Defining success through the eyes of employers

Employer Solutions | 29 days ago

An Evolving Orthopedic Landscape: Defining Success Through the Eyes of Employers

With musculoskeletal injuries making up 70 percent of occupational injuries, it’s important to have plans in place in the event of an accident. Learn more about the importance of adding orthopedics specialist coverage to employer healthcare plans.

By Lawrence Raymond, MD, medical director, Atrium Health HEALTHWORKS

Consumerism has received big press lately. High-deductible health plans, price transparency and expectations for convenient and affordable care have driven healthcare providers’ attention to the increasingly savvy consumer. One health segment demanding attention is orthopedics and spine care. Given that musculoskeletal injuries make up more than 70 percent of occupational injuries, employers are looking at this piece of healthcare related to their employees. 

Employers Seek Partners to Help Them Manage Risk

Just as healthcare providers are challenged with managing supply chain costs in the era of evolving provider risk, employers are increasingly taking on healthcare supply-chain risk for their own employees. According to the Employee Benefit Research Institute, 60 percent of health plan-covered workers are enrolled in self-insured plans, and between 1996 and 2015 there was a 37 percent increase in the percentage of private sector establishments offering self-insured plans. It’s no surprise that employers are asking more of healthcare providers than ever before.

As we think about appealing to the employer through an orthopedic lens, we quickly find no shortage of press on direct-to-employer bundled payment activity. The list of employers looking for high-quality, predictable prices and outcomes for their workers goes on and on. But this isn’t just about large national employers or bundled payment models for surgical procedural episodes. Increasingly, providers’ efforts to manage nonoperative episodes are gaining traction with employers who are looking for partners to help them manage their risk.

Employers have weighed in on providers’ capabilities to address their challenges in this space, and the results are not good. Ninety-four percent of employers believe that both benefit managers and healthcare consumers need greater insights into the relative cost and quality of services and products available to them. Thus, the traditional metrics utilized by providers aren’t always capturing the right amount of information for our employer audience. In this new era of “employerism,” a provider’s definition of success must evolve to effectively demonstrate the value proposition for this rapidly growing buyer segment of orthopedic services. As provider organizations seek to create smart growth in their orthopedic programs, employer relationships facilitate an evolving access channel.

Enhance Your Relationship With Employers

If you were expecting a complex dashboard or long list of suggestions, you’ll be disappointed. Employer audiences prefer a short list of differentiators. Here are two ways to enhance your employer value proposition:

  1. Capture return-to-work metrics. Do this first, and begin tomorrow! This will require following your patients through their system of care via homegrown or commercially available software products. If all else fails, in the short term assign a navigator to follow your patients to return-to-work status.
  2. Improve access. Research clearly demonstrates that earlier intervention for musculoskeletal injuries results in improved outcomes. Your age-old metric of “days to first available appointment” will have to evolve to a results-oriented metric such as “number of injuries evaluated within 24 hours.” Provider organizations will be well served by leveraging multiple access solutions, including triage protocols, virtual health options, establishment of orthopedic-specific urgent care clinics and enhanced use of early rehabilitation to facilitate early intervention.