Good News is Back!

Well I must apologize for the lack of postings over the past few months.  Starting a new job is exciting (and overwhelming) but I am happy to back on the blog!

I was reminded of the power of people today.  Some of you may recall my blog on Dwight Johnson, an exceptional individual who never let adversity or the challenges in his life set him back.  On the contrary, it made him stronger and a never-ending source of inspiration and delight to those that had the privilege to know him.  Dwight passed away unexpectedly earlier this year, when I heard the news it literally took my breath away.  I did not believe it, but sadly it was true.  Dwight’s spirit carries on however, both in his beautiful family and through a charitable golf event being held on July 17 in his honor (donations & participants needed, please consider!).

I had been pondering whether to continue this blog.  Struggling with the fact that people tend to be more fascinated by “bad” news… good news doesn’t sell… getting our work comp industry to write about all the good has been difficult…l could go on, but you get the point.  Then out of the blue, my company’s marketing team said that our (m)Community (short for Mitchell Community) will be donating to Dwight’s memorial golf tournament!  They remembered Dwight, used my prior blog story to share with the (m)Community and wanted to do something nice in honor of someone who had touched our industry with heart and “soule.”

It was a message from beyond, Dwight still working his magic, my amazing company showing compassion and doing something right…I am not ready to throw in the towel, there is a place for this blog and sharing ALL THE GOOD WE DO IN WORKERS COMPENSATION.

So back to work, this month’s theme is “Random Acts of Kindness” and I hope you will share with me one of your stories for posting.  I am blessed to have convened an amazing Advisory Council of talented folks to help me continue this blogging journey, my sincere gratitude for your kindness!

Dwight, I’m walking with soule, only wished I had you paint me golf shoes instead of high heels then I’d be walking with you a lot more!

New Back Pain Guidelines Shun Medications

New treatment guidelines promulgated by the American College of Physicians suggest patients try non-drug treatment options like massage or stretching for most cases of chronic low back pain before choosing OTC medications or prescription drugs.  Read more about it here.

Senator Tackling Opioid Crisis, an Interview with Jen Flanagan (D-MA)

Senator Flanagan has been a leading proponent and champion in her state on issues that involve setting mental health policies and more recently in passing two key bills on the opioid crisis. The first, An Act to Increase Opportunities for Long-Term Substance Abuse Recovery, provides people with an opportunity to access treatment. As well as An Act Relative to Substance Use Prevention, which seeks to avert people away from substances.

Q.  Tell us a little bit about yourself and what has driven your passion around the issue of opioid use? Is there a personal connection that has inspired you to work on the opioid epidemic?

A.  There is no personal issue per se, I get asked that a lot. I actually came about it from a side door. Growing up, I am the daughter of an ER Nurse and witnessed first hand the impact of accidents involving drugs. I knew I couldn’t be a nurse, I just can’t handle blood and guts, but I wanted to be on the recovery side of mental health. I specifically recall a story of a 14-year-old cocaine addict. Her mom was her supplier, whereas my mom was a nurse helping people, what a contrast! I then thought about becoming an attorney, to learn more about the law and go after those that abuse children. I eventually graduated from college with a degree in political science and began as a legislative aide for the Massachusetts’s House of Representatives.   This was followed by my obtaining a master’s degree in mental health counseling while remaining in public service. It’s just my passion to help people!

Let’s move into some background on what’s happening in Massachusetts. Unintentional opioid-related deaths continue to increase. The estimated rate of 17.4 deaths per 100,000 residents for 2014 is the highest ever for unintentional opioid overdoses & represents a 228% increase from the rate of 5.3 deaths per 100K in 2000. Since 2004, 6600 members of your communities have died of an opioid overdose.

Q.  What is driving this trend from your perspective in MA? And do you view the issue within your state any different than neighboring states in this regard?

A.  Our state has had a Mental Health & Substance Abuse Committee in place for over 10 years. The problem is that it only addressed chronic disease. People that needed help with addiction and detox couldn’t get into treatment, many were dying. So in 2014, we made access easier.  Insurance did not want to cover 5 days of detox or post detox but the problem is that tolerance goes down after detox then overdose can happen when they go back to using drugs again.   So we began allocating money in our budget for more open beds for addiction treatment even though insurance was saying no way. The legislature basically walked over them, forcing them to understand we were talking pennies to make this work! By addressing addiction treatment head on, there are immediate savings in reduction of treatment costs associated with Hep C as an example. Yes, we do have 99% insured in our state and now insurance does cover some of the cost. But with more beds and treatment coverage, inpatient is much safer as the patient is under observation and assistance. We also have a $5M substance abuse trust to help cover costs, but individuals must apply for it.

