by: Lawrence Earl, MD
December 12, 2021

At some point in the development of your occupational medicine services you are going to be looking at effective ways to expand the practice.

As I think about the “core” services, we are actually interacting with a very small percentage of our employee populations.

Drug testing is performed on about 5.8% of the working population. If done for pre-hire purposes, it is about 12-15% of your client’s workforce per year on average.

Physical exams would follow the same 12-15% for pre-hire, but only for those clients that perform pre-hire exams. Some are only doing drug testing and some neither drug testing nor exams.

The average worker’s comp case rate in 2020 was 2.7%, down from previous years.

So best case scenario, you are interacting with between 10-15% of your employee population for “core” occupational medicine services.

Beyond the Basics

The first areas of expansion of the core services is likely to be in the “regulated” exams area. DOT/Commercial driver and FAA are examples, as well as respirator, hazmat/hazwoper, Silica and firefighter exams. All of these will require a higher level of expertise than the basic pre-hire exam, and some require additional certifications, such as the DOT/Commercial Driver exams (under the NRCME – National Registry of Certified Medical Examiners)and FAA – under FAA examiner certification.

Traditional Expansion Areas

One of the next “traditional” areas of expansion of the occupational medicine practice is for health and wellness services.

Conducting annual health fairs for companies typically reaches about 30% of the employees. Services will include health risk appraisals (HRAs), biometric assessments and cancer screening education and referrals.

Onsite Services

Staffing a full or part time APN will generally add some level of acute care services, as well as a convenient way for employees to monitor and receive education and coaching for chronic medical conditions.

Go Mobile

Whether using a mobile van or setting up shop for the day or a few hours at your client location, annual respirator clearance exams, DOTs and audiometry exams are common services to expand beyond your bricks and mortar.

Sort of Traditional

  • These will all require additional training or certification:
    • MRO – Medical Review officer to interpret drug tests – certify through AAMRO or AMROCC
    • SAP – Substance Abuse Professional to determine follow plan and testing for positive drug tests under regulated programs
    • IMEs – Independent medical examiner through ABIME
    • Immigration exams — Physician only, requires Civil Surgeon designation

Ancillary Services

Physical Therapy

If you are referring out a large volume of PT you may well consider bringing that in house. There are pros and cons of this. Some employers may perceive a bias towards over use of PT when it’s in house. If you do it right, you will highlight faster onset of therapy and better communication between therapist and treating physician/APN/PA for more effective course of therapy and faster return to work.

Diagnostics

CT/MRI/US are potential imaging add-ons, again always driven by current volume of referrals out, but tempered with an analysis of whether you will get credentialed and paid by your work comp carriers.

Covid Testing

As of this writing we are still in the midst of the Covid-19 pandemic and on the cusp of the OSHA Covid 19 Vaccination and Testing Emergency Testing Standard, currently stayed due to pending court decisions.

However, many companies are going ahead with their own safety determinations and implementing a similar policy to the OSHA ETS, requiring proof of vaccination from employees, or failing that, weekly testing for active Covid 19 infection.

You should be out there educating your employer clients about the standard, and how to implement the testing with your help to go onsite.

A common concern among employers is how to track and report on which employees are vaccinated and which have obtained the weekly testing, and what are the results.

This is where our sponsor, SnapHealthcare, comes in to play, providing the software to manage that entire process, from uploading employee vaccination cards, to recording and tracking testing results, reporting that out to employer and employee by text and online portal access.

Here is a video demonstrating exactly how that all works.

If you’d like to learn more about using Snaphealthcare for your own organization and/or your employer clients, click here and we’ll arrange a quick demo.

 

Total Person Health

With all we’ve talked about so far, we’ve gone from reaching only 10-15% of the employee population to 100% with Covid testing.

Another “100 percenter” is the Total Person Health or TPH initiative. In fact it is beyond 100%, maybe even 200 or 300% if you consider involved dependent family members.

That’s because with a TPH program you are looking at the total medical cost and risk across the entire employee and dependent covered lives with an initial “Corporate Health Profile.”

This involves a medical claims and pharmacy data analysis, as well as additional information from HRAs and other health and wellness data collected, in order to identify the specific health care conditions, costs and future risks in the total population.

Once this is known, the occupational medicine provider can take the lead in recommending and coordinating specific interventions to mitigate those risks in chronic disease management, behavioral change coaching, smoking cessation, musculoskeletal training and other programs to reduce overall costs and increase employee productivity.

This provides real value to the employer and brings additional health system resources and services into play.

When your hospital administration is looking for your “downstream” revenue, this is it on steroids.

You don’t have to do this alone. Learn how to leverage the relationship with your employer clients into a TPH program to vastly improve their employee health and productivity. The NAOHP TPH Initiative will help you do it, along with our sponsor, Trestletree.

Learn more here:

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