensation Management

14 Improving our Workers Compensation Management: 2010 Structured brainstorming meeting which concluded these 7 priorities: 1. Describe critical pathways; draft SOP for refinement 2. Eliminate waste: e.g., unnecessary & multiple data entry 3. Correct inconsistencies 4. Minimize handoffs; build in accountability 5. Determine process & outcome measures 6. Reengineer IT support systems 7. Determine training, coaching & consultative needs

15 Structured brainstorming Tools used: post-its, brown paper & enthusiasm Goals*: 1. Map & standardize WC processes 2. Reduce waste: info overload, time delays between steps, defects, re-work & variation 3. Monitor processes & finances to advise communities on ongoing basis 4. Prioritize to determine greatest point of need for improvement 5. Produce balanced scorecard & report success compared to internal & external benchmarks Assumptions: 1. Accidents don t just happen: they can be prevented & lessons can be learned 2. Consistent processes are important to outcomes: but flexibility needs to be built in 3. Too much info can be overwhelming: technology & info must support our customers (employee, manager, HR, nurse, provider & TPA) *Deming: consistency of purpose, break down barriers All ideas placed into 3 buckets: Waste, No brainers & Future!

16 Workers Compensation Management: 2017 Please refer to handout

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18 Onsite Medical Treatment by EHWC Employees are encouraged to seek medical treatment for their work injury/illness through the onsite Employee Health and Wellness Center. 1. Onsite Nurse Practitioner (NP) performs physical assessment of injury/illness and determines treatment plan and work abilities. 2. Employee can receive physical therapy through onsite Outpatient Rehab Department. 3. NP can review and address any barrier with Transitional Duty assignment. 4. NP can determine need for referral to specialist, if appropriate. 5. NP can closely monitor injury recover and facilitate optimal communication. Barriers with Transitional Duty or Return-To-Work Process: Offsite provider/specialist maintaining off work status with minimal supporting medical evidence. Supervisor cannot accommodate work restrictions NP. Employee refuses the Transitional Duty assignment or makes minimal attempt to perform the assignment. Work restrictions change and updates are not communicated to supervisor. Work restrictions placed by offsite provider are not advancing.

19 Questionable Claim Intake Process Early adjudication of claims that present as Questionable require timely recognition and communication of the Red Flags. NP can provide assistance with early identification of a questionable claim: Obtain injury details from different sources Security, Manager/Supervisor, and the employee. Reach out to Human Resources for possible information that may be triggering/impacting claim. Discuss red flags identified with claim adjuster, Human Resources and Sr. Occupational Health Nurse within 48 hours, to determine a plan of action. NP can provide key stakeholders with additional Red Flag information claims denied by CorVel claims denied by CorVel through 9/30/17

20 Sample Weekly Communication to leaders, adjusters and corporate support partners New injuries within last 7 days: (employee name) Dining Associate (CC Dining) 8/31/17 Finger Laceration Employee states he was putting bus bins away, and while reaching for a bin, he cut his right index finger on a small piece of glass. Employee washed finger immediately. OCV Security completed assessment and report. No further medical treatment was warranted and employee resumed unrestricted work duties. Not seen in the EHWC. No LT. No TD. (Claim #: 0877-WC ). (Start Date 6/25/2017) Updates on Injuries within last 30 days: (employee name) Housekeeper (CC Housekeeping) 8/19/17 Low Back Injury Employee states she injured her back about 2 weeks ago and then again this past Saturday 8/19/17. She cannot recall the specific day she initially injured her back, however she states it resolved in a few hours and that is why she did not report it. This past Saturday she states she injured her right lower back again doing the same work duty which was mopping. She states the mop head became detached from the handle which thrust her forward causing pain to her right lower back. She has continued to work without seeking medical treatment until 8/19. OCV Security was contacted and a report was taken while the employee was in the EHWC on 8/21. Employee was treated in the EHWC and released to RESTRICTED DUTIES that include: No lifting, pushing, pulling > 5 lbs. Accommodated in Gen.Services department. Employee also seen at Patient First on 8/19. Plan of care and work restrictions remain the same. On 8/22 Patient First placed employee off work with resuming restricted work duties on 8/23 and a full duty release on 8/28. PT started on 8/23. Employee seen in the EHWC on 8/23. LT: 1 day. TD: 6 days. (Claim #: 0877-WC ). UPDATE: Employee continues with PT treatment. Resumed unrestricted work duties effective 8/28.

21 S-M-A-R-T Goal Process S = specific M = measureable A = attainable R = relevant T = time-bound Also refer to position description for full listing of essential duties and responsibilities.

22 EHWC Center Provider Goals 2017: Financial Achieve Increase in Elective Use by 5% Compared to Same Time from Previous Year. (Visits include Sick Visits and Follow Up, Health IQs and Follow Up, Well Visits, Flu Vaccines, and Smoking Cessation). Verify Insurance Information at Time of Appointment and Collect Missing Insurance Information Within 2 Working Days. Achieve Employee Health and Wellness Center Revenue Projections and Budget Control. Achieve Average Incurred Cost per Workers Compensation Incident At/Below Internal Benchmark. Achieve 50% Increase in Well Visits from Previous Year.

23 Mid-year and Year-end Performance Scorecard

24 Definition of Value on Investment (VOI) ROI (Return on Investment) is the measure of the tangible benefits of a program or service (e.g. revenue). VOI includes: Cost avoidance (e.g. clinical services that are offered at the workplace instead of ER/Urgent Care/Private physician office) Intangible benefits (e.g. stay- at-work programs to reduce lost work time and staff replacement costs, increased employee satisfaction and engagement, higher productivity and decreased absenteeism, increased retention, improved population health metrics, etc.). VOI includes ROI.

25 EHWC VOI Calculation

26 EHWC VOI Calculation cont d

27 Workers Compensation Savings Compared to Market Trends 3.00% 2.80% 2.60% 2.40% 2.20% 2.00% 1.80% 1.60% 2.71% 2.71% 2.62% 2.69% 2.69% 2.47% 2.38% 2.46% 2.37% 2.25% 2.29% 2.27% 2.06% 1.94% Actual Actual Actual Actual Actual Actual Forecast FY11 FY12 FY13 FY14 FY15 FY16 FY17 Workers Comp - % of Wages Workers Comp - Market Rates $9,026,974 in hypothetical savings over market rate '11-'17 Savings represent the additional expense Erickson would have incurred had their rates grown with the market.

28 Key Insights Apply evidence-based practices to improve Worker s Compensation management. Practice quality improvement to get a little bit better every day. Partner well with CorVel to understand and use all available resources: Close contact with Adjusters and monthly case reviews Weekly calls with CorVel Account Manager to address concerns and opportunities. Set clear S-M-A-R-T goals and track progress on a scorecard. Celebrate successes and reward strong performance

29 2016 ACOEM Corporate Health Achievement Award

30 Thank you. Questions? See you at the pool!!!