Fulcrum Health supports DCs in federally funded study

The impact of unemployment and underemployment can be mentally, physically and financially devastating.

Research data shows that if someone is out of work for more than three months, whether due to an injury or some other cause, only 50% return to work. If that time without work is over 12 months, only 5% return to work. This results in escalating costs to the worker, employers and the state, and also takes a toll on workers’ finances and health.

Minnesota’s Retaining Employment and Talent after Injury/Illness Network Initiative (RETAIN) is a collaborative effort among various organizations to combat the issues surrounding the effects of unemployment or underemployment. Participating groups include Minnesota’s Department of Employment and Economic Development, Department of Health and Department of Labor and Industry; the Mayo Clinic; the Governor’s Workforce Development Board and Workforce Development Inc.

In 2023, Fulcrum Health Inc., a nonprofit healthcare network of credentialed DCs, joined them to help support and improve return-to-work outcomes for injured workers. Participating in Minnesota RETAIN allowed Fulcrum’s DCs to be part of their study exploring the potential benefits of an early intervention stay-at-work/return-to-work program to support ill/injured individuals in retaining their employment as they recover.

An underlying issue

Musculoskeletal injuries and their resulting economic impact make up a much larger issue than most people are aware of. According to the National Safety Council, in 2021 the financial impact of such injuries was $167 billion. Several distinct elements comprise this dollar amount, including the initial cost of treating injuries, the value of lost workplace productivity, potential ongoing state and federal healthcare costs, unemployment benefits paid and emotional/behavioral health concerns. Not being able to work or having excessive time off from work can quickly lead to acceptance of life without a job. This can progress to deconditioning; withdrawal from colleagues, friends and family; depression, anxiety, financial insecurity, losing feelings of self-worth and hope for the future; and even mortality. This withdrawal can occur in as little as a few months.

To address these issues, the U.S. Department of Labor and the Social Security Administration collaborated to implement RETAIN to promote closer coordination among individuals and organizations who influence workers’ decisions about how or whether to stay at or return to work after a work disability. RETAIN programs implement early intervention strategies to improve stay-at-work/return-to-work (SAW/RTW) outcomes of individuals who experience a work disability while employed.

Minnesota was one of eight states selected to participate in this pilot program and one of only five states chosen for the second phase; the phase two study closed May 16.

“Time lost to injuries and long-term illness can cost employers and the state millions each year. This is whether employees are injured on the job or on their own time,” said Deb Zurcher, DC, LAc, Assistant Chief Clinical Officer, Fulcrum Health.” They are also a part of a successful return to work and reducing future disabilities.

“Fulcrum Health represents a standard of excellence among chiropractors,” Zurcher continued, “and participating in Minnesota RETAIN gives providers an opportunity to deliver additional support for patients, while reinforcing the power of physical medicine to help people overcome injury and get back to work and life faster.”

Fulcrum’s participation in RETAIN allowed initial access to the Centers of Excellence providers and then opened to the more than 1,500 Minnesota DCs in its network who had the potential to refer patients to the Minnesota RETAIN study. Once accepted, those patients who were randomized to the intervention group received services to support or sustain their employment, retain job skills or help ease the transition back to work. Each worker in the intervention group was assigned a return-to-work case manager who served as a liaison between the worker, their healthcare provider, employer and other stakeholders to help them access services needed to return to work.

Fulcrum Health joins the project: Phase II

During Phase I of the project, Minnesota RETAIN successfully developed protocols, processes and collaboration among various stakeholders. Phase II expanded the program to include 3,200 participants across Minnesota, and was designed to validate and bring the program to scale. RETAIN services were provided to individuals who met the eligibility criteria of being 18 or older, were living and working in Minnesota and had a qualified health condition that impacted their ability to work. These conditions included chronic illness, behavioral health (including substance-use disorders), musculoskeletal issues and more. However, the largest category of conditions were musculoskeletal related, which is why Fulcrum joined Minnesota RETAIN as part of the Phase II expansion.

Ninety percent of all Minnesota counties had some level of participation, including patients referred and enrolled through Fulcrum as well as other healthcare providers, self-referrals and community outreach.

Referring providers had to complete a 45-minute CME training course on preventing needless work disability. This course emphasized the need to manage time away from work in a positive and productive manner. Having a broad range of participating providers registered within the Minnesota RETAIN network was a much-needed asset for busy caregivers and also provided the best resources to patients.

The role of chiropractic care

Chiropractic care provides early intervention and is a non-pharma, best practice, first-line approach to back and joint injuries. The care includes at-home instructions to ensure the patient is performing the correct movements and exercises. DCs also provide instructions on how to avoid further injury. This is effective in providing back and musculoskeletal care and supporting a quick return to work post-injury.

Participation in the program and study produced outstanding results for patients who enrolled as well as for their treating providers.

“I am thankful to have had Minnesota RETAIN as a resource for my patients. One of the patients I referred was connected with some really amazing resources,” said Hans Thurmer, DC, with Arrow Health Chiropractic and Rehab. Thurmer found Minnesota RETAIN has been excellent in its communication and supported patients in every step. The support of the treating healthcare provider is an important contribution to the success of this free and innovative study.

The future of RETAIN

The study concluded on April 8, as the enrollment goal was met. The Minnesota RETAIN program continues to pursue sustainability efforts, and those who participate may receive services.

For more information, visit mnretain.com.

DEB ZURCHER, DC, LAc, is the assistant chief clinical officer at Fulcrum Health Inc. Serving 3.2 million members, Fulcrum Health is NCQA accredited and has delivered quality care through its credentialed provider network for more than 40 years. A leading nonprofit physical medicine benefit management organization, Fulcrum represents a standard of excellence among doctors of chiropractic and focuses on first-line, non-pharmacological, physical medicine. Fulcrum’s participation allows access to more than 2,400 DCs in its ChiroCare network to refer patients to the Minnesota RETAIN study.

Disclaimer: Minnesota RETAIN is funded by the U.S. Department of Labor and the Social Security Administration under a grant award of $19,518,509 to the Minnesota Department of Employment and Economic Development that will be incrementally provided. One hundred percent of grant funding is from U.S. federal funds. This website does not necessarily reflect the views or policies of the U.S. Department of Labor or the Social Security Administration, nor does its mention of trade names, commercial products or organizations imply endorsement by the U.S. government.