Over $250M has been allocated toward opioid epidemic substance use disorders, education, prevention & treatment, increased bulk purchasing of Narcan and also changes to the PDMP including 24 hour reporting, not 7 days. 200 substance use treatment beds have been opened. We continue to invest in major programs, i.e. beds, treatment, expert training & screening for $1.4M per year. We gave a lot of attention and dollars for the treatment side of this epidemic. But we also now have prevention programs to assess risky behaviors for teens for example. Streamlining use for all of these programs is our next goal.

However, we are now faced with increasing use of heroin. What is more concerning is that heroin is being cut with fentanyl which is leading to higher rates of overdoses. Our first responders must wear gloves when treating overdosed patients because they could get sick from even minimal contact with the patient. Our police and firefighters carry Narcan as a matter of routine. Just when you think you have one spoke of the wheel fixed (making it harder to get opioids), you realize you need another spoke for something else (increased use of heroin).

In May 2016, Governor Baker signed landmark legislation to address the deadly opioid and heroin epidemic which was supported by a large contingency including HHS Secretary, Senate President, House Speaker, Attorney General, Auditor and members of the legislature, law enforcement, health care providers, community leaders, individuals in recovery and others. The bill, titled an Act relative to substance use, treatment, education and prevention passed with unanimous votes in both legislative chambers and included numerous recommendation from the Governor’s opioid working group as well as the first law in the nation to establish a 7 day limit on first time opioid prescriptions.

Q.  How was the legislature able to get on the same page and agree to the terms in the bill?

A.  The key word here is Honesty. We have a Republican Governor with a Democratic majority in the legislature. When the Governor began his term, it wasn’t part of his agenda to deal with the opioid crisis. That changed quickly, substance abuse impacts everyone no matter what side of the aisle you’re on. There was a lot of proactive work in the legislature with respect to the problem, the Governor supported our efforts, and all sides and stakeholders were included. Trust was also a big factor.

Back in June 2015, the Governor’s Opioid Working Group released its recommendations including 65 actionable recommendations with an Action Plan for the administration to consider for implementation.   I appreciate how the recommendations were broken down from short-term goals (0-6 months) with long terms goals (3+ years) by 4 categories: Prevention, Intervention, Treatment & Recovery. According to the Governor’s website, approximately 90% of the initiatives in the Governor’s Action Plan are complete or underway, impressive!

Q.  Was it important to develop the recommendations and action plan? How are you measuring its success?

A.  First we had to figure out how we could move around money and not increase taxes. Next, we needed a roadmap. I traveled from the corner of our state to the Cape. We brought in all stakeholders while working on the issue in the Senate and the Governor’s plan mirrored our plan. Absolutely it has been important to have these documents. We may not have gotten everything we wanted or asked for, but the roadmap sets the pathway for what we have agreed to work on together.

Use of data will be necessary to measure success; this is still new for us. Most likely our Department of Public Safety will be the ones that aggregate and create the metrics for quantitative and qualitative analysis of the impact of our roadmap’s initiatives.

In December 2016, the Governor joined Secretary of Labor & Workforce Development Ronald Walker, II and Secretary of HHS Marylou Sudders to announce a new 2 year voluntary workers compensation pilot for opioid-related cases to assist injured workers who have settled workers’ compensation claims get treatment for pain management, aimed at limiting the use of opioids or other narcotics. The program assigns a care coordinator to mediate treatment options between an injured worker and the insurance company paying for medical care.

Q.  May be too soon to tell, but what are your thoughts on this voluntary, work comp program for opioid-related cases?

A.  I was not involved with this latest initiative however I feel that people on opioids just want to find some sort of balance. So for example, how do we utilize alternative therapies (yoga or acupuncture) versus use of opioids? How can we do a better job of having a conversation on do you want to spend the next 60 years of your life on drugs or having a quality of life?   Education matters, let’s be open to trying other things. Doctors need to be part of the conversation in helping to change the disability mindset of patient. It has helped that younger doctors today are getting trained in school on addiction.

