Integrated Disability Management Approach

Transcription

1 Healthcare Benefit Trust s Integrated Disability Management Approach Presented by: June Murray, Team Leader Integrated Disability Management Services Dan McGinnis, VP Client Services

2 Agenda What is Healthcare Benefit Trust HBT Strategic Focus Standardized Reporting Background What we heard Response to Stakeholders Partnership in action FH, GWL & HBT Body of Knowledge Mental Health Resource Kit

3 What is Healthcare Benefit Trust Not-for-profit health and welfare benefit trust For healthcare and community social services organizations in BC and the Yukon Administer the Trust Fund Ensure health and welfare benefits comply with the collective agreements Provide Benefit and Financial Administration services Provide Disability Management, Early Intervention, and Rehabilitation Services

4 HBT Strategic Focus Activist Board increased focus on Alignment Collaboration Transparency Interim CEO - Bob Smith (Permanent CEO Search underway) Werner Schulz Returns in December as VP Integrated Disability Management Services

5 HBT Strategic Focus Client Focus To be recognized as a highly-valued, collaborative partner, supporting client needs Engaged Team To create a workplace culture and environment that fosters an engaged, healthy and highly productive workforce Operational Excellence Financial Sustainability Achieve end-to-end operational excellence through a measurable increase in efficiency, productivity, service and quality Ensure financial sustainability through costeffective service delivery and sound investment management

6 Standardized Reporting Objective Develop a standard data set to facilitate the development of accurate information and tracking to support decision making Background Different organizations have adopted unique data definitions and data base structures Differences result in different types of data being made available Compromised comparability

7 Standardized Reporting Audiences Financial & Executive Decision Makers Benchmarking and metrics Medical Researchers & Decision Makers Strategic Planners HEABC CSSEA Provincial Government Other Stakeholders Unions Other Health employers Etc. 7

8 Standardized Reporting Benefits of Standardization Facilitate information exchange Reducing data costs Providing Rich information Rapid access to large volumes of data Improved communications & coordination Facilitates accurate, comparisons and planning Benchmarking & Metrics 8

9 Background to Disability Outcomes

10 Demographic Shift Source: Public Health Agency of Canada, Report on the State of Public Health in Canada, 2008.

11 Direct Costs of Disability % 1.26% 1.8% In 2007 WCB claims accounted for 31% of direct costs LTD STD WCB Percent of Payroll Source: Watson Wyatt, Work, 2007.

12 Healthcare Disability Costs Disability costs are a continuum and currently are distributed approximately 55% to Sick Time, 10% to WorkSafeBC claims and 35% to LTD. Source: Examining Disability Management Practices within the Healthcare Industry in British Columbia. May 7, 2009

13 Top 10 Medical Conditions $450,000 $400,000 $350,000 $300,000 Presenteeism Absenteeism $250,000 $200,000 $150,000 $100,000 $50,000 $0 Fatigue Depression Back/Neck Obesity Hypertension Arthritis Chronic Pain Anxiety High Cholesterol (Annual Cost Per 1000 FTEs) Sleeping Problem Source: Loeppke R, et al. J Occup Environ Med. 2007;49:

14 Total Disability Costs Non-Work Related Disability Work Related Disability 80% 20% If 80% of the total disability costs are attributable to Non-Work Related disability, how should we allocate our resources to prevent and manage that disability?

15 Capturing the LTD Opportunity Absence Future RTW Current RTW 17 month opportunity on 50% of LTD claims 18 35

16 What we heard about HBT Services Areas where we can improve Areas where we should collaborate more Streamlining and efficiency requirements

17 Listening and learning Employer s were not a part in planning process HBT has been poor communicator of information Clunky processes Administrative barriers Silos in service provision

18 Listening and Learning Early identification is critical All staff working hard but systems not connected Significant variability in case management practices Understanding each other s business

19 Stakeholder Engagement HBT Mgmt Employee WH GWL Union Medical Workplace absences are very complex - we have to work together 19

