Strategic Vision: Improving Medical Care for Injured Workers Gary Franklin, L&I Medical Director

1 Health Care Strategy Goal: Improve worker outcomes  Prevent/reduce disability by providing highest quality medical care Every provider is a high quality provider

2 Disability Prevention is the Key Health Policy Issue 70% Return to work in first 3 months Disability and Chronic pain coincide at 3 months 70% Return to work in first 3 months Disability and Chronic pain coincide at 3 months 8% account for 85% of cost Less than 1% catastrophic injury 8% account for 85% of cost Less than 1% catastrophic injury % of cases on time loss Time loss duration (months) 2014 L&I Actuarial Services Analysis (for fiscal accident yrs ).

3 L&I Quality Expansion Vision 1.Set Minimum Standards Medical Provider Network and Risk of Harm Evidence based coverage decisions 2.Incentivize Collaborative Model and Best Practice Use COHE Expansion Top Tier Evidence based treatment guidelines 3.New Best Practices – Identify and Pilot UW Expert Group Identification of Best Practices Functional Recovery Questionnaire/Intervention Activity Coaching Surgical Best Practice 4.Identify areas of ongoing need Behavioral health Long term disability/Chronic pain

Years lived with disability 2010 – Low back pain 3.18 million YLD Major depressive disorder 3.05 million YLD Other MSK disorders 2.6 million YLD Neck pain 2.13 YLD Anxiety disorders 1.86 million YLD Diabetes (#8) 1.16 million YLD Alzheimers (#17).83 million YLD Stroke (#23).63 million YLD Burden of Diseases, Injuries, and Risk Factors The State of US Health, , JAMA 2013; 310:

Innovation in Collaborative, Accountable Care Primary Occupational Health Best Practices Surgical & Specialty Best Practices Chronic Pain Best Practices Behavioral Health Prosthetics HSCs OHMS Burns