Insurer to bring workers compensation customers better outcomes

Workers compensation customers with hand, knee and shoulder injuries are set to receive a new style of coordinated care as part of a six-month pilot beginning in Sydney this month, a first in Australia.

RecoveryPlus aims to aid recovery and assist workers to return to work by reducing delays in treatment and longer term costs. The pilot is an initiative of icare, NSW’s insurance and care provider. icare’s CEO John Nagle said that through the delivery of coordinated, holistic treatment and care pathways, the outcomes for injured workers would be improved.

“A fundamental part of RecoveryPlus is the introduction of a local clinical Care Coordinator who will manage delivery of a treatment plan with every patient in the pilot. This will improve approval times and help them get the care they need more quickly,” said Nagle.

“Removing delays and giving injured workers peace of mind by approving holistic treatment plans, rather than approving each individual intervention separately, will assist their recovery and enhance their opportunities to return to work.

“This is a streamlined approach removing red tape from the workers compensation claims process which benefits the worker and their employer. Currently workers and employers face a journey lacking an end-to-end view of the process which leads to sub-optimal outcomes and unmet expectations following treatment,” he said.

The treatment plans will be developed in collaboration with the patient and their specialist and may include medical procedures, nursing care, allied health services and other support services to assist their recovery. Currently, each of these interventions requires individual approval, adding delays and uncertainty.

The Care Coordinator will also coordinate the worker’s support before, during and after the specific medical intervention, incorporating a biopsychosocial view of recovery.
icare’s Chief Medical Officer Dr Chris Colquhoun said that the Care Coordinator would also create efficiencies for service providers.

“They will be able to plan appointments knowing that approval has been received,” Colquhoun said. “This is a new initiative aimed at getting workers the treatment they need faster, improving long term injury outcomes and lowering the risk of secondary associated injuries.”

After six months the pilot, initially being trialled at North Shore Private Hospital, will be reviewed to assess whether the new approach had helped the participating recovering employees achieve their return to health goals and, where possible, returning to work. “We hope to have initial results at the end of the year. This will inform future plans to expand the program in terms of both eligible injury types and hospital locations,” Colquhoun said.