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Thought Leadership in Action

Category: HR Risk Management

How to Improve Coordination with Managed Care for Injured Employees

Workplace injuries are on the decline — according to the federal Bureau of Labor Statistics, the nonfatal workplace injury and illness rate in the private sector was 2.9 cases per 100 full time workers in 2016. But nearly a third of those injuries were classified as “serious” and resulted in days away from work, representing serious disruption to day-to-day work cycles, businesses’ bottom lines and the lives of these employees.

Risk management for workplace injuries starts with safe workplaces, but it extends beyond an injury or illness itself and into how well the employer can coordinate managed care, communication among multiple entities and new-role opportunities to get the injured employee back to work. The International Association of Industrial Accident Boards and Commissions agrees, saying returning to work needs to be a bigger priority for all stakeholders: employees, unions, insurers, care providers, regulators and employers.

“Return-to-work is just now getting the attention it needs in industry when it comes to risk,” says Karen Eaton, project manager at Ebix. The work environment and behavioral and social situations all play a part in getting injured employees back to work, all of which saves money in the long run. Here’s what you need to know to improve.

Adopt a Comprehensive Strategy

Injured workers represent financial risk, and the longer they’re out the more likely they are to not come back. According to Washington state’s Department of Labor & Industries, there’s a 92 percent chance of a worker coming back from an injury after three months, but that chance drops to 55 percent after six months. Employers are quickly faced with the necessity of hiring for the position.

Adopting a comprehensive strategy that takes into consideration all stakeholders — the employee, the employer, the managed care provider, the insurance company and the workers’ compensation provider — is key to success, Eaton says. Even though there are a lot of moving parts, making the employee’s return to work a priority will help get everyone on the same page and working toward that goal.

Foster Communication Among All Players

Managed care can make coordinating a return to work more complicated, so keeping the lines of communication open among everyone will bring more successful outcomes. “It’s really about building collaboration with the injured worker, providers, any third-party managed care if they use them, and being proactive about the person who is off work,” Eaton says.

For employers, this means using software where possible to automate reports and updates so you can build stronger relationships with all stakeholders. “There are a lot of moving parts,” Eaton says, but when everyone is on the same page regarding diagnoses, treatment plans, return-to-work schedules and expectations, it can get the employee back in their role more efficiently.

Build a Supportive Culture

The behavioral and social factors of your culture play a big role in getting an employee back to work, Eaton says. For example, does your culture have a strong plan for graduated work options for people to come back from injuries — and do employees know about them? Are you more inclined to communicate regularly with employees off work, or do they get radio silence?

“ ‘Risk’ is not only the working environment; it’s also behavioral and social situations with employees,” Eaton says. A culture that doesn’t consistently support and care for employees will make it more likely that an employee takes longer to return to work than one that works hard to keep everyone informed and supported. And that can affect more than your bottom line, Eaton says — it represents a risk to your reputation as well.

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