Smart Return to Work programs: Standing Strong in Shifting Sands
US industries are standing on the threshold of change in how healthcare will be provided and utilized. With the Affordable Care Act[1], employers are required to provide healthcare coverage that won’t exceed 9.6% of their workforces total income — that’s precisely what the Affordable Care Act does.

Keep it under that percentage when health plans are increasing in cost and deductibles are going up is a concern for all employers.

For some, the answer may be cost shifting to the Workers Compensation system. Under Workers Comp, there are no deductibles for the injured employee, which could be seen as a means of covering healthcare costs that have historically been filed under traditional health insurance plans.

But not so fast: A lot of people are wondering how much of this activity is really going on, it’s the elephant in the room that is not being discussed. Mostly due to the political ramifications but also that any utilization of either benefit program has development tails, claims that stay open for extended periods of time, and those can make it difficult to actuarially pinpoint the shift.

The answer to how risk is avoided or prevented on the front end is not a simple one. But it’s not rocket science either. It’s knowing how to treat and when to treat employee injuries and how to control the costs associated with them. And that’s Return To Work: a platform that works with the injured employee, the insurance company, the physician, and employer to make sure that employee injuries are validated, investigated, and treated appropriately.

“Appropriately” means the injured employee gets treated fairly, respectfully, and consistently when they get hurt in order to bring them back to their job. Return to Work programs are designed to do this for the most part. But these programs can fail when not properly implemented and monitored (i.e., no one is held accountable). In most cases it’s not efficiently done due to the subjectivity, documentation requirements, and competing goals of all involved. The answer to this puzzle is automation.

If the Return to Work process goals are clearly defined, objective in it’s design, and efficient in application, then you’ve really got something. Riskonnect has developed the process recipe through its revolutionary platform to meet and exceed the goals of an effective Return to Work program. With the application of performance metrics, third party cost benchmarking, and electronic communications embedded into the system, there is finally a viable solution to help employers avoid the cliffs and pitfalls of the “shifting sands” between employee health plans and Workers Compensation.

[1] https://www.hhs.gov/healthcare/about-the-law/read-the-law/

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Tim Davidson

Tim Davidson joined Riskonnect in 2016 with more than 25 years of industry experience, working extensively in the risk consulting field. Most recently, he was the assistant vice president of loss prevention and corporate safety and security officer for IASIS Healthcare. His previous leadership role as senior vice president with Marsh had him leading new consulting sales for the Southeast and prior to that, developing Marsh’s healthcare consulting practice. Prior to joining Marsh in 1998, he worked for the Yasuda Fire & Marine Insurance Company, Ltd. as their foreign operations (U.S.) ergonomics specialist and domestic business development leader. Prior to his tenure at Yasuda, he worked for the USF&G Insurance companies as a senior consultant, practice manager and field underwriter. Davidson has a very diverse background with his consulting focused primarily on the manufacturing, construction, retail, transportation and healthcare industries.

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