Reed Group’s the Medical Disability Advisor (MDA) Comcare National Conference Oct 24,25 2007, Canberra,Australia The Business Case for setting Return to.

Section 1 The Product

Reed Group. Ltd. © 2007 Reed Group’s the Medical Disability Advisor is a return to work guideline that is used to set return to work expectations. Managing risk without setting RTW expectations is protracted, energy intensive and expensive.

Reed Group. Ltd. © 2007 MDA at a glance The Medical Disability Advisor has been in existence for 15 years It combines actuarial data from multiple sources. The data is then reviewed by multiple eminent physicians to arrive at the duration tables The method of review is detailed and the data is updated twice a year The MDA is used in 38 countries About 25,000 organisations and business use the MDA worldwide In Australia 7 of the 8 Workers Compensation authorities either directly use or are trialling the MDA In NZ, the Accident Compensation Corporation has been a user for the past 6 years Since the Daubert decision in the Supreme Court of the United States in 1993, judges are required to inform themselves of the evidentiary basis of a doctor’s opinion. American courts are not at liberty to rely upon a doctor’s experience in reaching a decision. The same approach is being adopted in Australia. The MDA provides the evidentiary basis for the normal course of recovery for the treating doctor to consider when certifying the claimant It helps determine the most timely stay at work or return to work timetable. Research indicates that timely return to work on suitable duties facilitates healing

Reed Group. Ltd. © 2007 An Overview of The Medical Disability Advisor (MDA)  It is a reference resource in the claims management process.  It is actuarial based, physician reviewed, complete and has readily usable disability durations and guidelines. It provides claims personnel with medical information on more than 10,000 reference codes for injuries and illness of working people. The guidelines provide evidence-based, objective expectancy figures for normal recovery from a medical condition, injury or procedure in its renowned disability duration tables. It does not replace the need for medical opinion, but can assist in establishing a framework for dialogue among all stakeholders to help ensure consistent and fair treatment and recovery for all injured and ill workers. The MDA is based on actual normative case data gathered from more than 5 million case records. It is the world’s most widely used information resource for disability information with more than 22,000 customers worldwide.

Reed Group. Ltd. © 2007 Key benefits of the Medical Disability Advisor (MDA) Key Benefits: 1.Gives you rapid, flexible, and easy access to a huge body of relevant information so you can quickly find the information you need. 2.Helps you quickly explore subjects of interest and develop and refine inquiries through cross-linkages in the data. 3.Lets you copy, paste, print, and even email pertinent portions of the authoritative topic materials to other stakeholders. 4.Keeps you abreast of what the Claims Manager knows

Reed Group. Ltd. © 2007 Organisational Performance The Medical Disability Advisor provides evidence based disability duration guidelines that assist in setting RTW expectations. Case managers drive organisational performance by benchmarking days lost against industry standards. The MDA benchmarks provider performance in over 1300 individual conditions.

Reed Group. Ltd. © 2007 Using MDA Duration Guidelines allows companies to:  Impart a non-biased, medically objective approach with each case  Provide consistency across departments and throughout the company  Save time and maximize individual contacts with employees and physicians  Enhance areas of expertise with comprehensive clinical and non-clinical information Positively impact employee relations and communications during a disability period

Reed Group. Ltd. © 2007 MDA benefits Create greater internal efficiencies More accurate Case Management More consistent Claims Administration Credibility with Employee and other Stakeholders Ease of implementation

Reed Group. Ltd. © 2007 Time saving from Claims Managers using the MDA rather than using Internet searches and library research Current number of Claims Managers Minutes saved per day Labour hours saved per year Average hourly rate per employee Potential direct savings 1910791$25 $19,791

Reed Group. Ltd. © 2007 Results from using the MDA in every case  Accident Compensation Corporation of New Zealand decreased days lost from work by 40% over 5 yrs using the MDA  The Nova Scotia Workers Compensation Board of Canada decreased days lost by 50% over a 9 month period by requiring both Claims Managers and Certifying Doctors to incorporate MDA data in their Injury Management plans. How can you use the MDA data to better manage your own cases ?

