Striving for world class

By Bill Teets, BWC Communications Director

It is no secret that successful organizations have a strong sense of direction and purpose. At the Ohio Bureau of Workers’ Compensation, we want to be a world class insurer.

We have a clear mission to “protect Ohio’s workers and employers through the prevention, care and management of workplace injuries and illnesses at fair rates.” Keep people safe. Make them better when they’re hurt. Do it effectively to not over-burden business. We also have a core set of values—service, simplicity and savings—that guide us.

While these are essential to being world class, they’re not enough. As communications director for BWC, I spend much of my time discovering all the great things happening here and sharing them with the outside world. There are so many stories to tell. Great investing has helped us return $3 billion in rebates over the last several years. Ohio’s injury rates are below the national average and our claims are at record lows. We’re finding ways to speed care to the injured and our nationally recognized pharmacy management program has drastically reduced opioid usage among injured workers.

What I’ve learned from telling these stories is that world class organizations have world class people. Our mission and values may guide us, but ultimately, it is the people that deliver on those promises. Several recent accolades prove my point.

Recently, our Chief of Enterprise Services, Shadya Yazback was named a C-Suite Award Winner by Columbus Business First. In their own words, “the C-Suite Awards recognizes Central Ohio’s top executives for their contribution and commitment to the community and their outstanding professional performance.”

This year’s 19 winners were selected by a panel of business school professors in Ohio. Among her achievements at BWC is the implementation of a multi-year, multi-million dollar replacement of our core claims and policy management systems—systems used by more than half our 1,800 employees to serve Ohio’s injured workers and employers. It was not always a smooth transition, but as the driver of the process she proved world-class people are able to adapt and keep an organization driving toward a common goal.

Kendra DePaul is another example of our world-class staff. Kendra has been named as one of 11 NexGen award winners by the International Association of Industrial Accident Boards and Commissions (IAIABC). She achieved this accolade for leading Ohio’s effort to build our Other States Coverage and managing the program. Because of this program, Ohio employers who do business in other states have options that make life easier when it comes to covering their employees.

That same organization awarded our pharmacy department the second annual IAIABC Innovation Award. That entry, “Saving Lives — Building a Model Pharmacy Program Amid a Deadly Epidemic” reflects Ohio’s efforts to reduce opioid abuse and excessive prescribing of the painkillers while building a pharmacy program that’s recognized as a leader in the industry today. Because of the pharmacy department efforts, led by John Hanna, who just retired, we have reduced the number of injured workers dependent on opioids from 8,000 in 2011 to 4,100 today. You can point to policies, but it was John and his people who took the initiative to make this reality.

Three world-class accomplishments. Three world-class people. And that’s just the tip of these iceberg. At BWC, we have 1,800 other dedicated individuals who work every day to help keep workplaces safe, get the injured back to their lives, and help reduce bureaucratic obstacles to their success. Not a bad place to work.

Opioid infographic illustrates BWC’s success, pharmacy leadership

Document’s release coincides with director’s retirement

By Nick Trego, Clinical Operations Manager, Pharmacy Department

Click on infographic  for larger image.

BWC’s communications department recently completed an infographic summarizing our work over the last six years to rein in excessive opioid prescriptions and the dangers they pose to injured workers, namely abuse, addiction and death.

Using a mix of colors, illustrations and statistics, the infographic is a roadmap of the steps we’ve taken to reduce the number of injured workers dependent on opioids from 8,029 in 2011 to 4,101 in 2016, a near 50 percent drop.

It’s called “Saving Lives — BWC battles the opioid crisis.” A better title might be, “Saving Lives — a tribute to John Hanna.”

Hanna, our pharmacy director, retires Sept. 29 after eight years in the job. More than anyone, it is John who is responsible for the achievements highlighted in the infographic, as well as for other pharmacy program reforms we’ve implemented to protect injured workers.  Along the way, with the backing of BWC leadership, he also built a pharmacy department that is a model in the work comp industry today.

When John arrived at BWC in 2009, we had no real pharmacy department to speak of. It was essentially a mix of disparate services shared by various personnel in service offices throughout the state. We had no formulary, no clinical review committees. Controls and best practices were low. Costs and drug utilization were high. For a system that experienced more than 100,000 new injured workers a year, we had to do better.

