© 2002 Six Sigma Academy0 Define Point one Point two Point three Workman’s Compensation.

Slides:



Advertisements
Similar presentations
Work Related Injuries Training Module. Hi ! My name is Bill Moore. I want to talk briefly with you today concerning work related injuries.
Advertisements

WORKERS COMPENSATION, WORKPLACE SAFETY AND JOB RELATED DISABILITIES This presentation will focus on legal and procedural issues related to workers compensation,
Rehabilitation What is it? Does it work? Is it cost effective?
Think safe. Act safe. Be safe. Supervisory Safety Leadership Best Safety Practice # 1 Understanding Legal, Employee Safety/Health & Economic impacts Understanding.
OSHA Injury Reporting.
The Workers Compensation Claims Process START (Click Here) START (Click Here)
©Copyright 2005 Quantum Patient Assessment, Inc. The Ready to Work Report™ Web-Based Medical Reporting Software by Quantum Patient Assessment, Inc.
1. 2Workers' Compensation Workers’ Compensation and The Three Parts Workers’ Compensation is a social insurance program that provides:  Medical care.
Effectiveness of BWC’s SafetyGrant$ Program. July 1999 – June 2003 results o No claim required to complete an application until November 2001 o Employers.
JOB FUNCTION EVALUATION Lowering Your Accident Costs.
Safety and Health Programs
Responsible CarE® Employee health and Safety Code David Sandidge Director, Responsible Care American Chemistry Council June 2010.
Workers Compensation Managed Care By: Laura Deterding, ACAS, MAAA Midwest Employers Casualty Company.
Course Code: SW-SFTY.  Sizewise Rentals is committed to working with our employees to provide a safe work place.  It is our policy that employees should.
Leveraging Your Broker/Agent & Insurance Carrier to Reduce Insurance Costs Presented by Mary Kay Depperman, CSP.
Copyright © 2008 Delmar Learning. All rights reserved. Chapter 17 Workers’ Compensation.
INCIDENT REPORTING RISK MANAGEMENT WORKERS COMPENSATION PROGRAM.
Axiom Medical Consulting, LLC
“Your Complete Employers’ Outsourcing Solution” Claims Management is Cost Management A Claims Management Presentation By Tri-State’s Claim Management Department.
A CCIDENT D ATA A NALYSIS Many times, safety professionals conduct data analyses involving accident data as a means to identify prevention activities Common.
Case Management Teams Marianne Cloeren, MD, MPH USACHPPM Force Health Protection.
SAFETY AND HEALTH PROGRAMS 1. This presentation is adapted from the OSHA Safety and Health Programs presentation available on the OSHA website. CREDITS.
September 28–29, 1998 Philadelphia, Pennsylvania Lisa G. Chanzit Patrick R. Newlin Ruth E. Winnicki Actuarial & Claims — Strange Partners? Casualty Loss.
1 Medina Healthcare System: Centralized Scheduling Center.
Incident Reporting Procedure
© 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Computers in the Medical Office Chapter 2: Information Technology.
Claims Management. Initiatives Bureau of Workers’ Compensation (BWC) Industrial Commission (IC)
Problems Requiring Special Attention
Return To Work & Transitional Jobs
Claims Management Presented by: Patty Davidson – Qual-Lynx 2013 ACM JIF Retreat.
1 Your Skills and Experience Are a Valuable Resource to Your Department and to the City of Houston. We Wish You an Expedited Recovery and Safe Return to.
COMMON EXCUSES FOR NOT REPORTING AN INJURY: “It was just a little scrape, it really wasn’t worth reporting” “I was just so busy I forgot” “It didn’t seem.
Black Belt Level DMAIC Certification Checklist
Workers’ Compensation Program CEO Risk Management Branch
WORKERS’ COMPENSATION PROGRAM: THE ROLE OF THE ON-SITE COUNTY REPRESENTATIVES TONY TARAS (800) ext 1678
1. Objectives  Describe the responsibilities and procedures for reporting and investigating ◦ incidents / near-miss incidents ◦ spills, releases, ◦ injuries,
RETURNING INJURED WORKERS TO SUITABLE EMPLOYMENT Presented By: Justus Swensen Utah State University Facilities Safety
1 Your skills and experience are a valuable resource to your department and to the City of Houston. The purpose of this presentation is to refresh your.
Modified Duty Closing the Claim. Overview  Elements of an effective Modified Duty Program  How to implement a successful program.  Branch level roles.
Christopher E. Schaffer, Esquire Vice President of National Sales National Claim Trends Insight. In Touch.
Implementing an Effective Safety and Health Program
Sue Keener Director of Virginia Office of Workers’ Compensation GOVERNOR'S HEALTH POLICY ADVISORS ANNUAL CONFERENCE.
Workers’ Compensation Managed Care Pricing Considerations Prepared By: Brian Z. Brown, F.C.A.S., M.A.A.A. Lori E. Stoeberl, A.C.A.S., M.A.A.A. SESSION:
Return To Work & Transitional Jobs. Vincent & Vincent Companies (Dept. of Loss Control Engineering) P.O. Box 304 Freeland, PA Program Goals To lower.
Accident Reporting. Ouch! I’ve Had A Job Related Accident & Injury What happens now? Immediately report it to your Supervisor or Manager – By Law, late.
1 Your Skills and Experience Are a Valuable Resource to Your Department and to the City of Houston. We Wish You an Expedited Recovery and Safe Return to.
Chapter 9: Hypothesis Testing Section 3: The P-Value in Hypothesis Testing.
One-way ANOVA: - Comparing the means IPS chapter 12.2 © 2006 W.H. Freeman and Company.
Project Storyboard (Page 1 of 2)
© 2002 Six Sigma Academy0 Define Point one Point two Point three Increase Market Share.
Understanding Workers’ Compensation Coastal Carolina University Office of Risk Management.
Disability Retirement Services “A Day In the Life of an Investigator” Presenters: Tamara Caldwell & Debbie Semnanian.
M EDICAL P ROVIDERS & E MPLOYERS Carrie Freeland, Manager Integrated Leave Department 1.
Division of Risk Management State of Florida Loss Prevention Program.
©Towers Perrin September 13, 2004 Reserving Implications of Reform Workers Compensation David Mohrman John Booth.
DIRECT REIMBURSEMENT. © 2012 American Dental Association, All Rights Reserved DIRECT REIMBURSEMENT The ADA recognizes that the Direct Reimbursement concept.
Presented by Charlotte Price August 12, 2015.
Green Belt – SIX SIGMA OPERATIONAL Intro to Analyze Phase.
A Method for Evaluating the Impact of Medical Networks in Workers Compensation Claims N. Mike Helvacian, PhD Director of Research and Chief Economist 1999.
Colville Confederate Tribes Workmen’s Compensation What is Workmen’s Compensation?
DoD Lead Agent: Office of the Assistant Secretary of the Army (Installations and Environment) Department of Defense Voluntary Protection Programs Center.
Workers Compensation Basics Prepared for Fresno County Self Insurance Group-FCSIG.
The Differences in Ticket Prices for Broadway Shows By Courtney Snow I wanted to find out whether there was a significant difference in the price of musicals,
1 Office of Risk Management and Insurance Services Workers’ Compensation Program Update Audit, Business and Technology Committee October 5, 2004 David.
Return to Work (RTW) After an injury.
Accident Data Analysis
COMBINING SERVICE & SAVINGS
Presentation transcript:

