adapted from SFM Companion
When was the last time you spent $4,000 in a day?
According to a recent New York Times article, that’s the starting price of an average day spent in an American hospital.
With the price of healthcare climbing, medical expenses make up a growing percentage of workers’ compensation claim costs.
Since claim costs determine your experience modification factor (e-mod), which helps set your workers’ compensation premium, higher medical costs can mean higher future premiums.
That’s the bad news.
The good news is that there are things employers can do to manage medical costs, such as:
Establish a relationship with a medical clinic
Establish a relationship with a clinic skilled in occupational medicine before a work injury occurs. If no occupational medicine clinic is available in your area, look for a reputable primary care clinic. This helps your employees avoid low-quality medical providers, who might order unnecessary tests or ineffective treatments that can increase costs and delay return to work.
How to do it: To start the relationship, contact the clinic’s business office to see if they have a formal program for employers. If not, set up a meeting with an appropriate staff member (this could be medical or administrative staff, depending on the clinic’s size) to tell them that you’d like them to be your primary clinic. When you talk with them, you can:
- Let them know that you have light duty work available.
- Ask that they complete a work ability statement each time an injured employee visits the clinic.
- Ask them to visit your facility so they can better understand your operation and the types of transitional work you have available.
If you’re an SFM policyholder and need a recommendation of a good clinic in your area, contact your claims representative.
Legal tip: Remember that in most states it’s ultimately up to the employee where to go for medical treatment, so employers can only recommend that employees use their primary clinics. Iowa law differs in that employers can choose the initial medical provider for the employee.
Have an effective wellness program
Factors like obesity or a sedentary lifestyle can cause and exacerbate workplace injuries. A recent report by a global risk management firm says that wellness programs can reduce the costs of workers’ compensation claims and prevent them altogether. For example, an NCCI report cited by the firm shows that obese claimants incurred 6.8 times higher medical costs than non-obese claimants, and were twice as likely to file a claim.
As part of your wellness program, encourage employees to stretch and move around throughout the day. SFM offers posters, a stretching guide and other resources to encourage employees to move often.
Report work injuries quickly
Claims representatives can help you control medical costs in a variety of ways, such as suggesting network providers for diagnostic tests and consulting with SFM’s physician advisors to make sure injured workers are getting the most effective treatments. To take full advantage of these services, let your SFM claims representative know as soon as possible that an injury has occurred.
Tell your claims representative when diagnostic imaging or medical equipment are ordered
SFM has negotiated rates with high-quality providers of imaging (such as MRIs, EMGs or CT scans) and medical equipment (like crutches or knee braces). If you learn that your injured employee needs one of these services, let your claims representative coordinate with one of SFM’s network providers to ensure fast, quality service at a fair price.
Keep your claims representative informed of major developments in the claim
If you learn that an injured worker might require surgery or a referral to a specialist, let your claims representative know. That way, your representative can tap into the right resources to manage the claim, such as SFM’s nurse case managers or physician advisors. To stay informed about the status of the employee’s injury, keep in touch with the claimant or their front-line supervisor.