By Karen O’Hara
Everyone would benefit if all employers and workers had a MOM who cares as much as this one.
Macon Occupational Medicine, fondly referred to as MOM, is the first program in Georgia to be awarded a three-year Quality Certification by the National Association of Occupational Health Professionals (NAOHP). The program was recognized for “Outstanding Achievement,” with a score of 97.75 percent compliance to standard out of a possible 100 percent, following a May site visit
The award acknowledges that MOM offers a high level of occupational and environmental medicine expertise to employers and employees in central Georgia. NAOHP Site Surveyor Donna Lee Gardner, a nurse and RYAN Associates consultant who was instrumental in developing the NAOHP’s performance standards said she is particularly impressed with MOM’s emphasis on qualified staff, documentation and communication practices, and contributions to the community at large.
“I want to commend all of the Macon Occupational Medicine team members,” Ms. Gardner said. “There are many aspects of the practice that truly set it apart, and they have been very generous about sharing their knowledge with others.”
MOM has been serving Central Georgia employers and employees with a diverse array of services since 1990. The privately held company has operated from a freestanding clinic in downtown Macon since 2001. It also provides services at local worksites and offers 24-hour access to care via affiliations with local hospitals and urgent care clinics under detailed operational protocols.
“The NAOHP seal of approval says we provide excellent service,” said Leonard Bevill, CEO. “We are pleased with our performance to date, and we will integrate lessons gleaned from the certification process into our continuous quality improvement activities.
“We have many companies that look to us to provide the best possible service. Now, as we reach out to new clients and payers, we can tell them we are the only certified program in Georgia.”
While the NAOHP standards are extensive, Mr. Bevill found the certification process relatively seamless and easy to accomplish with information supplied in advance by the NAOHP and Ms. Gardner.
“My staff was able to put 95 percent of the material together in an organized manner prior to the site visit,” he said. “Of course, like anything else of this nature, we were anxious to get the review underway.” For other programs considering a certification, he believes there is no time like the present.
“A major aspect of certification is that you can take advantage of the surveyor’s expertise to enhance your overall operation and specific processes,” Mr. Bevill explained. “For us, just the finetuning adjustments we made in documentation and coding as a result of Donna Lee’s recommendations paid for the certification times two or threefold. Meanwhile, he noted, “With health care changing dramatically as we speak, NAOHP certification means that your facility is doing what it needs to do to be in compliance with best practices and set itself apart.” Noteworthy Attributes During her site visit, Ms. Gardner noted that MOM places a particular emphasis on staff training and certification in clinical areas.
“Certification is extremely important, especially in an occupational medicine environment. That is one of the ways we have been able to differentiate ourselves,” Mr. Bevill said. “We take pride in the fact that our staff has obtained training and certification in their areas of expertise.
“When you have the appropriate certifications and credentials, you can help your clients avoid potentially litigious situations. We don’t have on-the-job trainees or non-certified staff.”
Outcomes measurement is another area where MOM distinguishes itself, Ms. Gardner reported.
“We do a lot of outcome analysis and reporting for our clients, which has helped raise our program to the next level,” Mr. Bevill said. “Cindy Stephens, a licensed claims adjuster and case manager, keeps us in tune and ensures that patients don’t get lost in the system. That is how we adhere to guidelines and communicate effectively with all parties to avoid a spiral into lost time and disability. We strive to remain at the center of all of the touch points.”
MOM reports a national average of four physician visits for the treatment of an acute work-related injury and an average of six to eight rehabilitation visits. To adhere to these benchmarks, it has developed a protocol to manage cases more efficiently and effectively. Under the protocol, if an injured employee exceeds the fourth physician visit or eighth rehabilitation visit, system software automatically flags the chart for a physician to conduct an in-depth case review. Information on the review is provided to the employer via a medical note and/or phone call. This may include referral for diagnostic testing, referral to an outside physician for evaluation, and/or future physician and rehabilitation visits. Functioning as a case manager, Ms. Stephens verifies the medical rationale for physician recommendations and keeps the employer and insurer informed of patient status. In addition to her work as a case manager, Ms. Stephens functions in an educational capacity.
“A lot of offices have nurses who do that – and that’s fine – but we provide that added piece by flagging cases. We know that by the fourth doctor’s visit, the patient is not getting better in the timeframe we would typically expect,” Mr. Bevill said. “Many employers, especially at smaller companies, don’t understand the workers’ compensation rules in Georgia. Cindy educates companies on the basic concepts.” This approach is consistent with MOM’s slogan: The health of your business may depend on us.”
Looking Ahead
MOM is focusing now on refining its wellness and health promotion offerings, with an eye toward developing a total health management delivery model. One step in that direction involves a new contract to manage employee disability for the city of Macon, which includes a wellness component. The contract supports a nurse with disability management experience. It also involves consolidation of services in a single location, saving the city more than $100,000 a year. Meanwhile, MOM continues to work with the county government to develop an education and disease management program targeting high-risk conditions in response to established baseline biometrics. In general, as national policies take shape in response to health care reform, Mr. Bevill says he will be watching closely to see how it plays out.
“With workers’ compensation being a state-sponsored system, who knows what will happen? But I believe wellness is what is really going to take off,” he predicted. “Prevention and disease management are major aspects of the reform act.”
To take advantage of the monumental shift from reactive medical care to proactive intervention, he advises occupational health providers to strive to clearly demonstrate return on investment and “value added” to clients and payers. Occupational health programs have an opportunity to take greater advantage of their ability to help companies save money on their insurance premiums, he said.
