The Patient Experience in Perspective: Applying Empathy to the Work Comp Claims Process
Patient empathy has been a popular topic within the healthcare industry over the past two decades. As healthcare organizations began focusing on the patient ‘experience of care’ as a measure of success, demonstrating empathy became an important goal for individual healthcare professionals, as well as overall patient engagement programs.
In workers’ comp, there is increasing support for a more empathetic and patient-centric claims model, and with good reason. A poor claims experience is not simply a matter of dissatisfaction on the part of the injured worker. A strong correlation has been reported between the claims process experience and return to work status. According to one study, injured workers who had a negative or neutral claim experience were less likely to have returned to work than those who had a positive experience – 65% as compared to 84% – when controlling for all other factors.1 In addition, negative interactions during the claims process can cause or exacerbate psychosocial factors, which can impact worker health in both the short and long term.2
Although the degree of injury or illness can vary, the majority of employees who file workers’ compensation claims require medical attention and, therefore, become patients. And their experience as patients may be inferior to those covered by other types of insurance. According to a recent study, workers’ comp patients are less satisfied with their medical providers than other payer patients (including private insurance, Medicare and Medicaid) with 59% of workers’ comp patients saying they would recommend their providers, as compared to 79% of non-workers’ comp patients.3 And a recent Healthesystems’ study found that 60% of patients who had initial medical exams reported a negative provider experience.4
But medical providers are not the only driver of unsatisfactory patient experience. A review of multiple qualitative studies regarding injured workers’ interactions with employers, insurers, and healthcare providers found that a majority of injured workers experience negative interactions at every stage of the claims process.2 And approximately 70% of patients who were referred to specialists were satisfied with the care they received, but only 59% were satisfied with how that care was coordinated…5
Tags: RxInformer, empathy, engagement, patient, program design
IQVIA Reports on Telemedicine Trends and Opportunities
The IQVIA Institute for Human Data Science, a multinational health information technology and research company, published Telehealth Transformation: Moving from Crisis Response to Population Health Solutions, which highlights telemedicine trends during the COVID-19 outbreak and illuminates opportunities to expand telehealth to support population health management.
According to data from the Centers for Medicare and Medicaid Services (CMS), weekly telemedicine visits were at 14,000 per week pre-pandemic, jumping to 1.7 million per week in the last week of April 2020. While in-person visits have resumed, numbers still remain high.
Telemedicine rates prior to the pandemic made up less than 1% of medical visits, but they have increased ten-fold during the pandemic. Also of note: pre-pandemic, a majority of telemedicine visits were focused on mental health. While such visits have increased, telemedicine has come to mirror broader populations, with chronic conditions like hypertension and diabetes contributing to more visits.
The report also goes into detail how telemedicine can benefit four different patient populations, including:
The 58-page report contains several insights and areas of opportunity, specifically highlighting how other aspects of telemedicine, beyond virtual visits, can benefit patients via the use of other technologies. Key highlights include:
Tags: telehealth, telemedicine, IQVIA, technology, CMS, COVID-19
New York Prepares to Launch New Claim Portal
New York is preparing to launch a limited release of their new claim portal, OnBoard, a platform meant to eliminate many paper processes and replace various legacy systems within the state, at the beginning of 2021.
This change, having passed various rounds of legislative and regulatory approval, signals a growing acknowledgement that technology must be embraced to improve the claims processes within workers’ comp. New York has already adopted or will soon be adopting several of the foundational regulations which will require use of the portal, which is expected to become mandatory for all providers by July 2021.
Since Summer 2019, the New York Workers’ Compensation Board (WCB) has been working to launch OnBoard, stating that this portal will provide users access to real-time data to speed up the claims process.
OnBoard users will be able to access the following data and functions with the limited release:
The portal is designed to be available to injured workers, their representatives, carriers and medical providers. Regulatory adjustments allow not only traditional providers to access the portal, but also physician assistants, occupational therapists and acupuncturists.
A full release is planned for 2023, at which point most WCB-required claim forms will be available digitally, pre-populated with known data, guiding users on how to fill necessary information.
An application programming interface (API) will be available as part of the full release of OnBoard in 2023 for stakeholders to communicate directly between organizational computer systems and the Board to automate the submittal of eForms.
WCB already held initial provider trainings for OnBoard, and they have posted several informational videos on their YouTube channel.
Tags: New York, OnBoard, portal, claims portal, claims management, innovation
Dr. Robert Goldberg Discusses Congressional Marijuana Vote with WorkersCompensation.com
The U.S. House of Representatives passed the MORE Act in early December, a bill written to decriminalize and tax marijuana at the federal level. The bill now sits with the Senate, where most believe it is unlikely to advance. Regardless, this is the first time that comprehensive legislation to decriminalize marijuana has passed the full House or Senate. The vote comes at a time when most Americans live in states where marijuana is legal in some form, and national cannabis policy has lagged behind changes at the state level.
This divide has created a host of problems in regulating medical marijuana use, which impacts workers’ compensation as some states require workers’ comp payers to reimburse medical marijuana on certain claims.
WorkersCompensation.com recently discussed how this momentous vote could be an important step towards furthering medical research, reaching out to industry experts for their opinion on the matter, including Healthesystems Chief Medical Officer, Robert Goldberg, MD, FACOEM.
Dr. Goldberg was quoted saying:
“The medical community and the pharma industry could perform the robust research that is sorely needed on clinical safety and effectiveness, dose formulations and pharmacology, the dose-response curve, and workplace/public safety. Once cannabis is no longer Schedule I, physicians could prescribe, pharmacists could dispense, patients could legally acquire and use in all 50 states, and payers would no longer be restrained by federal or state regulations to reimburse for medically necessary and appropriate prescriptions/ recommendations.”
Tags: Robert Goldberg, Goldberg, Healthesystems, WorkersCompensation.com, marijuana