Mining companies looking to rein in soaring workers compensation insurance costs may soon get some relief from firms such as Medepartner, a self-styled “facilitated care” provider promising to ease headaches for employers, medical practitioners and insurers caught up in the current workers compensation maze.
Compounding the problem of high premiums caused by the industry’s unsafe image, mining companies are just as burdened as those in other industry sectors by the often cumbersome interface between uncommunicative insurers and GPs.
According to Medepartner director, Wayne Miller, lost work time and costs linked to workplace injuries are clearly being magnified in the mining industry by the lack of “patient focused” medical treatment procedures and administrative resources. The remoteness of many mines, which meant interaction between injured workers and GPs frequently occurred away from site in cities and major regional centres, accentuated the problem.
The link in the workers compensation chain, the insurer, often faced the same administrative hurdles as the employer in tracking individual medical cases, and had an “adversarial” relationship with general practitioners to boot. Those companies endeavouring to regain some measure of control over their insurance costs by becoming self-insured faced the same administrative difficulties at the “treatment” level, Miller said.
“Claim costs frequently blow out when the control mechanisms are not in place,” he said.
“There are unnecessary barriers to recovery, often just the result of paperwork doing the rounds between employers, insurers and GPs, there is too much paperwork — one company that we know of has contracted an organisation just to pay bills that were getting lost in their system faster — and there are inevitable delays to peoples’ return to work.
“You also have a situation where, increasingly, the GP is based a long way from where the workplace injuries occur. There is little familiarity with the workplace and little scope for an early return to work based on knowledge of the working environment and how the injured person might return to it in a productive capacity.
“The worker is on the sidelines, the insurer is on the sidelines and, unfortunately, so is the employer.
“Medepartner can be used to facilitate realistic return to work outcomes. It is a valuable outsourcing opportunity for mining companies because we assist the medical management process for them using state-of-the-art software, accessible via the internet, with the support of a dedicated network of handpicked specialist practitioners and our growing team of registered nurses.”
An unlisted public company currently based in Miller’s home town of Perth, Western Australia, Medepartner is the exclusive Australian agent for the US-developed CarePartner medical management software. The local firm has spent a year customising the software for the Australian medical and insurance market and claims to have enhanced its usefulness as a “web accessible database”
“It (the software) has maintained its edge in the US marketplace over a significant period of time,” Miller said.
“The edge for us in Australia is that no-one is using a database with CarePartner’s capability to facilitate the medical recovery of workers’ compensation with accessibility via the internet. It is leading edge medical diagnostic software that electronically generates care plans using sophisticated medical care guidelines.
“The care plans give the ability to actuarially estimate a return to work date for full fitness and light duties for the patient, which may also include multiple care plans for multiple injuries. This has huge potential for cost reduction by assisting supervisors and managers in workplace resource planning of partially fit workers’ compensation patients.
“It offers the best available tool for the Australian environment that we are aware of, for integrating claims, illness/injury management and medical management, and it enables you to monitor a person’s progress through the medical management process seamlessly and with secure, real-time access for authorised users.”
Medepartner currently has eight medical co-ordinators (qualified occupational physicians) in its national network, a number the company aims to expand in the next six months.
“They are building a network below them of 10-15 eminent return to work specialists in each state to cater for a national corporation seeking consistent treatment and return to work practices,” Miller said.
“Their total focus will be to deliver their services, completely electronically, via their desktops to Medepartner, or directly to our customers, whichever our contract stipulates.”
The mining industry is one of a number of industry sectors being targeted by Medepartner, which has plans to seek Australian Stock Exchange listing. Statistics recently produced by WorkCover in WA were said to reflect the seriousness of workplace health and safety issues, with an annual workers compensation claim bill of more than $448 million and 1.1 million working days lost due to injury reported in this state alone. In New South Wales, the deficit is a reported $2.2 billion, growing at $1 million a day.
“Our markets are insured and self-insured companies, or those seeking to apply for self-insurance licences in the next 12 months, general medical practitioners and insurers,” Miller said.
He said a small but growing percentage of mining companies were self-insured and were seeing some benefits from links with dedicated medical specialists who had knowledge of the mining industry and its work environments. Medepartner could enhance these benefits.
“The self-insured market is one that is growing quickly because insurance companies are pushing up their premiums and mining companies, even those with exceptional loss records, are paying the price for being part of a mining community where there are some deaths and serious injuries, and some problems in mining processes which are causing accidents in the workplace,” Miller said.
“Most self-insurers have insurer injury tracking systems with patient information on them. They tend to focus on the injury, not the patient. Our system is focused on the patient and it is a medical system which incorporates insurance claims tracking.
“Also the medical staff at the mining company can utilise our medical database to completely store medical records, including hospital records.”
See the related story, How Medepartner will help stakeholders in the workers compensation supply chain.