Category: Preventing Claims

An Occupational Medicine Program Outline

I was invited to the 28th Annual National Conference of the Ryan Associates where the theme will be Adapting to the New Healthcare Environment. The Pre-Conference theme was Core Components for Occupational Health Program Management. While I can’t go due to a scheduling conflict, I thought the conference outline was an education in good practices so, with some editing on my part, here it is. Consider it a checklist for your program.

EMBRACING THE OCCUPATIONAL HEALTH OPPORTUNITY

Objective: To understand the benefits of providing occupational health services to employersdoctors

  • The occupational health opportunity
  • The program of the future
  • Trends affecting the changing landscape

 

DEVELOPING BROAD AND COHESIVE PRODUCT LINES

Objective: To understand the product line and inter-relationship of services available for employers

  • Defining occupational health
  • Patient experience
  • Clinical model
  • Business model
  • Operational plan
  • Staffing plan
  • Clinical management
  • Integrated delivery systems
  • What employers need
  • Optimal clinic access

Objective: To understand the regulations and issues facing employers

  • Product lines defined
  • Total health management model
  • HIPAA implications
  • Protocol structure
  • Information sharing
  • Report card development

Objective: To understand the service and communication requirements for Work Injury Management

  • Injury management principles
  • OSHA regulations
  • Documentation standard development
  • ACOEM standards
  • Documentation tools
  • Coding standards
  • Care management model

Objective: To understand the service and communication requirements for Physical Exams and Screening services

  • Physical exams and screenings
  • Comprehensive physicals
  • Respiratory surveillance
  • Hearing conservation program

Objective: To understand the service and communication requirements for Substance Abuse Testing

  • Substance abuse screening issues
  • DOT regulations
  • Documentation forms
  • Drug free work place/substance abuse

Objective: To understand the service and communication requirements for Wellness/Prevention Services

  • Defining preventative and wellness services
  • Employer consulting services

Objective: To understand the service and communication requirements for Episodic Care

  • Defining episodic care
  • Documentation
  • Measuring outcomes

Objective: To understand the service and communication requirements for Primary Care

  • Defining the model
  • Documentation
  • Contracting services

Objective: To understand how to combine Employee Health Services and Occupational Health Services

  • Defining EHS
  • Benefits and challenges of combining EHS and OHS

 

MASTERING FINANCIAL MANAGEMENT

Objective: To understand how to develop and monitor budgets

  • Expectations, responsibilities and systems
  • Estimating market potential
  • Projecting patient volumes
  • Service utilization ratios
  • Price and volume variances

Objective: To understand how to maximize revenue while minimizing expenses

  • Ten techniques to maximize revenue
  • Dealing with discounts
  • Fixed, variable and semi-variable expenses
  • Monitoring staffing utilization

 

STAFFING CONFIGURATIONS, RELATIONSHIPS, AND RESPONSIBILITIES

Objective: To understand staff roles, components for competency, and productivity indicators

  • Staff roles and responsibilities
  • Staff inter-relationships
  • Scheduling
  • Productivity analysis and indicators
  • Competency overview
  • Performance standards
  • Instilling motivation

 

ACHIEVING OPERATIONAL EXCELLENCE

Objective: To understand occupational health program metrics, define the process for standard development, and identify the Quality Plan

  • Certification standards
  • Treatment standards
  • Financial standards
  • Billing
  • The Quality Plan
  • Patient satisfaction drivers
  • Employer satisfaction drivers
  • Patient service metrics
  • Benchmarking
  • Operational outcomes

• Policies and procedures

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An Open Letter to the New Secretary of Mr. Secretary

Congratulations on your appointment. I wish to briefly share what the Mr. Secretaryoverall concerns are of the thousands of private company business owners that use our program and that I have had the chance to speak to over the last 14 years. 90% of the companies we work with have between 15- 500 employees. One of the few sectors of the economy with real job growth! So, here you go:

