During our time at RIMS 2014, we had Workers’ Comp industry stakeholders participate in WorkCompWire’s “4 For 14” series, focused on what to look for this year and in the future! Here’s what Kevin Glennon, RN, BSN, CDMS, CWCP, QRP, One Call Care Management’s Vice President of Home Health and Complex Care Services had to say:
1. What do you believe will be the most significant development in the Worker’s Comp industry in 2014?
Although the American Medical Association reclassified obesity as a disease in 2013, we are just beginning to understand the repercussions this will have on care in workers’ compensation. With this reclassification, one out of every three Americans is now considered to be obese, meaning they suffer from a medical condition that requires specific treatment and intervention. It’s going to be interesting to see how this affects payers across the country. We may see more requests for bariatric surgery as part of the medically necessary treatment plan. Clinical expertise is needed to understand when this type of treatment is appropriate for an injured worker to recover, and when it’s outside the scope of workers’ compensation coverage.
2. What is the top issue/problem you and your organization are currently grappling with?
Although it’s been delayed, healthcare and workers’ compensation will eventually need to move to the ICD-10 coding system. Payers and providers across the board will need to have their systems ready to transmit data compliant with the ICD-10 codes by October 2015. That’s a huge financial investment in terms of training, documentation changes, and IT system changes, and we need to ensure all our providers and other partners are ICD-10 ready so claims aren’t denied. Additionally, all states must be ready to accept EDI transmissions with ICD-10 codes—or perhaps CMS will extend the deadline again.
3. Looking out 5 years, beyond obvious trends, what do you think one big change in the Workers’ Comp industry will be?
Today, an injured worker may be older, heavier, and suffer from other medical conditions. How we control medical costs as we deal with the aging workforce, obesity, and the plethora of comorbidities out there is going to be a real challenge. In 2011, the first of the baby boomers reached what used to be retirement age. And for the next 18 years, boomers will turn 65 at a rate of 8,000 a day, but they’re not necessarily retiring. They’re working longer, living longer, and that’s going to pose significant risk and exposure within the workers’ compensation industry.
4. What is one thing you’d like to promote?
We need to promote job modification/accommodation to ensure the workplace is safe for older workers, who may be more susceptible to injury and require longer recovery times. I recently had the opportunity to discuss these issues with a risk manager at a municipality. The organization had a number of jobs that posed increased risk of injury for older workers. If you have workers in their 60’s or 70’s lifting manholes covers, that’s dangerous. Today, there are equipment and other accommodations we can make to assist with this type of labor and help prevent injuries.
About Kevin Glennon
Kevin Glennon is Vice President of Home Health and Complex Care Services at One Call Care Management. He has over 30 years of experience in healthcare, encompassing clinical and claims management for workers’ compensation, auto, and general liability. His background includes medical case management of complex and catastrophic injuries and long-term disabilities. He applies his combined knowledge and experience to assist organizations in better managing and controlling costs associated with complex injury claims for the best-possible outcomes. He can be reached at Kevin_Glennon@onecallcm.com.
One Call is a WorkCompWire ad partner.
This is not a paid placement.