© 2002 Six Sigma Academy0 Define Point one Point two Point three Workman’s Compensation

© 2002 Six Sigma Academy1 Define Point one Point two Point three Currently Worker’s Compensation Reserves are projected to be $2 Million for the Year Problem Statement Objective Reduce Worker’s Compensation Reserves Critical to Quality – CTQ Fast, appropriate medical treatment to affected employee Current/Goal/Stretch Goal 21.5DPMO – Current (Clinical visits) 23.2 DPMO - Current (Phy. Therapy) 247 DPMO – Current (L.T. Claims) 6.45 DPMO - Goal (Clinical visits) 6.96DPMO - Goal (Phy. Therapy) 74DPMO – Goal (L.T. Claims) 5.3DPMO – Final (Clinical Visits) 5.3DPMO – Final (Phy. Therapy) 102DPMO – Final (L.T. Claims) Benefits Achieved $712,000 Savings in Worker’s compensation reserves 75%, 77% and 59% improvement in DPMO respectively

© 2002 Six Sigma Academy2 Define Point one Point two Point three Metrics Critical to Quality - CTQ Fast, appropriate medical treatment to affected employee  DPMO – Clinical Visits  DPMO – Physical Therapy  DPMO – Lost Time Claims YearClaim Count Incurred $ 470, $1,195, $ 782, $ 546, $ 123, $ 253,066 Reported claims have been increasing at an average rate of 33 per year from 1995 through 1999.

