Nurse case managers are educators and motivators who work with injured employees to help them understand their medical conditions, get the necessary treatments promptly, and navigate the complex healthcare system.
Engaging a nurse case manager on a claim can reduce medical and indemnity costs by an average of $6,100, resulting in an 8:1 ROI. But how can you deliver the best outcomes to keep adjustors returning to use your services?
A nurse case manager's success is often evaluated by how quickly their patients go home and return to work. Timely and well-coordinated care, including a patient's prompt admission to a reputable rehab program, is key to facilitating treatment outcomes — especially in catastrophic workers' compensation injury cases.
In fact, delays in referring a claim can dramatically increase medical costs. An effective case management program must proactively address cost drivers at every stage of a work-related injury to avoid unnecessary expenses.
By finding timely care for work-related injuries and helping patients navigate complex workers' comp rehabilitation, a nurse case manager can help improve treatment outcomes significantly.
Timely care starts with the patient referral and admission process and continues through therapy and the transition to home care. Here's how you can facilitate every step in the vocational rehab journey to get the best care for your patients:
Identify the workers' comp rehabilitation programs available that take appointments, admit patients, and offer treatments immediately. Build relationships with these facilities, research their strengths and philosophies, and learn about their referral processes.
You may call a contact person directly or a toll-free number, fill out a referral form on their websites or send a direct email to refer a patient. Have the numbers and email addresses handy, so you can spring into action as soon as a case lands on your desk to find in-patient treatment within hours and ensure a smooth admission process.
Time is of the essence when it comes to work-related injury treatments. The facility you partner with must be able to offer timely assessment so the care team can deliver services immediately. For example, we start therapy the morning after admission to optimize outcomes.
Ask for references from other nurse case managers, adjustors, and patients to find a reputable facility that can meet your clients' needs. Look for a provider involved in industry events and conventions and invests in furthering their staff's education. Also, use a facility that offers physical therapy that accepts workers' comp.
Moving patients to a lower-cost care model as fast as possible without compromising treatment outcomes is essential for reducing medical expenses. Besides admitting patients and starting treatment promptly, a rehab facility should have a process to transition patients to home care and continue their recovery journey.
For example, when our patients are ready to move to a home-based program, we work with their nurse case managers to ensure they have the right equipment. Our team also offers advice on setting up the home environment to support recovery and minimize re-injuries.
Hospitals may suggest rehab programs that may not be the best fit for your patients. As a nurse case manager, you spend a lot of time with your clients and understand their conditions and perspectives. You're uniquely qualified to make recommendations and ensure they get the best care.
The rehab facility you partner with should account for each patient's condition and schedule. Instead of a cookie-cutter formula, the care team should evaluate their conditions upon admission and create a customized treatment plan to address their goals and challenges.
For example, not every person that comes through our door can handle 3 hours of therapy a day. We may start with 30 minutes to help them build stamina and gradually ramp up the intensity based on their progress. Too much too soon can hurt a patient's motivation.
Timely communication is critical for ensuring each patient is admitted to the program promptly and gets the treatment they need. For example, when a patient is ready to transfer to our facility, we call the hospital to gather the necessary clinical reports so our care team can prepare for their arrival.
We also proactively communicate with case managers and external care providers during a patient's time in our facility. Besides weekly clinical reports, we also offer a dedicated space for nurse case managers to meet with their patients privately to access progress.
Workers' comp rehabilitation involves many moving pieces. Using an experienced and reputable partner can help you navigate the complex process and streamline your workflow, ensure the best outcomes for your patients, and lower medical costs.
At Rehab Select, we have over a decade of experience supporting nurse case managers with work-related injury treatment programs in Alabama and physical therapy that accepts workers' comp. About 90% of our referrals come from nurse case managers—proof that our programs and processes help them do their job better.
With responsive services and timely communication, we can help you do your best work. Our specialty is navigating compensation claims, tailoring an effective workers' comp plan for an employee's return to work, and providing rigorous, frequent one-on-one physician-led therapy to achieve the best treatment outcomes.
Contact us or schedule a time to see how Rehab Select ensures the highest standards for our workers' comp rehabilitation programs in Alabama.