Q.  Last, what more needs to be done with respect to the opioid crisis? What are some of the items you’ll be working on?

A.  More transitional housing needs to be addressed. When addicts get out of detox, they are stuck…they have a record, background of drug use, they cannot get into public housing, “sober homes” aren’t always sober and most can’t go home. I want to encourage more public/private partnerships, dorm-style or apartment living to help with recovery and gainful employment.

Additionally, we need to educate employers that the best thing they can do for an addicted worker is to allow them to remain employed while seeking treatment. Employers can put posters in the bathroom on available resources for treatment help for example. Involving the Chamber of Commerce to support this issue would help. It doesn’t cost any money to educate workers on available resources and workers can’t pay taxes if they aren’t working!

Senator, thank you for taking time out of our busy schedule for our discussion on the opioid epidemic and for your tireless efforts to make a difference.

 

 

Thursday Thought Leader: Rx Professor Mark Pew

Love to see great recognition for my friend Mark Pew, Senior Vice President at PRIUM, aka Rx Professor!  His tireless passion for educating our work comp industry on chronic pain and appropriate treatment is exemplary.  Read more about him in LegalNet’s Thursday Thought Leader series!

Opioid Champions Among Us

I never cease to be amazed by the amount of really good people doing really great work on behalf of injured workers. Melanie Armstrong, RN, Medical Services Manager with American Mining Insurance is one of those shining stars. After speaking with her on the phone, I was immediately compelled to write about her and her team’s efforts on opioid use and getting workers back to work.

As you can imagine, American Mining Insurance insures difficult risk. We are talking mine operators, explosive contractors, mechanics, manufacturing, and transportation, truly the gamut of heavy duty, physical work. Melanie started her position back in 2006 with a goal to reduce the hundreds of injured workers on opioids down to less than one hundred. She’s done just that and she’s still not finished!

Melanie is an exceptionally knowledgeable and compassionate champion for good care on behalf of injured workers. She has worked closely with her business partners over the years to set up controls on opioid dispensing for new claims.  She has built a network of group physicians strategically placed to help with her program. The physicians hold each other accountable, agree to follow evidence based medicine and also agree to the company’s vision and objectives. As Melanie puts it “you meet with the providers, explain that this is the program and do you agree with that? And what we see is each doctor nudging the other to do the right thing. So you meet your goals, you meet the objectives because it’s peer to peer communication and more importantly it positively impacts the injured worker’s treatment plan by being safer and cost effective.” The examiners at American Mining believe this too, they are also questioning use and medical necessity at the front end of new claims.

But more importantly, Melanie continues to work tirelessly on those legacy claims with opioid use. You know the ones. Where some payers may tend to try to settle or just continue paying for maintenance opioid drug use, Melanie works that much harder to get them off the drugs. Data, really digging into its use to have conversations with physicians, comparing opioid use against their peers’ trends and impact on improved outcomes (RTW) makes a difference.

Melanie also recognized the key to winning the opioid war is collaboration. She engages ALL stakeholders in the process beyond just the injured worker and physician, but also the examiner, lawyer, nurse, labor and even judges. And she’s admitted that even if the judge doesn’t agree with the opioid reduction plan, Melanie continues to keep fighting on the claim where many of us would have rolled over and continued to pay for more drugs.

Melanie believes deeply that all workers can return to work without continued use of opioids. Her medical background certainly lends her credibility, but its her tireless belief that no one should be on opioids long term that keeps her up at night finding prescribers that will work with American Mining and be in alignment with their claims management philosophy.

I intend to follow up this blog with more details from Melanie on her program at American Mining Insurance and share those best practices with you. Everyone needs a Melanie, American Mining is sure lucky to have her and so too are their injured workers.

 

It Takes Grit! Becoming Business Insurance’s Women to Watch

Ever wonder what it takes to be nominated and recognized as a Business Insurance Women To Watch Honoree?  In its 11th year, this awards and leadership conference was recently held in New York and honored a diverse group of women from a variety of insurance industry backgrounds.  Honorees are selected based on criteria including recent professional accomplishments, expertise, leadership and future career prospects.

Congratulations to this year’s Honorees, you can read all about them by visiting Business Insurance’s website.

