Ohio Workers Compensation 2018 Snapshot

Transcription

1 Ohio Workers Compensation 2018 Snapshot Mark J. Clendenin BS, MPA NE Regional Business Development Manager Regional Territory Mark Clendenin Regional Business Development Mgr. Northeast Ohio DRAFT 1

2 Mission Statement To protect Ohio s workers and employers through the prevention, care and management of workplace injuries and illnesses at fair rates BWC Updates 4 DRAFT 2

3 BWC is the Largest Exclusive State Fund in the U.S. Total Active Employers FY17 = 242,474 State Fund Claims Filed in FY17 o Lost Time 10,745 o Medical Only 75,030 o Occupational Disease 360 o Death 155 o Disallow or Dismissed 11,641 o Total 97,931 o Net Allowed Injuries 86,290 All Open Claims in FY17 o Lost Time 242,778 o Medical Only 461,978 o Total 704,756 Total Benefits Paid = $1.49 Billion From BWC Annual Report Net Allowed Injuries 105, ,000 95, ,165 97,041 97,572 93,936 90,000 88,170 $86,290 85,000 80,000 75,000 Net Allowed Injuries DRAFT 3

4 2017 Reduced Claims BWC approved 86,290 new claims in FY17, a decrease of 1,880 from FY16. Contributing reasons for this decrease include: Continued safety funding; Continued promotion of safe and healthy workplaces; More employers putting safety education resources to work. Pharmacy program DRAFT 4

5 FY 2017 BWC Recap Private base rate reductions of 8.6%. $1 billion rebate for Ohio s employers 2 year $44 million wellness and safety commitment. Hosted 2 nd Medical and Health Symposium. New BWC rule governing the prescribing of opioids FY 2018 BWC Highlights $1.5 Billion rebate to Ohio s Employers. Private base rate reductions of 8.8%. Public base rate reductions of 9%. Launched Better You Better Ohio wellness program Hosted our 3 rd Medical and Health Symposium. DRAFT 5

6 BWC Initiatives 11 Safety Campaign DRAFT 6

7 Rebates to Employers Oregon WC Study Ranking of states cost of WC <10 years ago - 3 rd highest among all 50 states th lowest among all 50 states th lowest among all 50 states DRAFT 7

8 2016 Oregon WC Study -least expensive 2016 Oregon WC Study -most expensive DRAFT 8

9 Oregon Study-Surrounding States OHIO MICHIGAN INDIANA KENTUCKY WEST VIRGINIA PENNSYLVANIA NEW YORK* Increased Commitment to Safety o Safety Intervention Grants Program o Workplace Wellness Grant Program o Drug-Free Safety Program (DFSP) grants o Transitional Work Grants o In fiscal year 2017, BWC awarded grants totaling $12,600,000 to 662 employers. DRAFT 9

10 Employer Program Workplace Wellness Grant o Purpose: To assist employers with the development and implementation of workplace wellness program o Goal: To control escalating costs of claims by addressing health-risk factors o $300 per participating employee o $15,000 per employer. Employee Program DRAFT 10

11 Program Eligibility Targets two employee segments o Employed by a company with less than 50 workers, in targeted industries o Injured workers, by invitation Targeted Industries o Agriculture o Automotive repair and service o Construction o Firefighters o Health care o Manufacturing o Police and public safety o Public employers o Restaurant and food service o Transportation and trucking o Trash collection o Wholesale and retail DRAFT 11

12 Injured Worker The injured worker will be invited to participate after collaboration with the employer, the managed care organization (MCO) and BWC. Why Wellness? o Prevent injuries because of improved workforce health o Reduce the severity of an injury o Increase the speed of recovery from an injury o Improve return-to-work outcomes DRAFT 12

13 2017 Health Rankings by State Ohio ranking : 39th Factors Affecting Ranking DRAFT 13

14 Health Behaviors Ranking Ohio overall behaviors ranking: 46th Behavioral factor Value Rank Obesity 31.5% 32 Excessive drinking 19.1% 30 Physical inactivity 25.9% 35 Smoking 22.5% 45 Drug deaths per 100,000 pop High school graduation 80.7% 34 Health Outcomes Ranking Ohio overall outcome ranking: 39th Health outcome Value Rank Cancer deaths per 100,000 pop Cardiovascular deaths per 100,000 pop Diabetes 11.1% 31 DRAFT 14

15 Health Behavior Assessment and Intervention o Provides standards and criteria governing reimbursement for health and behavior assessment and intervention (HBAI) services offered to injured workers who may benefit from an assessment that focuses on identifying behavioral barriers impeding the injured worker s recovery which may be addressed through intervention services. 29 New Fee Schedule Adopted o Effective May 1, 2018 o Include hospital and ambulatory surgical centers o Based on Medicare reimbursement rates o Continued stability of fee reimbursements o Current rates are just above the US median. 30 DRAFT 15

16 Strategies that Work Strategic approach Handicap reimbursement Subrogation Settlement Strategic Approach Drug-free On-site training Documentation Wellness Transitional work Formal procedures BWC programs Safety visits Positive culture DRAFT 16

17 Program Interdependency Transitional Work Program Premium Management $15,000 Medical- Only Program Workplace Wellness Program Handicap Reimbursement o Substitute House Bill 27 o Effective July 1, 2017 o Amends handicap reimbursement o Incorporates lump-sum settlements 34 DRAFT 17

18 Handicap Reimbursement o There are 26 allowed conditions. o Discount based on relationship to injury: Prolongs healing process; Contributes to the injury. o The percentage of discount is charged to the surplus fund. Settlement o A formal agreement needs to be completed before the experience period snapshot: July 17 for private employers; Feb 15 for public employers. o Must allow 30 days for Industrial Commission of Ohio approval. o Reserve drops to zero. DRAFT 18

19 Subrogation o The right to recover benefits from a third party because of negligence o How recoveries are credited o Injured worker must file suit against third party HB 207 Subrogation Law o HB 207 Effective at BWC July 1, 2017 o To allow a state fund employer to have a workers compensation claim that is likely to be subrogated by a third party paid from the surplus fund account in the state insurance fund rather than charged to the employer's experience DRAFT 19

20 HB 207 Subrogation o Notification and Update Eligibility Motor Vehicle Accident Citation Third Party Insurance 180 Day for BWC Determination Comparable Liability AC-28 Request to Charge Surplus Fund-Auto DRAFT 20

21 AC-28 Request to Charge Surplus Fund-Auto Important Questions? DRAFT 21