Patient Engagement Key to Improving Compliance, Return to Work in Workers’ Comp Claims

A new whitepaper by Coventry, a company that offers workers’ compensation cost and care management to insurers, third party administrators and employers, discusses ways to improve compliance and return to work in workers’ compensation claims.

The paper, released this month, noted non-compliance begins with refilling and taking prescription medicine. Between 15-20 percent of patients refill prescriptions and then only 50 percent actually take the medication. “When the prescription is for a lifestyle change – such as weight loss, smoking cessation or exercise – compliance is even worse,” noted the authors.

Part of the problem is the term compliance which, according to the authors, implies a passive patient. Partly the result of technology and the availability of personalized information, patients no longer want to be told what to do. Instead, patients want to be more involved in their treatment and recovery and, as a result, the medical community needs to consider the idea of patient engagement instead of compliance.

The authors noted several barriers to engagement. Time is one hinderance – doctors have less time and more patients to treat. The unfiltered information available on the Internet is another issue, the paper stated.

In order to move to a patient engagement atmosphere, the authors suggest adopting the Health Belief Model, developed by psychologists in the 1950’s. This includes understanding the patient’s beliefs about:

• His/her health
• Severity of condition
• Perceived benefits of treatment
• Perceived ability to engage in treatment intervention

It’s a time and labor intensive process that includes educating the patient, follow up and motivational interviewing.

Co-morbidity is another area that can cause issues with compliance and return to work. The authors note that claims with co-morbidity are typically more expensive than other claims.

Trust must be fostered by all stakeholders involved a claim, the authors wrote, indicating that showing genuine interest and spending quality time with the patient are among the top ways to do so.

According to Coventry’s white paper, four ways to foster trust:

1. Leveraging trusting relationships with nurse case managers.
2. Find out what is relevant to the patient by zeroing in on all of the factors that could affect recovery and return to work.
3. Use early identification, like risk modeling and 2/47 nurse triaging, to hone in on potential problems.
4. Understand that the injured work doesn’t care about “health silos”.

Lastly, the authors advise that improvement will occur in these areas when the patient is actively engaged/understands the treatment and acknowledges the benefit in following treatment to recovery.

Source: Coventry