Strategic Vision: Improving Medical Care for Injured Workers Gary Franklin, L&I Medical Director.
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Transcript of Strategic Vision: Improving Medical Care for Injured Workers Gary Franklin, L&I Medical Director.
Strategic Vision: Improving Medical Care for Injured Workers
Gary Franklin, L&I Medical Director
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Health Care Strategy
Goal: Improve worker outcomes
Prevent/reduce disability by providing highest quality medical care
Every provider is a high quality provider
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100%
56.3%
44.7%
37.7%33.1%
29.8% 27.2% 25.1% 23.4% 21.9% 20.6% 19.6% 18.6%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 1 2 3 4 5 6 7 8 9 10 11 12
Percentage of time-loss claims with duration beyond given month
Average of fiscal accident years 2009 to 2011
Queried: May 28, 2014Actuarial Servicesincludes time-loss and LEP claims
Duration of disability in Months
Disability Prevention is the Key Health Policy Issue
70% Return to work in first 3 monthsDisability and Chronic pain coincide at 3 months 8% account for
85% of costLess than 1% catastrophic
injury
% o
f c
ase
s o
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tim
e lo
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Time loss duration (months)2014 L&I Actuarial Services Analysis (for fiscal accident yrs 2009-2011).
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L&I Quality Expansion Vision
1. Set Minimum Standards• Medical Provider Network and Risk of Harm• Evidence based coverage decisions
2. Incentivize Collaborative Model and Best Practice Use• COHE Expansion • Top Tier• Evidence based treatment guidelines
3. New Best Practices – Identify and Pilot• UW Expert Group Identification of Best Practices• Functional Recovery Questionnaire/Intervention• Activity Coaching• Surgical Best Practice
4. Identify areas of ongoing need• Behavioral health• Long term disability/Chronic pain
• Years lived with disability 2010– Low back pain 3.18 million YLD• Major depressive disorder 3.05 million YLD• Other MSK disorders 2.6 million YLD• Neck pain 2.13 YLD• Anxiety disorders 1.86 million YLD
• Diabetes (#8) 1.16 million YLD• Alzheimers (#17) .83 million YLD• Stroke (#23) .63 million YLD
Burden of Diseases, Injuries, and Risk Factors The State of US Health, 1990-2010, JAMA 2013; 310: 591-608
Innovation in Collaborative, Accountable Care
PrimaryOccupational Health Best
PracticesSurgical & Specialty
Best Practices
Chronic Pain Best Practices
Behavioral Health
Prosthetics
HSCsOHMS
Burns