Chapter 3 – Services - Ohio Bureau of Workers' Compensation
Ohio Workers’ Compensation 2018 Snapshot · Northeast Ohio 330-312-4713...
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5/9/2018 DRAFT 1 Ohio Workers’ Compensation 2018 Snapshot Mark J. Clendenin BS, MPA NE Regional Business Development Manager Mark Clendenin Regional Business Development Mgr. Northeast Ohio 330-312-4713 [email protected] Regional Territory
Transcript of Ohio Workers’ Compensation 2018 Snapshot · Northeast Ohio 330-312-4713...
5/9/2018
DRAFT 1
Ohio Workers’ Compensation 2018 Snapshot
Mark J. Clendenin BS, MPA
NE Regional Business Development Manager
Mark Clendenin
Regional Business Development Mgr.
Northeast Ohio
330-312-4713
Regional Territory
5/9/2018
DRAFT 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
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DRAFT 3
BWC is the Largest Exclusive State Fund in the U.S.
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 2016-2017 Annual Report
Total Active Employers FY17 = 242,474
Net Allowed Injuries
101,165
97,041 97,572
93,936
88,170$86,290
75,000
80,000
85,000
90,000
95,000
100,000
105,000
Net Allowed Injuries
2012 2013 2014 2015 2016 2017
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DRAFT 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
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DRAFT 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 2nd 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 3rd Medical and Health Symposium.
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DRAFT 6
BWC Initiatives
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Safety Campaign
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DRAFT 7
Rebates to Employers
Oregon WC Study
• Ranking of states cost of WC
• <10 years ago - 3rd highest among all 50 states
• 2014 - 17th lowest among all 50 states
• 2016 - 11th lowest among all 50 states
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DRAFT 8
2016 Oregon WC Study
-least expensive
2016 Oregon WC Study
-most expensive
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DRAFT 9
Oregon Study-Surrounding States
MICHIGAN 34 34
INDIANA 50 50
KENTUCKY 36 40
WEST VIRGINIA 48 43
PENNSYLVANIA 26 17
NEW YORK* 03 04
OHIO 40 33
2016 2014
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.
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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.
Employer Program
Employee Program
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DRAFT 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
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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
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2017 Health Rankings by State
Ohio
ranking
: 39th
Factors Affecting Ranking
46 33
24 33
39
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DRAFT 14
Health Behaviors Ranking
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. 24.5 46
High school graduation 80.7% 34
Ohio overall behaviors ranking: 46th
Health Outcomes Ranking
Health outcome Value Rank
Cancer deaths per 100,000 pop. 208.7 40
Cardiovascular deaths per 100,000
pop.
283.6 39
Diabetes 11.1% 31
Ohio overall outcome ranking: 39th
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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.
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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.
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Strategies that Work
• Strategic approach
• Handicap reimbursement
• Subrogation
• Settlement
Strategic Approach
Wellness
Drug-free
Transitional
work
Safety
visits
On-site
training
BWC
programs
Positive
culture
Formal
procedures
Documentation
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DRAFT 17
Program Interdependency
Premium Management
Transitional Work
Program
Workplace Wellness Program
$15,000 Medical-
Only Program
Handicap Reimbursement
o Substitute House Bill 27
o Effective July 1, 2017
o Amends handicap reimbursement 4123.343
o Incorporates lump-sum settlements
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DRAFT 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.
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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
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DRAFT 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
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AC-28 Request to Charge Surplus
Fund-Auto
Important
Questions?
![State ex rel. Aaron's, Inc. v. Ohio Bur. of Workers' Comp. · [Cite as State ex rel. Aaron's, Inc. v. Ohio Bur. of Workers' Comp., 2014-Ohio-3425.] IN THE COURT OF APPEALS OF OHIO](https://static.fdocuments.us/doc/165x107/5b78071f7f8b9a515a8e5c12/state-ex-rel-aarons-inc-v-ohio-bur-of-workers-comp-cite-as-state-ex.jpg)
![State ex rel. Ohio AFL-CIO v. Ohio Bur. of Workers' Comp. · [Cite as State ex rel. Ohio AFL-CIO v. Ohio Bur. of Workers’ Comp., 97 Ohio St.3d 504, 2002-Ohio-6717.] Workers’ compensation](https://static.fdocuments.us/doc/165x107/5e78ad3e9cea4d6a6e68d8e3/state-ex-rel-ohio-afl-cio-v-ohio-bur-of-workers-comp-cite-as-state-ex-rel.jpg)