  1. Allow me to grow my business. Sounds simple, and straightforward, but I can tell you the general feeling is that the government doesn’t support, but rather impedes, this growth.  The fact you mention moving away from an adversarial approach is a great start! As corny as it may sound, it is time to start playing win/win.
  2. Allow me to hire people I can trust. This means inquiries like criminal background, financial, and medical backgrounds are relevant. For example, I can’t trust a felon in general and if I want to engage in a compassionate act and give somebody a second chance then that should be my choice, not a government requirement. This is not an act of discrimination on the part of any employer but one of legitimate concern. Who wants to hire a trouble maker or potential claim? More than anything, employers want to be able to hire on the basis of skills and character: the building blocks of trust.
  3. Allow my people to be productive. For example, I have worked with JAN (Job Accommodation Network) and have a great deal of respect for the work they do and for people with real disabilities trying to be productive. Unfortunately, I have seen far too many people pull out the disability/discrimination/retaliation card as soon as they realize they may be fired for non-productivity at a job they gave up on years ago. Employers are being told they can’t really understand the nature of a disability but only its limitations. Getting independent medical information is very difficult under the law. As a result of this, well intentioned employers, who are in fact concerned about a worker’s health, have learned that no good deed goes left unpunished. The lesson they often learn is not to proactively offer help because it can and will be used against them.
  4. Don’t drag me through a frivolous lawsuit simply to satisfy a political agenda. We don’t have the time or money for that. For example, the EEOC and NLRB in particular have “pushed too far” and I’m a former plaintiff’s attorney saying this. For example, I don’t want the NLRB to waste my tax dollars expanding NLRA precedent to protect some disgruntled loser who tweets some seriously damaging information while sitting in the parking lot on his break to another worker who should be getting their job done. This is not “concerted activity” as intended by the laws passed more than 60 years ago designed to protect workers who wanted to put in a hard day’s work for fair pay. It’s simply more social media nonsense dragged into the workplace. And…it is really the NLRB/Administration agenda to get rid of “at-will” employment? Really??
  5. Lastly, the ACA is a mess. Of course, employers are not in the job of being responsible for the health of others outside legitimate safety concerns. But for now it’s the law so we are stuck with it and as the Administration had to finally concede, it’s confusing as all heck, even to the regulators. I can tell you that many employers and their brokers remain confused about what to do. Pay or play calculators, FAQ’s, checklists, audits, webinars, and more can be used to support the EBSA website.

Let me conclude by saying I understand there are in fact bad people who care neither about their employees or legitimate laws designed to protect them. Most folks I know have zero sympathy for these people. Most business owners I know want to and try to do things right, do care about people, and want a mutual success. What they and I don’t want to see is an agenda that supports anything but good work.

I wish you the best in your new position; our country needs you to be successful.

Don Phin, Esq.
President of HR That Works

P.S. Perhaps you can also get the website to work so folks can really leave you comments. I tried to do so four times but it kept saying I can’t do basic math right!

Do You Know Employee Rights?

Fact is many people in the HR role do not do the job full-time and very often do little or no proactive compliance efforts. One way to begin learning these laws is to watch or read the info generated by the government and lawyers on behalf of employees. For example,  the DOL has just released and employee video education series. Minimum wage, regular pay, overtime, off-the-clock, child labor, independent contractor, migrant worker and how to file a claim videos are presented. We have training on eemployeesach of these subjects for employers on HR That Works.  A few more:

Those are just a few examples. Where the government has done a good job of creating materials (like in the health and safety area) we have pointed to those tools on HR That Works too.

Bottom line: Don’t let your employees know more than you do about the law!

Americans with Disabilities Act (ADA) & Civil Rights Update: New ADA Rules Take Effect March 15, 2011

Revised regulations implementing the Americans with Disabilities Act (ADA) take effect on March 15, 2011. The regulations apply to the activities of more than 80,000 units of state and local government and more than seven million places of public accommodation, including stores, restaurants, museums, sporting arenas, movie theaters, doctors’ and dentists’ offices, hotels, jails and prisons, polling places and emergency preparedness shelters.

For more information visit https://www.disability.gov/civil_rights/laws_%26_regulations/americans_with_disabilities_act.