What followed over the next several years were a series of improvements to reduce inappropriate prescribing of opioids and other dangerous drugs. We created a Pharmacy & Therapeutics Committee of six physicians and six pharmacists to provide recommendations on all medication-related policy. We created the first work-comp-specific closed formulary in the nation. We stopped coverage of any new opioid formulation until it was reviewed by our P&T Committee. And in 2016, we implemented a rule that requires providers to use a set of best practice guidelines when prescribing opioids. If they don’t follow those guidelines, they risk losing their BWC certification.

To further demonstrate our commitment, we offer injured workers who meet specific criteria up to 18 months of paid recovery services if the treatment for their workplace injury leads to an opioid addiction.

In other enhancements, we developed an automated program that flags claimants with high-risk medication regimens. We implemented “electronic edits” that require all drugs in medical-only claims to have a prior authorization to continue to be covered past 60 days. The same goes for workers who’ve had no claim activity for 270 days. We became the first state agency to cover naloxone products, as well as the first state agency to add Abuse Deterrent Formulations of opioids as a choice for prescribers. And earlier this year, our board of directors approved a rule restricting first prescriptions for opioids to seven days or 30 doses.

Our work has garnered local and national media attention, and work comp programs across the country are calling us, wanting to mirror our success. Topping it off, we wound up saving our agency money. That’s right, I said “saving.” For every dollar we spent on reforms, 50 came back to us in savings. All told, our department spends nearly $49.6 million less on medications today than we did in 2011.

Not that any of this was cost-driven. John always told us, “If we implement best clinical practices, the savings will follow.”

Earlier this year, Gov. Kasich recognized John for his efforts, awarding him the Governor’s Award for Employee Excellence. The industry has recognized his efforts, too. Just last month, the International Association of Industrial Accident Boards and Commissions named John and our team winners of its 2017 Innovation Award.

None of this was easy, but John kept us focused on one guiding principal: “Do what’s best for the injured worker. That’s why we’re here.”

Thanks, John.

Click here for more on BWC’s efforts on the opioid front.

 

Motivation equals success

By Jim Landon, RN, and Mukesh Kumar Singh, CFE, LLM, MBA, BWC Compliance & Performance Management

In any workers’ compensation claim, motivation is always a key factor in not only the rehabilitation of the injured worker but for a successful return to work.

While this holds true in any industrial injury claim, it’s particularly true for catastrophic injuries that result in an amputation. When an injured worker suffers an amputation injury, not only are they faced with physical hurdles to overcome but also the challenge of regaining their self-esteem.

Obtainable goals, collaboration
Injured workers who suffer an amputation must learn to adapt both physically and mentally to return to a state of normalcy post-injury. Without motivation and obtainable goals, the injured worker will quite often ultimately fail. However, for an injured worker to be motivated it is crucial they have a strong support system. This system should consist of a positive collaboration between family members, the employer, providers, as well as BWC and the managed care organization (MCO) for ultimate success.

A key to this success is fitting the injured worker with the correct prosthesis as soon as he or she is medically stable to do so. The philosophy of this is well proven. There is only a limited window of opportunity in sustaining the motivation factor for the injured worker before frustration and poor self-esteem set in. If this does not occur, a successful return-to-work and the return to a normal life are unlikely.

The process of fitting the injured worker with the correct prosthesis follows a very simple logic. In choosing the proper device it need not be high tech or low tech, but the right tech.  The choice should be fitting a device that provides optimal function and gives the injured worker the best chance of not only returning to gainful employment but to a pre-injury quality of life.

Support + motivation = success
We must remember that behind every claim number is a person that is more than likely going through the worst period of their life, and they need collaborative support. Support provides motivation.  Motivation equals success.

We saw this recently when we participated with Ryan Nagy, an injured Middleburg Heights police officer, in the Wounded Heroes’ Trek of Hope. Together, we trekked the Annapurna circuit in Nepal.

Ryan’s successful return to work and a normal life following his above-the-knee amputation is a testament to teamwork along with BWC and finding ability in disability with a courageous attitude. His motivation, goal setting, collaboration and a strong support system at home and at work made the difference. Learn more about Ryan’s story by viewing this video.

BWC nurses help provide quality, holistic care for Ohio’s injured workers

By Mary Charney, BWC Director of Nursing

Nursing: The Balance of Mind, Body and Spirit. That’s the theme for National Nurses Week that runs this week until Friday, May 12. This year’s holistic theme also reflects BWC’s approach to caring for Ohio’s injured workers.

