How Does Occupational Accountable Care Differ From Usual Care?

With USUAL CARE, return to work decisions are based primarily on subjective complaints and physical exam findings that are poor predictors of work and lifestyle functioning:

  • No pre-injury baseline of musculoskeletal fitness is available to monitor recovery progress.
  • “Sick Notes” written to excuse “patients” from work fail to indicate which job demands prevent return to usual duties.
  • During initial and follow-up visits, “patients” are asked to describe and rate their pain from 0 to 10 as a vital sign for treatment progress, with no objective measures of physical function.

This USUAL approach to care prioritizes medications over activity and contributes to needless work disability, drug abuse, and treatment costs for work-related and non-occupational health conditions.

With OCCUPATIONAL ACCOUNTABLE CARE, return to work decisions are guided by objective assessments of fitness-for-duty and job demands to reduce work participation barriers:

  • Workers receive a post-offer WorkAbility Fitness Screen to establish a baseline for musculoskeletal health and fitness-for-duty.
  • Workplace wellness programs emphasize employee participation in voluntary WorkAbility Movement Screens and triage to manage musculoskeletal risks and promote suitable physical activity.
  • When a worker requests to be taken off work or put on job restrictions, the priority is to clarify job demands in a manner that allows physicians and therapy professionals to identify job demand barriers that need to be addressed through job accommodation and treatment plans.
  • During initial and follow-up work rehab visits, objective measures of musculoskeletal health and physical function are re-assessed to validate recovery progress compared to pre-injury baseline.
  • During work rehabilitation services, the physician and employer are provided with regular reports of functional progress to expedite a safe transition back to usual duties.
  • Rehabilitation services are delivered at the most convenient work-site or out-patient clinics with appointment times that do not interfere with stay-at-work or return to modified duties.

This is an integrated care process that engages the worker in workplace intervention based on participatory ergonomics and graded activity to promote sustained return to work. A research study by Lambeek et. al. revealed a 26:1 return on investment for integrated care compared to usual care in a randomized controlled trial of workers sick-listed with chronic low back pain.

WorkAbility Network is a member of Occupational Accountable Care (OAC), which is an Ohio collaborative to improve the health, fitness and productivity of employed populations. OAC develops Integrated Disability Management (IDM) solutions for employers by developing relationships with local rehabilitation providers to reduce musculoskeletal claim frequency and severity. OAC can also facilitate a baseline and ongoing return on investment (ROI) analysis to demonstrate the financial benefits of the IDM program for employers. The innovative WorkerFIT Platform is used to integrate Functional Job Analyses, Worker Fitness Exams and Modifications solutions for employers. WorkAbility therapy providers have completed specialized occupational health training to objectively measure physical capacities and monitor worker readiness for job-relevant demands. Functional recovery progress is monitored by objective measures of musculoskeletal fitness and job-specific physical capacities to minimize productivity loss. WorkAbility Examiners also deliver ergonomic job analyses and wellness movement screen services to support workforce safety and productivity.

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