Faster treatment and better care will lead to quicker, safer return to work and lower an employer's costs. That is what all of us at BWC want to achieve on each and every claim. And that is why, we worked with a team of stakeholders representing business, labor, managed care and the medical community to re-engineer how to deliver health care. The result is the Enhanced Care Program (ECP).
- Claimants at risk of poorer outcomes should have their care managed by a high-quality physician of record (POR).
- PORs should establish comprehensive care plans that consider not only a claimant's workplace injury but other physical, social and behavioral health issues that could impact the claimant's successful return to work.
- MCOs should support high-quality PORs by coordinating the exchange of information among key parties and removing barriers that prevent the claimant from returning to work.
We launched the ECP as a pilot in Northeast Ohio, on July 1, 2015, for state-fund claimants who only have knee injuries. The program empowers the POR to treat both allowed conditions in the claim, and those injuries the POR believes are causally related to the workplace injury. It also encourages the POR to begin care immediately without fear of nonpayment so long as the POR treats within the boundaries of the Official Disability Guidelines.
The program also separates the medical and legal components of the workers' comp process without affecting any party's due-process rights. For more complex claims, this approach can reduce delays by as much as five weeks - which means claimants will get back to work faster and healthier than before. Equally important, BWC and its stakeholder-design team are hopeful a more coordinated approach to care with fewer delays will enable more injured workers to return to work - and to life - as quickly and safely as possible.