Wednesday, November 9, 2011

Underutilized Wellness Programs & Work Comp - Great Idea!


The integration of group health benefits with workers' compensation programs is, apparently, taking off in some directions that previously weren't considered, and which indicate a trend towards rethinking the medical delivery component of workers' compensation to reduce disability.

Roberto Ceniceros, well known to those who read the publication Business Insurance, and his recent article in parent publication Workforce, "Wellness Programs Adapted for Workers' Comp" highlights this trend.

Ceniceros points out that large employers, which have the economies of scale and resources to make something like this work, see their group health wellness programs as a new risk management tool to provide injured workers with the tools and guidance needed to expedite recovery and return-to-work rates.

I have blogged in the past about co-morbidities, and about dealing with the "soft" part of workers' compensation claims - the underlying psycho-social elements that complicate treatment and recovery, and ultimately increase disability. The examples cited by Ceniceros indicate that these large employers likewise see the benefit of supplementing what would usually be outside of the sphere of workers' compensation treatment.

In addition, these employers see these wellness programs as underutilized anyhow. These are employee benefit programs that aren't well regarded by the work force mostly because the work force doesn't see a value in these programs - things like weight reduction help and smoking cessation help. The work force, reflective of most of America, doesn't put a high level of importance to self-management of health, until there is some intervening event. For some it is a diagnosis of cancer or other threatening illness. For others it is a work injury.

An unidentified global manufacturing business is cited by Ceniceros as how this integration occurred. Some forward thinking disability management person in the organization started referring injured workers to the company's wellness programs, and it took off from there with work comp claimants being referred to learn how to manage back pain and other chronic conditions.

The  most difficult part of the process, says Ceniceros, is the mechanics of implementing this integration because of the barriers created by corporate management - workers' compensation is in the risk managent category, and health is in the human resources category. So the coordination requires many meetings and understandings between the two groups for a smooth work flow transition.

But one thought process that may assist in expediting such an integration is thinking of group health and wellness programs as just a part of risk management, rather than an employee benefit from the HR side of the equation.

The single biggest risk for any employer is its work force, and maintaining a healthy, productive work force is risk management at its best.

This is a tactic used by some Texas non-subscribers who have put together interesting ERISA compliant programs that blur the line between work injury care and general health care. The simple viewpoint is that the employer doesn't care how the employee got hurt or ill, the treatment is the same and the vast array of employer tools that can be accessed via benefit programs facilitates expedited recovery. The result is healthier, happier employees who feel they are working for a company that cares about them, and an employer with extraordinary productivity experience and employee loyalty.

I am encouraged by this trend - the only reason there is a wall between the medical component of workers' compensation and group health and wellness systems is because the two systems grew up separately and independently. Resourceful employers see no distinction and make use of all the tools available to get the job done..workers compensation, work comp, injured worker

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