I wanted to write about the event from another vantage point, from that of the Nominator.  Someone who not only took time to write the nomination, but who was so inspired by the nominee to take the time to do so.  I went behind the scenes and spoke with Mary O’Donoghue, Chief Clinical Officer for MedRisk Inc on her nomination of Honoree Shelley Boyce, CEO/Founder for MedRisk.

Q.  What inspired you to nominate Shelley as a 2016 Woman To Watch?

Mary:    At the time, I was working for another company that has been a long-time customer of MedRisk.  I got to know Shelley through that lens.  Shelley started MedRisk over 20 years ago, the concept for her business sprang from a college thesis and is today a thriving business employing over 800 employees providing managed physical medicine and diagnostic services to the work comp industry.

There are two characteristics exhibited by Shelley that inspired me to nominate her.  The first is humbleness.  Shelley may be the CEO and founder of MedRisk, but she has never forgotten the people that helped her grow the business.  She is rooted in her community as well, constantly giving back to causes that are important to her.  The second characteristic is Shelley’s strategic mindset.  Shelley can turn an idea upside, engage her team in providing new ways at looking for a solution and allow them to play out.

Shelley is someone I trusted working with, so much so that she was the first person that came to mind when I was looking to make a career move.  And today I’m honored to be working with Shelley and the MedRisk team!

Q.  Do you see a theme or trend for women that rise to the top in their profession?

Mary:    Financial acumen is good, but equally important is knowing the business from every angle so you can think strategically on how to grow the business.   Shelley set out to solve a very specific problem in work comp, a lack of focus on the benefits of physical medicine.  She built a business based on her knowledge of the work comp delivery system, what was lacking at the time and how to create value for stakeholders while returning an injured worker to work more timely.

It’s important to deliberate about where you want the business to be in five years, what’s next, what are the problems we are going to solve for.  Strategizing, thinking big, not giving up…frankly true grit are important themes.  Also important are working on people skills, respect for others, embracing diversity, creating a culture where women and men can equally be successful.

Q.  What has been the biggest shift you’ve personally witnessed since you began your career?

Mary:    Flexibility in the workplace.  Not only where you work, home or office, but how you work.  More and more companies understand a need to focus on work/life balance.  So what if you need to leave work at noon to pick up your child from day care, or if you do your best work at midnight?  Today’s work environment affords employees the flexibility to decide when and how to get their work done, and have fun while doing so.

Q.  How can we get more women to nominate one another or receive more recognition at work?

Mary:    We underestimate the value of mentoring.  Find someone and mentor them!  There is so much a tenured person takes for granted because you’ve been in the business for a while, you just assume that everyone knows.  Encourage women to take risks in the workplace and allow them to fail without negative ramifications so they can learn from their mistakes and grow.  And promote them when it’s deserved.   Also, make sure co-workers are aware of each other’s successes to keep the momentum, visibility and recognition alive.

Q.  What is your company doing to promote women in the workplace?

Mary:    Shelley certainly leads by example, she is a supporter of anything that helps advance women in the work place.  She encourages her team to be on Boards or get involved in events that are supportive of women.  Our company offers employee recognition programs such as distinguishing an employee for when “they brightened someone’s day” or when he/she created an excellent customer service experience.  We support one another, which is not only limited to women, but offering equal pathways for whoever is the most qualified for a promotion.

Q.  What would be a takeaway or two to inspire younger women to get involved in our industry?

Mary:    We are the perfect industry for millennials, however we don’t do a good job of explaining why.  Millennials are motivated by having a purpose, they want to have an impact.  Think about what we, in workers’ compensation, do every day.  Our work impacts a person’s quality of life.  Our industry strives to provide the best quality medical care an injured worker can receive during a time of crisis.  Injured workers want to get back to work, they want to support their families and they want their pre-injury quality of life.  Our job is to help them do just that, which is something millennials can believe in.

Q.  Last question, did you attend the W2W event?

Mary:    Unfortunately, I was unable to attend due to work commitments.  However, Shelley drove a van full of MedRisk women to the occasion, who were representative of all levels of occupations within our organization!  They couldn’t stop talking about the event when they returned, all of them loved seeing Shelley honored and being a part of the conference.

