Faster treatment for injured workers

Treatment approval for injured workers has been reduced to approximately four days for employees participating in a new icare pilot.

The 12-week Medical Support Panel (MSP) has been running since May 2017 and is trialling how a panel of medical specialists can improve outcomes for injured workers.

Approval times are usually up to six weeks, but have been significantly reduced for more than 100 workers who have so far been involved in the pilot.

“The trial has already shown a strong evidence base at the halfway mark, meaning injured workers get their treatment faster,” said icare Chief Medical Officer Chris Colquhoun.

“Through this pilot, we’re providing our case managers with credible medical recommendations to help them make more informed decisions when it comes to the whole-person health and wellbeing of injured workers.

“The recommendations provided by the Medical Support Panel are evidenced based, tapping into the most current global medical practices and recommended treatment pathways for different types of injuries.”

Interim outcomes of the pilot include:

• Time to decision for injured workers reduced from an average of 30 days to 4 days.
• 73% of new treatment requests reviewed by the MSP were supported.
• 12% of cases referred to the MSP were referred to an independent medical examination (IME) for review.
• Of the remaining cases, injured workers may have received a different treatment recommendation or new case strategy, after agreement was reached with all relevant stakeholders, including the injured worker and treating doctor.

All cases reviewed got to a decision in an average of four days.

The focus for the MSP is to support faster treatment approvals where possible. In cases where there is insufficient information to recommend approval, the case is referred to an IME.

“While the pilot still has a way to go, these preliminary results show that a small step in how we approach claims management can make a big difference to people’s outcomes,” Colquhoun said.

“In a number of cases, the medical panel collaborated with the injured worker, treating doctor and case manager to reach agreement and recommend a different treatment pathway than that originally proposed. This is evidence that the panel not only ensures workers receive treatment faster, but also receive the best treatment for their circumstances.

“The results are compelling and tell us that by focusing on the customer needs as opposed to process, we can achieve extraordinary outcomes.”

icare’s MSP provides guidance, medical case support, case resolution strategies and recommendations to case managers and other key support staff who may not have a medical background within no more than five business days.

The medical professionals on the panel are occupational health physicians and psychiatrists, currently in clinical practice, with experience in the NSW Workers Compensation scheme requirements.

Under the trial, the panel’s doctors have been able to fast-track approval times by proactively communicating with workers, treating doctors, case managers and IMEs. The pilot will run for a further 6 weeks to mid-August 2017. icare will evaluate the overall value of the panel to injured workers and update stakeholders on the next steps to more broadly operationalise the outcomes in coming months.

Image credit: ©stock.adobe.com/au/Artistan