Is there a place for telemedicine in workers’ comp?

Happy Friday! First some housekeeping. I will be changing the name of my weekly blog posts to “Experts in Work Comp.” My friend / colleague Stephen Sullivan over at WorkCompWire already has a product in place by the name of WorkCompRecap, so out of respect, I am changing the name of my blogging activities. Please bear with me as I figure out how to switch over the account, but I do have @expertsinwc on Twitter which is where all this will be going eventually.

Vonesa Wenzel. Is there a place for telemedicine in work comp? You hear a lot of talk these days about telehealth and telemedicine. While there is definitely a natural place for it in the group health market, I don’t think the work comp space understands how to plug into it just yet. It probably won’t come to the forefront until folks in the industry figure out how they will get paid for it. Some resistance to it may be generational. Older folks do not gravitate easily to advances in technology such as using Skype or Facetime to communicate with others. However, I do think it offers opportunities for improvement in our industry.

For example, using telemedicine is a great way to get closer to the injured worker. It provides for more transparency, particularly as it pertains to home modifications. The #1 complaint I hear from clients regarding home modifications is often due to unexpected costs. Things that just can’t be seen until a project is started, or unexpected costs due to complications once a project is started. The adjuster often feels disconnected from the process. By using telemedicine and a virtual walk through, the adjuster can better connect with and interact with the team, improving communications all the way around. This allows the adjuster to get a “birds eye” view of what’s going on in the home. This is just one example of how telemedicine can be used in workers compensation. Click to read more from Peter Rousmaniere / CHCTelehealth on how telemedicine can be used in workers comp.

Rafael Gonzalez. Twitter @GonzalezRafael Hispanic and Black Working Poor Make Up Most of 30 Million 2017 Uninsured In February 2018, the National Center for Health Statistics (NCHS) published Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2017. The report presents selected estimates of health insurance coverage for the civilian non-institutionalized U.S. population based on data from the January– September 2017 National Health Interview Survey (NHIS), along with comparable estimates from previous calendar years. Estimates for the first 9 months of 2017 are based on data for 59,178 persons. The report concludes that in the first 9 months of 2017:

–28.9 million (9.0%) persons of all ages were uninsured at the time of interview—not significantly different from 2016, but 19.7 million fewer persons than in 2010.

-Among adults aged 18–64, 12.7% were uninsured at the time of interview, 19.5% had public coverage, and 69.3% had private health insurance coverage.

-Among children aged 0–17 years, 4.9% were uninsured, 41.9% had public coverage, and 54.6% had private health insurance coverage.

-Among adults aged 18–64, 69.3% (136.5 million) were covered by private health insurance plans at the time of interview in the first 9 months of 2017. This includes 4.4% (8.6 million) covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges.

-The percentage of persons under age 65 with private health insurance enrolled in a high-deductible health plan (HDHP) increased, from 39.4% in 2016 to 43.2% in the first 9 months of 2017.

When a greater percentage of the working age population is uninsured, there is a higher number of auto, liability, no-fault, and work comp claims filed. As a result, the fact that the number of uninsured has started to increase again, due in large part to the attacks on ACA and Medicaid, should be of concern to all property and casualty payers, as well as all individual policy owners who may end up paying higher premiums for same or lower coverage.

Yvonne Guibert. Twitter @ExpertsinWC. While in Atlanta, GA for a conference put on by Work Injury Law Group (WILG on Twitter @WILG_1), earlier this week, I had the opportunity to listen in on a session with Mark Pew and Donald Palmisano, Jr. on the topic of Opioids / Medical Marijuana in workers compensation. While I always find sessions on the topic of opioids / medical marijuana captivating, especially when Mark Pew is involved, I found this one in particular interesting with feedback from attorneys who represent injured workers. The overwhelming sentiment in the room on the topic of introducing alternative treatment methods including biopsychosocial therapies, was that the payers generally do not pay for these treatments. So why should they bother asking for treatments that are going to get denied? Donald Palmisano, Jr. mentioned that at a recent event with about 300 payers in the room, when payers were asked if they would authorize behavior therapy treatments, only 3-4 raised their hands and one even said “…why would we do that when pills are so much cheaper?” In case you didn’t already know it, we have a big problem if this is how our industry thinks. Our system is broken and disconnected and we need to fix it. Read more on the topic of biopsychosocial in workers compensation from Mark Pew. WorkCompCentral hosted a one hour webinarearlier this year with Marcos Iglesias, MD of Broadspire on the topic of biopsychosocial issues and we will feature him again on this topic at an upcoming symposium with myMatrixx this summer. Details will be announced soon.

Thank you for reading. Website is coming soon that will allow for much more interaction and dialogue. In the meantime. please like and share here, and go find us on Twitter @expertsinwc. Comments and suggestions are welcome. #workcomp #workerscomp #workcomprecap #expertsinwc #biopsychosocial