Anyone who’s been a patient at a hospital (or the caregiver to someone who has) knows all too well that being discharged is not the end of the recovery journey; it’s merely a milestone along the way. For many patients, their next step is a stay in a long-term care, inpatient rehabilitation or skilled nursing facility; others may be able to return home with home health assistance. Securing the right type of care for each individual at the right time can be challenging — especially in areas where facility beds and healthcare professionals are in short supply.
Effective coordination of care after discharge from the hospital is essential to a smooth recovery, particularly for those injured on the job. It also helps employers keep their claim costs in check and provide employees with a positive experience. Here, I’ll explore the importance of well-coordinated post-acute care in workers’ compensation.
Best care, best price
Post-acute care facilities are not all created equal. Some have a stronger focus on rehabilitation, and that factor is especially important when the goal is to get the person back on the job as quickly and safely as possible. It’s not enough for an injured worker leaving the hospital to have “somewhere to go”; they have the best chance of recovering and returning to productivity if they can spend time in a facility appropriately equipped to help them rebuild strength and learn adaptive working techniques. Having a post-acute care coordinator as part of your claims team means each injured worker’s recovery progress is carefully monitored to ensure they receive the right care at the right facility and for the appropriate duration.
In addition to quality of care, there’s also the issue of cost. Proactively engaging a post-acute care expert in an injured worker’s case from the time of hospital admission helps to eliminate unexpected and out-of-network costs associated with the next phase of recovery. Without the 24/7 availability of a care coordination team, unanticipated expenses are likely to arise when hospital discharge orders are issued outside of standard business hours, as is often the case. These costs can include extended hospital stays due to discharge delays (especially over weekends) and facility transfers via ambulance, rather than more cost-effective transport. Additionally, having post-acute care coordinated by specialists removes the burden of facility rate negotiation from the busy desks of workers’ compensation claims examiners — many of whom don’t have a lot of experience doing so.
It’s in employers’ best interest to embed post-acute care coordination in their workers’ compensation and managed care programs. Doing so not only helps to control spending on care associated with on-the-job injuries (based on our book of business, they can save as much as 30%), but also significantly improves the likelihood of injured workers regaining the skills they need to safely return to work.
The transition home
Just as discharge from the hospital is one milestone on the extended recovery journey, so is the return home following a stay in a post-acute care facility. Without the right support, it can be very overwhelming for the injured worker’s family to properly meet the patient’s multifaceted needs and promote continued healing. Many injured workers expect to benefit from the assistance of home health, but they may not consider other types of support they’ll require, including medical equipment, supplies, transportation, therapies and home/vehicle modifications. Post-acute care specialists are experienced in coordinating all of these things; they can even begin the process in advance of discharge to facilitate a smoother transition home for the injured worker.
Whether it’s durable medical equipment (DME) and supplies, in-home healthcare and therapies, dental or audiology services, orthotics and prosthetics support, or modifications to an injured worker’s home (ramps, grab bars, door widening, etc.) or vehicle (such as controls, automatic doors, adjustable seating and more) — a post-acute care specialist can help in securing the appropriate resources for the best price from a network of credentialed providers and suppliers.
Caring counts
In the big picture, effective coordination of post-acute care in workers’ compensation is about connecting the dots. It’s ensuring seamless transitions from the hospital to the right rehab/nursing facility and back home again with proper support — so injured workers and their families don’t have to worry about what comes next in the process or how they’ll get from point A to point B. It’s using specialized knowledge of post-acute care to alleviate stress from injured workers and their claims examiners. It’s the winning combination of helping employers control their medical spending on workers’ comp while showing employees that caring counts. When employers embed post-acute care coordination in their claims programs, it facilities better quality experiences and outcomes for injured workers during a stressful and uncertain time.
Taking care of injured workers on their journey to recovery is not only my personal passion — it’s the mission of all of us here at Careworks. Contact us to learn more about what we can bring to your workers’ compensation and managed care program, so you can demonstrate to employees how caring counts.
Learn more — explore our post-acute care coordination solution