© 2002 Six Sigma Academy3 Define Point one Point two Point three Claim Procedure TPA’s Claim Procedure PROCESS MAPPING Reserve setting procedure identified as as one area for improvement

© 2002 Six Sigma Academy4 Attribute Gage R & R Pass! MSA Measurement system passed with 90% score

© 2002 Six Sigma Academy5 Cause & Effect Matrix Areas of Focus! C&E MATRIX Identified potential areas for improvement

© 2002 Six Sigma Academy6 Lost Time Claims Clinical Visits Physical Therapy Visits Initial Capability Analysis BASELINE CAPABILITY

© 2002 Six Sigma Academy7 Among Seats Built vs. Clinical Visits, PT Visits, Lost Days, & OSHA Recordable Injuries Correlation of Seats Built and Lost Time ClaimP-Value = Correlation of Seats Built and Clinical VisitsP-Value = Correlation of Seats Built and PT VisitsP-Value = Correlation Studies No Statistical Significance! P-values all greater than 0.05 Correlation studies used to determine if linear relationships exist between factors (X’s) and response (Y)

© 2002 Six Sigma Academy8 Multi-Vari for Total Injuries by: Shift - Day - Month Thursday’s and Friday’s had an increase in injuries! Multi-vari studies used to look for differences between factors (x’s) and response (Y)

© 2002 Six Sigma Academy9 In-service was initiated to show supervisors the proper procedure on how to complete a supervisor’s report including an investigation report. Accommodating an employee’s restrictions. The number of loss time work days directly effects claim dollar amount. Employees referred to Barnes Care, by the nurse, must be approved by Human Resources. Case Management - Daily communication concerning cases, course of treatment, surveillance/investigation, and review of medical evidence to determine the validity of the claim among the Human Resources, Plant Nurse, Physicians, TPA, and Physical Therapy. Monthly meetings are scheduled to discuss and review open claims. Process Improvements

© 2002 Six Sigma Academy10 Old Process New Process Main Effects for Clinical Visits by Month Two-sample T Month 1 N Mean A B Difference = mu (A) - mu (B) Estimate for difference: 38.9 T-Test of difference = 0 (vs not =): T-Value = 3.46 P-Value = DF = 7 Ho = There is no difference between Aug-March & April-Sept Ha = There is a difference between Aug-March & April-Sept 2 Sample T-Test Clinical Visits REJECT Ho Hypothesis test shows statistically significant difference (improvement) between old and new process

© 2002 Six Sigma Academy11 Old Process New Process Main Effects for Physical Therapy Visits by Month Two-sample T Month N Mean A B Difference = mu (A) - mu (B) Estimate for difference: 29.5 T-Test of difference = 0 (vs not =): T-Value = 2.13 P-Value = DF = 11 Ho = There is no difference between Aug-March & April-Sept Ha = There is a difference between Aug-March & April-Sept 2 Sample T-Test Physical Therapy Visits REJECT Ho Hypothesis test shows statistically significant difference (improvement) between old and new process

© 2002 Six Sigma Academy12 Control Plan put in place consisting of following:  Nurse is responsible for case management, on-site care, scheduling therapy, advising and tracking restrictions, analyzing jobs, and meeting with the safety committees. Also, initiated internal care by treating minor injuries & illnesses resulting in a reduction of outside medical visits and costs.  Set Permanent Partial Reserves at the mean percentage opposed to the maximum percentage.  Worker’s Compensation Administrator reviews all reserves set for each reported claim.  Monthly meetings are scheduled with our Worker’s Compensation Specialist & Worker’s Compensation Health Care Provider to discuss further tests, specialist referrals, and case closure of reported claims.  An EDI Programming System has been installed to assist the nurse in submitting claims immediately, tracking injuries, review worker’s compensation claims, and increases efficiency and productivity.  Carma System is being installed to allow access to all the information in the TPA’s system. Company will be able to view the reserves and adjustments made for each claim, and all claims an employee has or has had.