About Mary and MedRisk:

Mary O’Donoghue is responsible for MedRisk’s new product and business line development as well as strategic leadership of all clinical programs and research. A Registered Nurse by trade, Mary has over 25 years of experience in the managed care, group health, disability and workers’ compensation industries having held senior leadership positions in strategic planning, operations management and product development with top carriers, third party administrators and managed care organizations.  Mary serves on the Board of The Alliance of Women in Workers’ Compensation.

MedRisk is a leading provider of managed physical medicine and diagnostic imaging services for the workers’ compensation industry and related market sectors.  MedRisk ensures high quality care and delivers outstanding customer service. To that end, all customer service professionals, healthcare advocates, physical therapists, and radiologists are based in the U.S. MedRisk is accredited under URAC for utilization management and has successfully completed a SSAE 16 Type II examination. For more information, visit www.medrisknet.com or call 800-225-9675.

Christmas Miracles in Workers’ Compensation

For those of dealing with MSAs, it’s all too common to see claims at settlement time that started out as basic and simple, then spiraled downward as a result of bad prescribing habits, increased drug use and opioid addiction.  Tower MSA Partners were hoping for a different ending, but can  miracles really happen?

Thinking Inside the Box to Save Lives

Texas Mutual thinks inside the box to save lives

David Wylie, Senior Technical Writer

Safety resonates loudest when we deliver the message where the work gets done – auto repair shops, manufacturing facilities, oil rigs. So I decided to ditch the comfort of my ergonomically correct office chair and walk a construction site this morning. The experience could have cost me my life.

Everything was fine until I got distracted by a text message and fell about 20 feet off the roof I was scrutinizing.

If you believe bad things happen in bunches, the ensuing events won’t surprise you.

In the span of five minutes, I managed to absorb the blow of a falling cinder block, get engulfed in a trench collapse and run head-on into a high-voltage wire. Talk about a shock.

Fortunately, my brushes with death were virtual, not literal, thanks to a new app developed by Texas Mutual. The app, aptly named Safety in a Box, empowers users to learn life-saving lessons without putting themselves in harm’s way. Here’s how it works.

Safety in a box walks users through four common construction site hazards.

The user downloads the Safety in a Box app onto their smartphone. Then, they slip their phone into a cardboard viewer also aptly named Google Cardboard. The app takes it from there, walking the user through a construction site, where they encounter the industry’s four deadliest workplace hazards: falls, electrocutions, struck-by incidents and trenching incidents.

Safety in a Box is a product of a new phenomenon that is changing the way we protect workers from on-the-job injuries. Of course, there will never be a substitute for time-tested safe work behaviors. But those behaviors are increasingly being supplemented by tech tools that remove human error from the equation.

The union between technology and safety has already been fruitful, and there’s certainly more to come. In case you haven’t been keeping score, here’s a quick review of where were are.

Apps
Millennials live life largely from their mobile devices. Safety professionals are meeting them on their terms with a host of powerful apps. Concerned your employees need hearing protection? There’s an app for that. Want to know what to do in case of a tornado, fire or other natural disaster? There’s an app for that, too.


Driver-assist safety tools
Wearables
The wellness industry has been leveraging wearable technology for years to help people eat, exercise and sleep their way to better health. Technology and safety professionals built on the concept, designing wearable tools that gather data about us and our surroundings, and then nudge us toward safer behaviors.

Blind-spot warning systems, smart headlights and other driver-assist safety features are a priority for 76 percent of drivers who are at least 50 years old, according to a new survey. The survey suggests older drivers equate advanced technology with enhanced safety. Still, safe-driving principles will never go out of style. So buckle up, slow down, stay awake and focus on driving.

Autonomous vehicles
Driver-assist safety tools represent the half-way point toward technology’s ultimate destination: removing humans and our flaws from the act of driving. Google has been testing fully autonomous vehicles in select markets, including right here in Austin. With backing from the government, 10 million self-driving cars could be on the road by 2020. At that point, we’ll simply be along for the ride.

Stay tuned
Technology is revolutionizing safety at a dizzying pace. Today’s trendy tools could be tomorrow’s relics. Follow our blog and stay up-to-date on the latest developments.