Section 3 Some snapshots of the MDA

Reed Group. Ltd. © 2007 The Three Areas covered in Topic Sections: 1.The orientation sections, which provides the most basic information about a condition or procedure to put it in context, and include: * Related Terms* Illustration * Definition* Medical Codes * Reasons for Procedure* Cited / General References * How Procedure is Performed 2.The medical sections, which provide guidelines to evaluate appropriateness of medical and rehabilitation care, and include: * Diagnosis* Specialists * Treatment* Rehabilitation * Differential Diagnosis* Co-morbid Conditions * Prognosis* Complications 3.The recovery and disability sections, which provide guidelines to evaluate the appropriateness of length of disability, and include: * Factors Influencing Duration* Return to Work * Length of Disability / Duration Tables* Failure to Recover * Reference Data Trends

Reed Group. Ltd. © 2007 Disability Management 1.Understanding the Duration Tables:  There are three categories of duration tables, i.e., Minimum, Optimum and Maximum.  Definitions and interpretation of the three duration tables.  Classification of Work (sedentary, light, medium, heavy and very heavy). 2.Understanding Duration Trends:  Mean: The average disability duration – the sum of all durations divided by the number of cases.  Median: The time at which 50% of cases have returned to work

Reed Group. Ltd. © 2007 Managing Risk vs. Setting Expectations  Re-active management. Managing Risks.  Pro-active management. Creating Stay At Work/Return To Work (SAW/RTW) expectations. The more stakeholders are familiar with the MDA disability duration guidelines, the easier it is to set RTW expectations and the greater chance of returning a worker to work in an appropriate time frame.

The Reed Group Limited Established 1981 by Dr Presley Reed  an industry-leading provider of :  disability duration guidelines,  software and services that streamline absence operations for the Employer, TPA, Insurers, Benefits Administrators, Workers' Compensation Boards, and Government Agencies nationally and internationally 2005 – Reed Group Asia Pacific (RGAP) established

Reed Group. Ltd. © 2007 The Reed Group Products & Services Medical Disability Advisor Disability, FMLA, Absence Tracking & Workers Compensation Case Management Services Absence & Disability Management Software Education Services

Reed Group. Ltd. © 2007 MDA Version 5 - options MDA5 – Internet; MDA5 – Internet with ACOEM’S UMK MDA5 – PC version for Windows MDA5 – 2 volume Text MDA101 – How to use The Medical Disability Advisor in Disability Case Management.

Reed Group. Ltd. © 2007 Reed Group’s the Medical Disability Advisor is a return to work guideline that is used to set return to work (RTW) expectations Managing disability without setting RTW expectations is like shutting the door after the horse has bolted

Reed Group. Ltd. © 2007 MDA at a glance The Medical Disability Advisor has been in existence for 15 years It combines actuarial data from multiple world-wide sources The data is then reviewed by multiple eminent physicians to arrive at the duration tables The method of review is detailed and the data is updated twice a year The MDA is used in 38 countries by about 25,000 organisations In Australia the MDA is used by Workcover authorities, Workers Comp insurers, Self Insurers and Life Insurers. The NZ Accident Compensation Corporation has been a user for over 6 years Since the Daubert decision in the Supreme Court of the United States in 1993, judges are required to inform themselves of the evidentiary basis of a doctor’s opinion. American courts are not at liberty to rely upon a doctor’s experience in reaching a decision. The same approach is being adopted in Australia.

Reed Group. Ltd. © 2007 An Overview of The Medical Disability Advisor (MDA) It provides claims personnel with medical information on more than 10,000 reference codes for injuries and illness of working people. The guidelines provide evidence-based, objective expectancy figures for normal recovery from a medical condition, injury or procedure in its renowned disability duration tables. It does not replace the need for medical opinion, but can assist in establishing a framework for dialogue among all stakeholders to help ensure consistent and fair treatment and recovery for all injured and ill workers. The MDA is based on actual normative case data gathered from more than 5 million case records. It is the world’s most widely used information resource for disability