BWC’s 58 nurses work in a variety of areas, from medical policy and employee health to rehabilitation, claims management and clinical advisement.

They help Ohio’s injured workers and each of us remember to balance our lives — our mind, body and spirit — for total wellness.

National Nurses Week is a good time for all of us to appreciate nurses and thank them for what they do. Take time to remember the last time you talked with a nurse and how that nurse helped you. Nurses make a difference in our health care journey throughout life.

Nursing is the largest of all health care professions, according to the American Nurses Association (ANA), which declared 2017 to be the Year of the Healthy Nurse. Accordingly, the association is encouraging nurses to be healthy role models for the rest of us.

In its Healthy Nurse, Healthy Nation™ Grand Challenge, the ANA states thatNurses, at 3.6 million strong and the most trusted profession, have the power to make a difference! By choosing nutritious foods and an active lifestyle, managing stress, living tobacco-free, getting preventive immunizations and screenings, and choosing protective measures such as wearing sunscreen and bicycle helmets, nurses can set an example on how to BE healthy.”

For more information on National Nurses Week, visit the American Nursing Association’s National Nurses’ Week website. Again, thank you to our nurses!

Provider perspective: Ohio Workers’ Compensation Medical & Health Symposium in photos

We did not think it was possible – the second year was better than the first for the Ohio Workers’ Compensation Medical & Health Symposium. We increased participation with a capacity crowd of more than 400+ health-care providers.

Thank you!

We appreciate everyone who joined us for our two-day event held last week in conjunction with the Ohio Safety Congress & Expo at the Hyatt Columbus. You share our joint passion for the comprehensive care of Ohio’s injured workers.

A special thanks to the symposium’s exceptional speakers, exhibitors and participants as well as our Medical & Health Division for leading this unique, multi-disciplinary event at no cost to participants.

For ongoing learning, Ohio’s providers took advantage of continuing education opportunities designed for chiropractors, nurses, occupational and physical therapists, pharmacists, physicians, psychologists, rehabilitation counselors and case managers.

What was new this year?

In 2017 our annual symposium featured an exhibit area with 13 exhibitors who help care for Ohio’s injured workers. The exhibitors ranged from prosthetic suppliers and health-care associations to inpatient and outpatient rehabilitation facilities. In addition, we added continuing education for occupational and physical therapists, pharmacists and psychologists.

We continue to include state, national and international experts for our symposium sessions detailing best practices in caring for Ohio’s injured workers. And, we are overwhelmed by the positive comments we are receiving from symposium participants.

Now as we look forward to 2018, experience the symposium by reviewing highlights from 2017.

#BWCmhs exhibitors ready to see providers at med & health symposium!

Between sessions exhibitors visited with #BWCmhs providers.

An association exhibitor was available to answer questions about a safe medicine and responsible treatment program for providers’ patients.

Dr. Matthew Levy (center), orthopedic surgeon at Cleveland’s St. Vincent Charity Hospital answers questions after presenting Periarticular Injuries of the Lower Extremity.

Providers waiting in line to ask Dr. Atchison questions after the first session. He is a medical director for the Rehabilitation Institute of Chicago who presented on managing pain and return to work early.

mhs providers in line

Dr. Ali Rezai, Director of the Neurological Institute at OSU Wexner Medical Center (center) talking with attendees after his session on Neuromodulation Advances for the Management of Chronic Disease.

Dr. William Marras, Director of OSU Spine Research Institute (left) pictured below with BWC’s Dr. Stephen Woods. Dr. Marras presented study results on the clinical lumbar motion monitor.

Dr. Nicholas U. Ahn, orthopaedic surgeon, University Hospitals of Cleveland, reviewed a recent discography study in the last session. He presented another study that examines workers’ comp patients with nonorganic pain.

Attendees on break between sessions.

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Kevin T. Glennon, vice president of clinical services for One Call Care Management in Jacksonville, Florida. Glennon spoke about the work comp challenges of the aging workforce. Read a detailed blog about his presentation here.

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Dr. Susan K. Blank, co-founder and chief medical officer for The Atlanta Healing Center, an outpatient treatment recovery program. Dr. Blank spoke about addiction and misuse of controlled substances. Read more in our blog Wired for addiction.

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Dr. Richard W. Rosenquist, M.D., chair of the pain management department at the Cleveland Clinic, addressing the transition from acute to chronic pain.

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BWC’s Dr. Brian Wilson, DC, introduces Dr. Robin A. Hunter, DC., who presented on approaches to non-opioid treatment options.