About Texas Mutual Insurance Company

Austin-based Texas Mutual Insurance Company, a policyholder-owned company, is the state’s leading provider of workers’ compensation insurance. Texas Mutual provides coverage to 40 percent of the market, representing over 66,000 companies, many of which are small businesses. Since 1991, the company has provided a stable, competitively priced source of workers’ comp insurance for Texas employers. Helping employers prevent workplace accidents is an important part of Texas Mutual’s mission.

 

 

Missing 33% Keeping Women from Reaching the Top

The combined forces of the Executive Women in Work Comp and Women in Work Comp were in full swing at this year’s National Workers Compensation & Disability Conference.  The two organizations recently joined together to form “The Alliance of Women in Workers’ Compensation” to talk about women and leadership.

The Alliance is a unique organization bringing together professional women (and men too) in the work comp industry to work together for the common good.  The Alliance’s goal of inclusivity manifests in not only encouraging women and men alike to work together for the advancement of women but with the benefit of industry improvement all around.

For the past three years, the Alliance has hosted the pre-conference event on the Tuesday before NWCDC.  The focus for this year’s event included what women are not told about leadership, what moves women from middle management to the top and developing business, strategic and financial acumen.  Quite an agenda!  And with a packed room of over 400 women, there was certainly a lot of excitement, exchanging and engaging going on!

Nina Smith, General Manager with Mitchell International and an Alliance Board Member, kicked off the event by getting us excited, up and out of our seats, clapping/dancing to some foot-stomping tunes.  It was enlightening to see a respected industry executive like Nina relaxed, having fun.. and still leading!

Next up was the keynote speaker Susan Colantuono, a recognized leadership expert, author, TED Talk extraordinaire and CEO of Leading Women.  If you were unable to attend the Alliance event, at least check out Susan’s TED Talk (click here) which will provide you with some good takeaways.

Susan’s discussion was enlightening:

  • Women are not told the essential skills for moving up, executives look for business, strategic and financial acumen.
  • Women don’t always know how best to speak the language of POWER

EQUALS= what Susan called the “missing 33%” of a woman’s professional background that keeps her from reaching the top.

So what do we do about it? Well that led to the workshop susanportion of the Alliance program, where each table began exchanging dialog on their jobs and practicing speaking the language of power.  Instead of “I feel confident I’m the right person to lead the organization” we practiced using power words such as “I understand the business, I have the cash numbers to talk about what new markets can help fuel our growth, I know our bottom line in terms of what’s needed in ROI and I know our customer…”  It’s a shift from being taught throughout our lives to be strong, confident, assertive, knowledgeable to then speaking the language of a CEO from the business acumen perspective.  It’s an important nuance.

It is no longer enough to understand the business, but women must speak to where the business is headed and her role in getting it there.  As to engaging, here’s where I believe women have a competitive edge that we don’t leverage enough.  We are THE BEST AT ENGAGING!  It’s what we do!  We engage every day from a personal level with family, our community, our faith which is then parlayed into how we interact at work.  Women not only lead, but do so with an engagement experience that sets us apart from men.  Women are great networkers and mentors, it’s in our DNA.  When you combine our natural talents with business acumen, glass ceilings should be blown away.

Leadership is using our own greatness, achieving and sustaining extraordinary outcomes and engaging the greatness in others.  Achieving and sustaining outcomes is the key to advancement, this is the business, strategic, financial acumen necessary to open the door to the top.  We can do this, it’s not only building our confidence but more importantly learning the business for advancement opportunities.

I believe there are already great women leaders in work comp today, I looked around the room and saw many of them there.  Many of them not only exhibit business acumen, but bring their compassion for helping the injured worker, building teams that provide world class service and are constantly trying to improve themselves and their businesses.  I met CEOs, nurse case managers, risk managers, general managers, senior vice presidents…so many in the room, so many that were excited, exchanging and engaging for the betterment of the industry and their businesses.

The Alliance proves that good things can and do happen in our industry.  It was energizing participating in this year’s event, knowing you are a part of a larger network and helping one another work towards professional greatness.  It’s inspiring to know women are not only committed to a career, but dedicated to the work comp profession.  We may not have solved the gender gap in a day, but I can tell you we all left the room with a better understanding of leadership and career success.

The Alliance continues to grow as an organization with local chapter events, pre-networking events at work comp conferences and an Ambassador Program.  For more information, please visit their website at www.allianceofwomen.org.