Reed Group. Ltd. © 2007 Key benefits of the Medical Disability Advisor (MDA) Key Benefits: 1.Gives you rapid, flexible, and easy access to a huge body of relevant information so you can quickly find the information you need. 2.Helps you quickly explore subjects of interest and develop and refine inquiries through cross-linkages in the data. 3.Lets you copy, paste, print, and even email pertinent portions of the authoritative topic materials to other stakeholders. 4.Keeps you abreast of what the Claims Manager knows

Reed Group. Ltd. © 2007 Organisational Performance Benchmarking The Medical Disability Advisor provides evidence based disability duration guidelines that assist in setting RTW expectations. Case managers drive organisational performance by benchmarking days lost against industry standards. The MDA benchmarks provider performance in over 1300 individual conditions.

Reed Group. Ltd. © 2007 MDA Duration Guidelines allow users to: Impart a non-biased, medically objective approach with each case Provide consistency across departments and throughout the company Save time and maximize individual contacts with employees and physicians Enhance areas of expertise with comprehensive clinical and non-clinical information Positively impact employee relations and communications during a disability period

Reed Group. Ltd. © 2007 Time saving from Claims Managers using the MDA rather than using Internet searches and library research An example of one company’s savings: Current number of Claims Managers Minutes saved per day Labour hours saved per year Average hourly rate per employee Potential direct savings 1910791$25$19,791

Reed Group. Ltd. © 2007 Results from using the MDA in every case  Accident Compensation Corporation of New Zealand decreased days lost from work by 40% over 5 yrs using the MDA  The Nova Scotia Workers Compensation Board of Canada decreased days lost by 50% over a 9 month period by requiring both Claims Managers and Certifying Doctors to incorporate MDA data in their Injury Management plans.

MDA Internet Navigation

Reed Group. Ltd. © 2007 The Three Areas covered in Topic Sections: 1.Orientation sections provide the most basic information about a condition or procedure to put it in context, and include: * Related Terms* Illustration * Definition* Medical Codes * Reasons for Procedure* Cited / General References * How Procedure is Performed 2.Medical sections provide guidelines to evaluate appropriateness of medical and rehabilitation care, and include: * Diagnosis* Specialists * Treatment* Rehabilitation * Differential Diagnosis* Co-morbid Conditions * Prognosis* Complications 3.Recovery and disability sections provide guidelines to evaluate the appropriateness of length of disability, and include: * Factors Influencing Duration* Return to Work * Length of Disability / Duration Tables* Failure to Recover * Reference Data Trends

Reed Group. Ltd. © 2007 Disability Management 1.Understanding the Duration Tables:  There are three categories of duration tables, i.e., Minimum, Optimum and Maximum.  Definitions and interpretation of the three duration tables.  Classification of Work (sedentary, light, medium, heavy and very heavy). 2.Understanding Duration Trends:  Mean: The average disability duration – the sum of all durations divided by the number of cases.  Median: The time at which 50% of cases have returned to work

Reed Group. Ltd. © 2007 Summary The MDA is the leading return to work guide Usage of the MDA is capable of markedly reducing costs by: Reducing work days lost through disability Streamlining Claims Management The MDA facilitates early RTW Early RTW facilitates healing By facilitating SAW / RTW using the MDA, Claims Managers drive business profitability

Reed Group. Ltd. © 2007 Contacts RGAP - Sydney – John Harrison Tel: 0429 007 059 Jharrison@rgl.net RGAP - Melbourne – John Jenner Tel: 0421 227 391 Jjenner@rgl.net The Reed Group Limited Reed Group 10155 Westmoor Drive, Suite 210 Westminster, CO 80021 USA www.rgl.net

Reed Group’s the Medical Disability Advisor (MDA) Comcare National Conference Oct 24,25 2007, Canberra,Australia The Business Case for setting Return to.

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Reed Group’s the Medical Disability Advisor (MDA) Comcare National Conference Oct 24,25 2007, Canberra,Australia The Business Case for setting Return to.

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Presentation on theme: "Reed Group’s the Medical Disability Advisor (MDA) Comcare National Conference Oct 24,25 2007, Canberra,Australia The Business Case for setting Return to."— Presentation transcript:

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