caring for employees pays off

Good practices in the real world

Dr Mary Wyattwww.rtwmatters.org

Multi-Faceted Case Management: Reducing Compensation Costs of Musculoskeletal Work Injuries in Australia.

Iles RA, Wyatt M, Pransky G.

J Occup Rehabil. 2012 Apr 1

Why talk about the study

1. We can be effective in getting people back to work

2. Good quality early intervention is challenging to implement (system barriers)

3. Many policy makers rely on regulations to prevent long term claims

4. Results in cost shifting to other systems rather than improve quality of life

Setting

• Workers comp publicly run system

• Can be a significant cost to employers

• Claims experience influences premium

• Centralised database for Vic comp claims

• Intervention implemented by private company

• Across varying industries – health, manufacturing, aged care etc

• Approx 12 companies, medium to very large

• Approx 800 cases and 2500 matched controls

Intervention

• Day one reporting 24/7

• Case managers coordinating

• Supervisors engaged• Senior managers• Early appropriate

treatment, usual GP or company Dr

• Dealing with the– Fears– Difficult workplace

issues

– Delays in treatment approvals

– The occasional person who didn’t wish to comply with the spirit of RTW

Data from

Intervention companies

Pre-Intervention period Intervention period

Matched controls

Pre-Intervention period Intervention period

Average claim costs

Average days off work

Average medical costs

Across industry

Challenges

• Working against the bureaucracy

• Working against the adversarial approach

• Finding the right people to be case managers

Social contributors and implications

Scheme management

• In Australia, scheme costs managed by reducing ‘tail’ claims

• Limited length of a claim, eg 2 years

• Many shift onto other systems

Policy approaches to RTW

• Focus on process

• Whereas it’s more about people

• Many barriers to effective early intervention

• History of the schemes play a large role

Impact of being out of work• The longer someone is

off work the less likely they are ever to return.

If the person is off work for:

•20 days the chance of ever getting back to work is 70%;

•45 days the chance of ever getting back to work is 50%; •70 days the chance of ever getting back to work is 35%.

AFOEM policy work

Contact details:marywyatt@rtwmatters.org

Link for AFOEM policy work:http://www.racp.edu.au/page/afoem-health-benefits-of-work