By Tammy Bradly, VP Clinical Product Development Coventry
In the last five years terms such as advocacy, engagement, coaching, and even “whole-person approach” have been much talked about within workers’ compensation — for good reason.
Each of these touches on the need to treat each injured worker as an individual with unique challenges and perspectives. Here we’ll explore these so-called social determinants of health and some of their implications. Next week, we’ll examine these critical factors that can hold so much influence over a person’s health.
This discussion has never been more critical. Today, with the spread of COVID-19, the disease caused by the novel coronavirus, we’re unearthing fresh evidence of just how important social determinants are. Every day, we’re seeing how different groups battling COVID-19 can experience wide gaps in outcomes. These differences point to factors not in the disease itself but in underlying health conditions and circumstances such as comorbid factors and access to care. Not surprisingly, these variations appear to be playing a sizable role in how patients respond.
In one small study, the Centers for Disease Control & Prevention found that one-third of patients hospitalized in about a dozen states were African American even though that group represented only about 18 percent of the population in those states. By comparison, whites accounted for 59 percent of the population in these states yet made up only 45 percent of hospitalizations. The results are based on a modest sample size yet they point to well-documented disparities in health among ethnic minorities.
The variations in the toll of COVID-19 illustrate why the whole-person approach in workers’ compensation is essential. The discussion around this concept generates several important questions:
- How do we support the whole person by offering one comprehensive solution?
- What part do digital health programs play in meeting the needs of injured workers and improving outcomes as demonstrated by reduced disability durations and optimal recovery?
- How do we deliver a personalized experience and meet injured workers where they are in their journey to recovery?
Social determinants of health are a big part of the answer to any of these questions. According to the nonprofit Robert Wood Johnson Foundation, 80 percent of health outcomes are determined by non-clinical factors. This appears to be what we’re seeing, at least in part, with COVID-19.
According to the nonprofit Robert Wood Johnson Foundation, 80 percent of health outcomes are determined by non-clinical factors.
Given the role these non-clinical factors play, it only makes sense to examine the social determinants of health and their impact on recovery and return-to-work. As we do this, we should look for ways to align our care-management approach to identify and address non-medical barriers.
We’ve always known social determinants are important
As case managers, it is hard to ignore social determinants of health even if we haven’t always applied that term to what we were observing. Consider that we often meet injured workers in their homes or workplaces. We often get to know their spouses and other individuals in their lives and most likely know more about the workers than anyone else involved in their claims. This relative intimacy presents unique opportunities to deliver support through a variety of methods: phone calls, video conferences, and, of course, face-to-face visits. As a best practice, case managers should make every opportunity to connect with and support the injured worker. The more we know about people the better we can engage with them at their comfort level to improve their experiences.
We can help ensure that our clinical programs avoid the pitfalls of treating the primary diagnosis only. Instead, we can look at the whole person and identify those social determinants of health that might be impeding recovery.
In our next installment, we’ll take a closer look at these factors.
About Tammy Bradly
Tammy Bradly is vice president of clinical product development for Coventry. Bradly is a certified case manager with more than 25 years of comprehensive industry experience through service delivery, operations management, and product development. She holds several national certifications, including certified case manager (CCM), certified rehabilitation counselor (CRC), certified program disability manager (CPDM), and critical incident stress management (CISM).
Coventry offers workers’ compensation care-management and cost-containment solutions for employers, insurance carriers, and third-party administrators. With roots in both clinical and network services, Coventry leverages more than 35 years of industry experience, knowledge, and data analytics. As a part of the specialty division of Aetna our mission is returning people to work, to play, and to life. And our care-management and cost-containment solutions do just that. Our networks, clinical solutions, specialty programs, and business tools will help you focus on total outcomes.
Coventry is a WorkCompWire ad partner.
This is not a paid placement.