Nearly 200 nursing homes in Missouri saw their liability costs drop when they largely cut out the middleman to get help to injured employees more quickly.
Health Care Facilities of Missouri, which manages 176 nursing homes, said it saw a 28% decrease in claims, a 59% decrease in lost time, a 35% decrease in medical costs, a 56% decrease in indemnity costs, and a 69% decrease in the total cost of claims between 2020 to 2022.
The organization made those gains after hiring a new partner that offered a rather basic path to success: two new phone lines.
The first was an 800 reporting number, which eliminated the need for staff to mail or fax potential claims with every potential workers’ compensation incident. The call-in option created less work for supervisors and also meant paying less money for adjusters to review each claim. Instead, the new claims partner handled the determination process.
That partner, a California-based claims management company licensed across the US, also instituted a nurse triage line available to injured staff around the clock. It reduced about half the claims to first aid or self care, rather than sending everyone for outside care for minor issues.
And the added resource resonated with both staff, who were reassured by quick consultations, and their supervisors, according to Scott Gilmore, vice president and co-owner of Carpenter and Company, the administrator for HCFM. He outlined the plan’s success in an article published in Risk & Insurance Thursday that noted the partnership’s selection as an industry award-winner.
“An administrator has a thousand things to worry about,” Gilmore said. “They’re going, ‘Do I really need to report this? Should I send the employee home?’ They don’t have to worry about it.”
Gilmore added that the faster, more anticipatory system is also likely heading off future problems.
“I don’t have the statistics, but I have to believe it has decreased our litigation rates — I know how many unhappy customers I used to deal with before,” he said. “Time and time again, it would be, ‘Hey, the adjuster’s not calling me back. I left a message, I called the main line, nobody answers.’ I can’t emphasize this enough, but it’s about the improved communication.”