20 HBT Silos (Old Think) Intake Intake Intake Intake DM Services request for services and approval of expenditures EIP initiated by payroll report DM Services - request for services and approval of expenditures Rehab Services referred for services by GWL Stay at Work 5 days up to 5 months off work If LTD claim is not accepted or delayed On LTD (after 5 months absence) Rehab Consultant Medical Case Manager Rehab Consultant Rehab Consultant

21 Starting Points

22 Fundamentals of Improved Approach Collaborative Developed in consultation Leveraging stakeholder skills Clearly defined roles and responsibilities Integrated across HA, HBT and GWL Employee Centric Providing right services early Removing barriers Streamlining processes Enhancing EIP process Maintaining confidentiality Transformational Workplace connected Fair and timely decisions Rigor in development of approach Based on recognized DM best practice guidelines Technology changes & improvements (MedGate) Aligns with the current Collective Agreements

23 Early Intervention - The Cornerstone 1. Employer-initiated response to an employee s medical condition as a result of the onset of illness or injury 2. Addresses the physical, social, psychological, vocational and financial implications of illness 3. Facilitates appropriate and timely treatment, rehabilitation and return to work 4. Goal to achieve safe and sustainable Stay at Work (SAW)/ Return to Work (RTW) 23

24 Current Day Developed in Collaboration (FH, HBT, GWL)

25 Differences in the Improved Process Stage Intake/Triage Case Management Medical Case Management Comprehensive Case Review Process Recommend the employer develop a central contact for reporting absences across HA - Early identification of absences Process is not entirely medically driven - It s an employee/employer conversation rather than a payroll report at 30 days absence to HBT Integrated HA, HBT and GWL team that will work with all stakeholders HA to lead case management to ensure right services as early as possible Remove barriers to improve access to timely medical services - HBT to lead this process within the integrated team File review at fixed intervals with input from all stakeholders to ensure that everything possible is being done to support the employee

26 Body of Knowledge Admin Handbook provides: Key processes ( e.g. Triage, Case Management, Medical Case Management, Addictions, Mental Health, Failure to Respond) Guidelines Policies Roles and Responsibility Clarity

27 Quality Assurance Problem Resolution Process Working Group Referral Monitoring / Control Plan Case Collaboration/Studies Stakeholder Feedback Annual File Review

28 Next Steps for Improved IDMS HBT to continue discussion with other Healthcare stakeholders Continue developing body of knowledge to support improved IDMS approach & implementation

29 HBT Resource Guide Identified need for practical information on supporting employees who are experiencing stress, distress and mental health concerns Increase manager s awareness of HBT services and community resources available

30 Resource Guide Development Story Collaborative process -internal & external focus groups Content reviewed by subject matter/industry experts Formed an industry advisory committee Finalized content and look Piloted the website Mental Health Resource Guide for Managers Sept 08 Completed pilot Dec 08 Updated site based on pilot feedback Website was made available to all Trust members Spring 09

31 The Resource Guide has 9 Modules Introduction The Basics Recruitment and Orientation At Work in Distress Off Work RTW and Accommodation Self Care for Managers References Glossary

32 Module 1 - Introduction

33 Module 2 The Basics - Case Study

34 Why the Manager Should Care Mental health issues: Adversely affect individual productivity, performance and attendance Increase costs in terms of absenteeism, benefit utilization and replacement Can lead to potential conflict, morale problems and grievances Raises the risk of accidents, injuries and complaints amongst staff, patients and clients

35 Module 3 Recruitment and Orientation

36 Module 4 At Work in Distress

37 Module 5 Off Work

38 Module 6 Return to Work & Accommodation

39 Module 7 Self Care for Managers

40 Module 8 & 9 References & Glossary

41 Resource Guide launched Spring 09 HBT Member Portal Website HA Intranets: VCH, FH, VIH, IH,PHSA For More Resource Guide Information contact:

42 Questions? For more IDMS information contact: June Murray, Team Lead IDMS Iris Lama, Manager IDMS