There’s potential synergy between occupational health and urgent care, Mr. Gerber said. Employees can be treated for on-the-job injuries and illnesses and can return for their urgent care needs. In addition, urgent care can create a steady stream of business because occupational health centers are typically busier during warmer months – when the construction industry is in full swing – while urgent care centers tend to see more traffic during cold and flu seasons, Mr. Gerber said. There are approximately 9,000 urgent care centers nationwide, with between 71 and 160 million patient visits annually. About 300 new urgent care centers have opened every year in the past few years, accord- ing to the Urgent Care Association of America. About half of urgent care cen- ters are physician-owned, according to the association. Ms. Horwitz said pairing urgent care with occupational health can be very positive. “In general, I think it’s a good thing for occupational medicine to diversify and not depend on a certain industry in their region for all business,” she said. “There’s a natural fit for those clinics.”
Factors to consider But there are a number of factors to consider before plunging in, experts agreed. While occupational health centers are accustomed to walk-in activities, they will need to offer expanded hours to accommodate urgent care visits. Expectations about clinic work hours will have to be re-set, and new staff members may need to be hired for early morning and evening hours. “Your staff may be used to working bankers’ hours and now suddenly they are working on Christmas,” Dr. Stern said. Or at the very least medical, administrative and support staff may have to work a few extra hours in the evening, he added. Work flow will probably have to be overhauled as well. For instance, patient wait times will have to be kept to a minimum, or providers will risk losing important clients or repeat visitors. “Employers want their workers to have a minimum time away from work,” Mr. Gerber said. “It’s a challenge to run a blended practice. You don’t want patients to have to wait. The success really depends on the planning and execution.” Providers should find out what the needs are in the community and among local employers before expanding into urgent care or other service lines, Mr. Gerber advised. “There are employers who don’t want their workers waiting in line behind a kid who’s getting a school physical,” he said. “The art of the blended practice is being able to focus on the needs of many different clients.” Another big issue is the skill set of the staff. Are occupational health providers equipped to diagnose and treat urgent care patients? In many cases, the answer is no. “Many physicians practicing in occu- pational medicine haven’t seen the kinds of conditions seen in urgent care in a very long time,” Ms. Horwitz said, citing examples such as women’s health conditions and pediatric illnesses. Excluding pediatric services and women’s health from urgent care serv- ices provided by a clinic would severely curtail potential clientele, said Dr. Stern. “Urgent care without kids just doesn’t work,” he said.
“And it’s the moms who make the decisions in the family about where to go for care. You have to have their buy-in.” Doing a blended practice the right way One solution could be to have a dedicated provider of occupational health, and others for urgent care working under the same roof, said Mr. Gerber. Separate waiting rooms for urgent care and occupational health can also help to make the practice run more smoothly, he said. Providers should care- fully weigh the types of software needed to run a blended practice includ- ing electronic medical records and billing soft- ware, both Mr. Gerber and Dr. Stern said. The most successful blended practices are blessed with good locations and lots of foot traffic, Dr. Stern said. However, many occupational health centers are located in industrial, out-of- the-way places that are inconvenient for the general population, Dr. Stern said. “You can put the biggest sign in the world up and you still won’t get any traffic,” he said. “Urgent care is driven by consumers,” he continued.
“You need to be in a location that would be a good place for a Starbucks or a McDonald’s.” An out-of-the-way location versus a central location can mean a big differ- ence in revenue once that urgent care center shingle goes up, he said. A great location can double or triple revenues by adding urgent care, said Dr. Stern. But even getting just a few extra walk-ins per day can add up over time, experts said. Adding urgent care to occupational health can tack on between a three per- cent and a 25 percent bump in overall revenues, Dr. Stern said. It’s also an opportunity to better serve employer clients who are hungry to make health care more convenient for their workers, reduce their medical costs and thus increase productivity. “It’s a chance to meet the total health needs of the community,” said Mr. Gerber.
Regulatory Agenda
Compiled by UL PureSafety
- Change in Opioid Drug Labeling Proposed A coalition of physicians, researchers, and public health officials submitted a petition to the Food and Drug Administration (FDA) proposing a change in opioid drug labeling. The aim is to address the overutilization of narcotic medications for non-cancer pain. The petition suggests dropping a reference to “moderate” pain, specifying a maximum dose equivalent to 100 mg of morphine, and establishing a limit for the duration of use.
- Coal Mine Inspection Rule The Mine Safety and Health Administration (MSHA) implemented a final rule regarding examinations of work areas in underground coal mines for violations of mandatory health or safety standards. The rule requires mine operators to identify and correct hazardous conditions and violations of health and safety standards posing the greatest risk to miners.
- Eight Arrested in Florida Fraud Investigation In Operation Dirty Money, the Florida Workers’ Compensation Fraud Task Force charged eight individuals with workers’ compensation fraud and money laundering. The operation has reportedly uncovered $140 million in fraudulent transactions associated with 12 shell companies.
- Family and Medical Leave Act (FMLA) Claims A study by Reed Group, a member of the NAOHP Vendor Program, found that employees taking intermittent time off under FMLA are nearly three times more likely to file a subsequent short-term disability claim than those who do not take leave. The study revealed musculoskeletal conditions and behavioral health problems as common reasons for claims.
- ICD-10 Compliance Date Extended The compliance date for the implementation of ICD-10 has been extended from October 1, 2013, to October 1, 2014, by the Centers for Medicare and Medicaid Services (CMS). ICD-10 replaces ICD-9 and significantly expands the coding system. The American Medical Association is advocating for a longer delay to give physicians more time for the transition.
- U.S. Inspector General Investigates Adverse Events A report from the Inspector General of the U.S. Department of Health and Human Services revealed that an estimated 27 percent of Medicare patients are harmed while hospitalized, costing $4.4 billion annually. Approximately 44 percent of these harmful episodes were preventable, with 86 percent of events not being noted in incident reporting systems.
- Lump-Sum Settlements May Not Impede Return to Work According to a Workers’ Compensation Research Institute study, lump-sum settlements in workers’ compensation cases do not discourage the return to work. The study followed 2,138 injured workers in Michigan and found that 78 percent who received a lump-sum settlement did not change their employment status.
- ‘Near-Disaster’ Oil Refinery Fire Under Investigation The U.S. Chemical Safety Board is conducting an investigation into an August 6 fire at a Chevron oil refinery in Richmond, Calif. The fire, described as a “near-disaster,” started when a combustible hydrocarbon liquid leaked, forming a flammable vapor cloud.
These regulatory updates cover a range of issues, from opioid labeling changes to fraud investigations and workplace safety rules. Stay informed to ensure compliance and promote a safe working environment.
Recommended Resources
- Telecommuting as a Reasonable Accommodation The federal Computer/Electronic Accommodations Program (CAP) has released a new video offering tips on how individuals with disabilities can request telework as a reasonable accommodation under the Americans with Disabilities Act. The video also outlines the equipment that CAP can provide to facilitate telework accommodations.
- Paid Sick Leave A study published by the American Journal of Public Health suggests that introducing or expanding paid sick leave programs may help businesses reduce injury incidence rates, especially in high-risk sectors and occupations. According to the study, workers with access to paid sick leave were 28 percent less likely to be injured on the job.
