Workers’ comp gets helping hand at St. Luke’s

The prognosis for injured workers, their employers and the Washington workers’ compensation system is looking up, in part because of a program developed by St. Luke’s Rehabilitation Institute in Spokane.

A University of Washington study released last week found that 7,162 injured workers tracked over a one-year period were one-third less likely to miss work if treated by one of 177 doctors and other providers linked with the Eastern Washington Center of Occupational Health and Education. Getting those employees back on the job saved the workers’ comp system $3.1 million.

The results mirror those registered in a second trial program based in Renton, where the estimated savings totaled $5.6 million on 10,000 claims.

To put those numbers in perspective, in 2004 the state-funded program handled 121,679 claims costing a total $659.7 million, an average of $5,442 per claim. The Spokane Center of Occupational Health and Education trimmed $447 from the cost of each claim. Renton did better, $566 per claim, but officials caution about side-by-side comparisons of the results, given differences like the size of area served.

About 2.3 million workers are covered by the state-funded workers’ comp program, another 830,000 are employed by companies that self-insure.

Washington business has complained mightily about workers’ comp costs. The outcry peaked a few years ago, when premiums were escalating at double-digit rates. Although the surge has subsided, the system remains a sore point. Replacing the incomes of workers off the job for long periods of time is a big cost driver.

But cost savings were just one objective of the COHEs. Improving communication among worker, employer, the Department of Labor & Industries and medical providers was another, as was identifying the most effective therapies, and sharing those among providers.

Daniel Hansen, the St. Luke’s chiropractor directing the Eastern Washington COHE, is justifiably happy with the UW findings.

“The goal is to get injured workers back to their job, back to their friends at work, back to being a productive citizen,” he says. Cutting lost-time compensation is one indication the program works, but so are survey findings that workers were satisfied with the treatment they received.

The studies of the Spokane and Renton programs focused on back injuries, fractures and carpal-tunnel syndrome. The St. Luke’s effort has been particularly effective treating spinal problems; in Renton, it’s carpal tunnel. Hansen says the absence of neurologists in some rural Eastern Washington communities may delay diagnosis of carpal tunnel until the injury, usually caused by repetitive motions, is more difficult and more costly to treat.

“It’s such a different environment,” agrees Diana Drylie, L&I senior health policy analyst.

She says all COHE stakeholders – the state, business, labor and providers – plan to meet in September to discuss what has worked best so far, and how the programs can be expanded. But the department does not expect to request funding for a statewide launch of a COHE-like program for the 2007-2009 biennial, Drylie adds.

The St. Luke’s effort has already expanded into 16 counties from the three covered by the UW assessment. Valley Medical Center in Renton is not actively recruiting more providers, Drylie says, but the program there has grown as doctors and clinics – Group Health in Tacoma among them – approach officials there about participating.

Considering that UW was looking at programs just one year along, she says, “At L&I, we’re really pleased with the results.”

Hansen says St. Luke’s is learning how to improve communication and tracking, identifying best practices in injury treatment, and simplifying or eliminating the paperwork that bloats medical costs in the United States.

“That’s currency,” he says of the potential time savings.

Potential currency as well for Inland Northwest Health Services, the parent of St. Luke’s and a leader in telemedicine that can benefit from the experience gained developing a more efficient workers’ comp program.

Whatever the complaints Washington business has about this state’s workers’ comp system, it rates fairly well compared with those in other states that may also be looking for programs that cut costs.

So far, the Spokane and Renton pilots seem to be serving all constituencies well. A little more therapy, and Washington workers’ comp could be good to go, from a medical standpoint anyway.