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Phil LeFevre, senior vice president of business development for the Work Loss Data Institute LLC in Austin, Texas greets a seminar participant. He presented on using the Official Disability Guidelines for evidence-based care management.

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Gerald Steiman, M.D., a practicing physician at Steiman Neurology Group in Columbus.He delivered a presentation on concussions.

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Attendees also heard from Dr. Michael Coupland, a registered psychologist who spoke about pain in his presentation, The Psycho Neurobiology of Pain: Up Pain, Down Pain, Good Brain, Bad Brain. Check out the BWC Blog here for a review of his presentation.

See you next year!

Comprehensive Care of an Injured Worker

By Stephen T. Woods, M.D., BWC Chief Medical Officer

When any group of individuals comes together with one common purpose, they can achieve what others believe is not possible. I got to see such a group at our recent Medical & Health Symposium, held in conjunction with BWC’s annual Safety Congress and Expo. In this case it was hundreds of providers with a shared passion for taking care of Ohio’s injured workers. Those of us at BWC share that passion and are dedicated to providing world-class care and coverage from Portsmouth to Ashtabula.

The Medical & Health Symposium was an excellent opportunity for providers to learn the latest best practices for the comprehensive care of an injured worker.

I was pleased that more than 400 providers attended. Our system often deals with people who are in their most vulnerable state – emotionally, medically and financially – after work-related injuries. The providers in attendance represented a broad range of disciplines, but all had the unique skills and the passion to pursue a virtuous cycle of continued improvement on behalf of their patients.

Those of us who serve injured workers do so knowing that we are choosing to be their advocates and understanding the complexities of their conditions and of our system.

That commitment is something we’re really focusing on at BWC. That includes being committed to holistic, comprehensive care that is patient-centered, minimizes the burden of injuries and avoids preventable disabilities. That focus on the customer also means that we have to understand the diverse needs of our customers and operate in a way that lets us quickly adapt to both their unique needs and the rapidly changing world around us.

Specifically, in BWC’s Medical & Health Division, we are continuing to push efforts to reduce the amount of bureaucracy our providers endure so they can spend more time managing the overall needs of the injured worker. Pharmacy management, better-designed fee schedules and treatment guidelines, access to non-medication options, and health behavior assessments are all areas we are exploring to make sure injured workers are better able to return to work and return to life.

Of course, no amount of effort on our part will make a difference without the partnership of our providers and other stakeholders. So, thanks to all of you for your commitment in providing comprehensive care for Ohio’s injured workers. You are all part of our world-class team.

Coping with pain

‘Visualize your way out of it,’ psychologist tells work comp audience

By Tony Gottschlich, BWC Public Information Officer

There’s another way to deal with chronic pain that doesn’t involve medications or surgery, a psychologist told an audience Friday at the 2017 Ohio Workers’ Compensation Medical & Health Symposium.

It’s called Cognitive Behavioral Therapy, and it’s not as complicated as it sounds. In fact, the techniques are rather simple, said Michael Coupland, medical director for Integrated Medical Case Solutions in West Palm Beach, Florida.

Cognitive Behavioral Therapy (CBT) is a widely accepted form of psychotherapy that is based on the cognitive model: the way that individuals perceive a situation is more closely connected to their reaction than the situation itself.

Coupland explained that we can condition our brains to control pain or banish it from our consciousness. But it takes practice, a daily repetition of mantras, deep breathing techniques, meditation and other mindfulness methods for it to take root and stick.

Thanks to neuroplasticity, the brain can reorganize or rewire itself, both physically and functionally, throughout your life in response to your environment, behavior, thinking and emotions.

“Exercise your neurons, visualize your way out of this,” he said. “I tell my patients, ‘Whether you believe in this or not, just humor me and do this every day for eight weeks.’ These techniques help stand down the body’s stress-arousal system.”

Coupland admitted it’s tough for most patients to accept this approach. Mindfulness, a state of active, open awareness of the present moment, and meditation are about “letting go,” but the American educational system teaches us to “hold on” to everything we learn.

Coupland shared with the audience a book he authored in the style of Dr. Seuss that illustrates the simplicity and effectiveness of CBT. It’s titled, “Up Pain, Down Pain, Good Brain, Bad Brain,” and can be found for free here.

For more on Coupland and his work, visit www.icms.us or www.cope-with-pain.com.