2018 Snapshot Mark J. Clendenin BS, MPA NE Regional Business - - PDF document

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2018 Snapshot Mark J. Clendenin BS, MPA NE Regional Business - - PDF document

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5/9/2018 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 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 Mark.Clendenin@ohiobwc.com

Regional Territory

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5/9/2018 DRAFT 2

Mission Statement

To protect Ohio’s workers and employers through the prevention, care and management

  • f workplace injuries and illnesses at fair rates

BWC Updates

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5/9/2018 DRAFT 3

BWC is the Largest Exclusive State Fund in the U.S.

State Fund Claims Filed in FY17

  • Lost Time 10,745
  • Medical Only 75,030
  • Occupational Disease 360
  • Death 155
  • Disallow or Dismissed 11,641
  • Total 97,931
  • Net Allowed Injuries 86,290

All Open Claims in FY17

  • Lost Time 242,778
  • Medical Only 461,978
  • 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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5/9/2018 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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5/9/2018 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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5/9/2018 DRAFT 6

BWC Initiatives

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Safety Campaign

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5/9/2018 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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5/9/2018 DRAFT 8

2016 Oregon WC Study

  • least expensive

2016 Oregon WC Study

  • most expensive
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5/9/2018 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

  • Safety Intervention Grants Program
  • Workplace Wellness Grant Program
  • Drug-Free Safety Program (DFSP) grants
  • Transitional Work Grants
  • In fiscal year 2017, BWC awarded grants totaling

$12,600,000 to 662 employers.

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5/9/2018 DRAFT 10

Workplace Wellness Grant

  • Purpose: To assist employers with the development and

implementation of workplace wellness program

  • Goal: To control escalating costs of claims by

addressing health-risk factors

  • $300 per participating

employee

  • $15,000 per employer.

Employer Program Employee Program

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5/9/2018 DRAFT 11

Program Eligibility

Targets two employee segments

  • Employed by a company with less than

50 workers, in targeted industries

  • Injured workers, by invitation

Targeted Industries

  • Agriculture
  • Automotive

repair and service

  • Construction
  • Firefighters
  • Health care
  • Manufacturing
  • Police and

public safety

  • Public employers
  • Restaurant and

food service

  • Transportation and

trucking

  • Trash collection
  • Wholesale and retail
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5/9/2018 DRAFT 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?

  • Prevent injuries because of improved

workforce health

  • Reduce the severity of an injury
  • Increase the speed of recovery from an injury
  • Improve return-to-work outcomes
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5/9/2018 DRAFT 13

2017 Health Rankings by State

Ohio ranking : 39th

Factors Affecting Ranking 46 33 24 33 39

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5/9/2018 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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5/9/2018 DRAFT 15

Health Behavior Assessment and Intervention

  • Provides standards and criteria governing

reimbursement for health and behavior assessment and intervention (HBAI) services

  • ffered 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

  • Effective May 1, 2018
  • Include hospital and ambulatory surgical centers
  • Based on Medicare reimbursement rates
  • Continued stability of fee reimbursements
  • Current rates are just above the US median.

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5/9/2018 DRAFT 16

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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5/9/2018 DRAFT 17

Program Interdependency

Premium Management

Transitional Work Program Workplace Wellness Program $15,000 Medical- Only Program

Handicap Reimbursement

  • Substitute House Bill 27
  • Effective July 1, 2017
  • Amends handicap reimbursement 4123.343
  • Incorporates lump-sum settlements

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5/9/2018 DRAFT 18

Handicap Reimbursement

  • There are 26 allowed conditions.
  • Discount based on relationship to injury:
  • Prolongs healing process;
  • Contributes to the injury.
  • The percentage of discount is charged to the

surplus fund.

Settlement

  • A formal agreement needs to be completed

before the experience period snapshot:

  • July 17 for private employers;
  • Feb 15 for public employers.
  • Must allow 30 days for Industrial Commission
  • f Ohio approval.
  • Reserve drops to zero.
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5/9/2018 DRAFT 19

Subrogation

  • The right to recover benefits from a third party

because of negligence

  • How recoveries are credited
  • Injured worker must file suit against third party

HB 207 Subrogation Law

  • HB 207 – Effective at BWC July 1, 2017
  • 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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5/9/2018 DRAFT 20

HB 207 Subrogation

  • 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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5/9/2018 DRAFT 21

AC-28 Request to Charge Surplus Fund-Auto

Important

Questions?