With workers’ compensation costs rising and steep fines for non-compliance proposed in pending legislation, employers are searching for a cost-containment model that allows them to operate at maximum efficiency. A multi-disciplinary approach to industrial medicine could be the answer many employers are seeking.
This multi-disciplinary approach combines the disciplines of chiropractic, physiotherapy, rehabilitation, objective testing and outcome assessments, and provides sought-after cost containment while producing a more productive workforce.
As you probably know, workers’ compensation is a nationwide, state-regulated, insurance program that requires employers to fund medical expenses, lost wages and other costs resulting from work injuries and illnesses. Instituting a program of pre-employment/post-offer screenings that are compliant with the Americans with Disabilities Act (ADA) can significantly reduce workers’compensation rates. This testing assures that the candidate hired is the best suited for the job task required.
Scope of the Problem
The U.S. Bureau of Labor Statistics reports that work-related illnesses and musculoskeletal injuries surpassed 5.9 million incidents in 1998. More than 5.5 million of those incidents were associated with musculoskeletal injuries.
Government statistics show that employers spend $60 billion a year in workers’ compensation costs. The cost of lost productivity and employee turnover is an additional $100 billion. These costs now total an average of 10% of an employer’s payroll expenses. Above and beyond workers’ compensation costs, indirect costs, including overtime pay, temporary employees, retraining, and lost productivity, comprise an additional 12% to 20% of employer payroll expenses.
Proposed changes in legislation, as well as the rising costs in caring for injured workers, are fueling an increased focus on industrial medicine within the chiropractic profession. Chiropractors must take a leading role if we are to be included in this multi-billion-dollar market.
Unparalleled Opportunity
One of the most significant reasons for the failure of the current industrial health treatment model has been its focus on passive care. Injured workers have been treated symptomatically and are often prescribed rest, drugs and other passive treatment modalities. A coordinated program that delivers prevention through ergonomic and biomechanic education, and objective analysis followed by treatment through active rehabilitation, can provide the combination of cost-effectiveness and quality of care that industry is demanding.
Industrial medicine provides the chiropractic profession with the single-most significant opportunity the profession has been confronted with in the last decade. An increasing percentage of the American population is seeking chiropractic care, and yet access to chiropractic has been severely restricted by managed care. By taking the forefront in this multi-billion-dollar arena, chiropractors can virtually insure the continued strength of their foothold in the health-care marketplace.
A model that combines chiropractic with conservative medical care and active rehabilitation can produce a highly successful outcome at a cost that is significantly less than when those same disciplines provide care independently. Studies have shown that fewer workdays are lost, and lower amounts of disability compensation and provider costs are paid, when chiropractic is included in the treatment model. Workers’ compensation costs have also been shown to be reduced, resulting from an earlier return to work by employees in cases in which chiropractic care is included.
Changing Times
Historically, chiropractors have had limited success in their attempts to enter the industrial medicine arena. In many areas of the country, chiropractors have been completely shut out of the workers’compensation market. In addition, the approach taken by many chiropractors of the “back school” or “employee health screening” has been largely unsuccessful and may have added to the marginalization of chiropractic in the eyes of employers.
With the proper tools, chiropractors are ideally suited to provide the cost containment and quality care that are severely lacking in industrial medicine. To do so, chiropractic must enter the mainstream of industrial medicine, bringing the practical clinical results required to fill the void that currently exists.
Chiropractors can incorporate the tools of computerized functional assessment equipment to evaluate injury, restriction and disability, objective outcome assessments, and biomechanic and ergonomic education. With the help of these education, assessment and treatment methods, chiropractors can position themselves to become the dominant force in the industrial medicine marketplace.
In order to successfully enter the industrial medicine market, chiropractors must be educated about marketing, clinic management and quality assurance. Corporations, third-party administrators and insurance carriers need to work together to create a health-care delivery system that allows for the containment of workers’ compensation costs. The ideal model controls the cost of health-care services and increases worker productivity through improved health and reduced absenteeism.
Preventive Approach
An important aspect of a successful industrial medicine program is the post-job offer employment screening, based on the guidelines provided by the ADA. Instituting the post-offer screening can reduce a company’s workers’ compensation costs by assuring the prospective employee is suited for the job task.
Amazingly, statistics show that 37% of all workers’ compensation cases are fraudulent. Objective testing for functional performance significantly reduces this rate of fraud.
The cost of litigation is an additional burden employers must bear. 67% of all workers’ compensation costs result from temporary or permanent disability cases. The average cost of litigation is an additional 15 cents to 33 cents for every dollar paid in benefits for injury cases.
In the event of an injury that results in litigation, the post-offer examination results are extremely valuable. By performing a comparison to the post-offer physical examination using the computerized range of motion, hand-strength testing, and isometric testing, and comparing it to a post-injury analysis, the impairment or disability resulting from the worker’s injury can be objectively measured. A settlement can therefore be based on the objective conclusions, and not on non-quantifiable damages or opinions.
In addition to the delivery of multi-disciplinary care, job-specific biomechanic and ergonomic training is an important element of industrial medicine. Preventive education is key to reducing injuries. Chiropractors should be trained in ergonomic and biomechanic assessments and certified to perform on-site workplace evaluations. $20 billion is spent annually due to repetitive stress injuries. Proper employee education further lowers injury costs and incidence.
A Synergistic Arrangement
Two challenges currently exist in the field of industrial medicine. Companies are spending too large a portion of their budgets on workers’ compensation; and at the same time, chiropractors are being squeezed out of the health-care market in general – particularly in the workers’ compensation arena. Something must be done, and it must be done quickly, to remedy this situation.
The answer is to bring industry and chiropractic together in a cost-effective approach to industrial medicine. This approach provides chiropractors with an abundant flow of quality patients, and industry with reduced costs and increased productivity. The arrangement is win-win-win, for industry, chiropractic, and maybe most importantly of all – workers.
