The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68273

Bryan E. Dowd, PhD¹, Michael McGrail, MD², Bill Lohman, MD³, Brent Sheasby, MS⁴, and Heidi O'Connor, MS¹. (1) Division of Health Services Research and Policy, University of Minnesota, 420 Delaware Street S.E., Mayo Mail Code 729, Minneapolis, MN 55455, (2) Regions Hospital, Occupational Medicine Residency Program, 640 Jackson St., St. Paul, MN 55105, (3) Research and Education Unit, Minnesota Dept. Of Labor and Industry, 443 Lafyette RD, St. Paul, MN 55101, (4) MHP Project, Park Nicollet Institute, 6465 Wazata Blvd., Minneapolis, MN 55426, 952-993-3361, obrieme@parknicollet.com

This project was designed to evaluate the impact of the Coordinated Health Care and Disability Prevention program on indemnity, medical care and workers' compensation costs. The intervention featured consistent treatment of employees' impairments whether work-related or not including: (1) employee choice of primary health care provider; (2) continuity of care with the employee's personal physician; (3) physician advice about activity levels; and (4) employer implementation of similar disability management strategies for all potentially affected employees. The study employed a pre-post, quasi-experimental design. The intervention occurred at the employer and clinic level. Baseline data were collected in 1997; the intervention began July 1, 1998; and the observation period extended through 2001. Two part expenditure models allowed the effect of the intervention to differ for the probability of some expenditure versus the amount of expenditure for those with positive expenditures. The study included seven test employers and five control employers, and seven test clinics and eight control clinics. The person-level database for the cost analysis merged data from health plans, health care providers and employers (N= 101,184 employees). The employer and clinic site interventions reduced total cost by 29 percent. Indemnity costs were reduced by 34 percent, entirely by the employer intervention. Medical costs were reduced 27 percent. The point estimate for workers' compensation savings was 88 percent, but based on a small sample. The employer and clinic interventions were successful in reducing indemnity and medical costs; there is reason for optimism regarding their ability to also reduce workers compensation costs.

Learning Objectives:

At the conclusion of this presentation the participant will be able to:(1)describe the elements of a model program for coordinating health care and disability management to employees and (
• discuss the effect of the clinic and employer interventions on the total costs, medical and indeminity workers' compensation costs.

Keywords: Economic Analysis, Disability Policy

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Minnesota Health Partnership
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.