As one of 15 managed care organizations (MCOs) that contract with the Ohio Bureau of Workers’ Compensation (BWC), Health Management Solutions has only one goal in mind: to get injured workers back to work as quickly and safely as possible.
“That’s the bottom line,” says Tod Phillips, executive director of Health Management Solutions. The company gets people injured on the job back to work quickly and safely by coordinating their medical care, surgeries and rehabilitation with an experienced nurse case manager who specializes in occupational medicine, he says.
“A lot of (the nurses) are (former) floor nurses … they’ve been through orthopedic, cardiac and mental health units at various hospitals and providers, and they have come to what we call the case management side and ply their expertise as it applies to workers’ comp injuries,” says Phillips.
It’s a collaborative effort, he says. The nurses conduct what’s called three-point contact, which means they communicate with the injured worker, the medical provider and the employer of the injured worker.
Health Management Solutions, which started handling workers’ compensation cases in 1997, also makes sure the medical providers are paid, he says. The MCO has about 90 employees, about 38 of them nurses, with offices in Cleveland, Columbus, Toledo and Cincinnati.
But before a worker who is injured on the job can have their medical care managed by a nurse at Health Management Solutions, their employer must first select the MCO during the state’s four-week open enrollment period. The open enrollment period takes place once every two years in May.
It can be a confusing time for employers, Phillips says. They may be inundated with marketing material from the state’s 15 certified MCOs during the open enrollment period—the only time these companies can market their services.
“The other 23 months we can’t say a word,” says Phillips.
So how do employers know which MCO to choose? One of the best ways to choose is look at one specific metric that the state uses to compare managed care organizations—the Measurement of Disability, Phillips says.
“The (Measurement of Disability) scores are the only … totally neutral metrics,” he says. “They’re the only true apples to apples recognized by the (Ohio BWC) that is comparative. It’s all weighted accordingly so that all (MCOs) are judged by the same standards. [We have] been in the top three of Measurement of Disability scores for the last two years,” Phillips says.
And if that’s not enough to convince employers to select Health Management Solutions as its MCO then the company’s commitment to a personal relationship might be the deciding factor.
“When you call (us) you get a person on the phone,” Phillips says. “You don’t get an automated attendant that says, ‘If you are this press one.’ You’re going to talk to the same nurse that’s assigned to your company every time.”
