Reed Group’s the
Medical Disability Advisor (MDA)
Comcare National Conference Oct 24,25 2007, Canberra ,Australia
The Business Case for setting Return to
WorkExpectations
Reed Group. Ltd.© 2007
Reed Group. Ltd.© 2007
Reed Group’s the Medical Disability Advisor is a
return to work guideline that is used to set return
to work expectations.
Managing risk without setting RTW
expectations is protracted, energy
intensive and expensive.
Reed Group. Ltd.© 2007
MDA at a glance
• The Medical Disability Advisor has been in existence for 15 years• It combines actuarial data from multiple sources. • The data is then reviewed by multiple eminent physicians to arrive at the
duration tables• The method of review is detailed and the data is updated twice a year• The MDA is used in 38 countries• About 25,000 organisations and business use the MDA worldwide• In Australia 7 of the 8 Workers Compensation authorities either directly use
or are trialling the MDA• In NZ, the Accident Compensation Corporation has been a user for the past
6 years• Since the Daubert decision in the Supreme Court of the United States in
1993, judges are required to inform themselves of the evidentiary basis of a doctor’s opinion. American courts are not at liberty to rely upon a doctor’s experience in reaching a decision. The same approach is being adopted in Australia.
• The MDA provides the evidentiary basis for the normal course of recovery for the treating doctor to consider when certifying the claimant
• It helps determine the most timely stay at work or return to work timetable.• Research indicates that timely return to work on suitable duties facilitates
healing
Reed Group. Ltd.© 2007
An Overview of The Medical Disability Advisor (MDA)
It is a reference resource in the claims management process.
It is actuarial based, physician reviewed, complete and has readily usable disability durations and guidelines.
• It provides claims personnel with medical information on more than 10,000 reference codes for injuries and illness of working people.
• The guidelines provide evidence-based, objective expectancy figures for normal recovery from a medical condition, injury or procedure in its renowned disability duration tables.
• It does not replace the need for medical opinion, but can assist in establishing a framework for dialogue among all stakeholders to help ensure consistent and fair treatment and recovery for all injured and ill workers.
• The MDA is based on actual normative case data gathered from more than 5 million case records.
• It is the world’s most widely used information resource for disability information with more than 22,000 customers worldwide.
Reed Group. Ltd.© 2007
Key benefits of the Medical Disability Advisor
(MDA)
Key Benefits:
1. Gives you rapid, flexible, and easy access to a huge body of relevant information so you can quickly find the information you need.
2. Helps you quickly explore subjects of interest and develop and refine inquiries through cross-linkages in the data.
3. Lets you copy, paste, print, and even email pertinent portions of the authoritative topic materials to other stakeholders.
4. Keeps you abreast of what the Claims Manager knows
Reed Group. Ltd.© 2007
Section 2
“Enabling case managers to benchmark
organisational rehabilitation
performance through use of an evidence-
based tool”
Reed Group. Ltd.© 2007
Organisational Performance
• The Medical Disability Advisor provides evidence based disability duration guidelines that assist in
setting RTW expectations.
• Case managers drive organisational performance by benchmarking days lost against industry standards.
• The MDA benchmarks provider performance in over
1300 individual conditions.
Reed Group. Ltd.© 2007
Using MDA Duration Guidelines allows companies to:
Impart a non-biased, medically objective approach with each case
Provide consistency across departments and throughout the company
Save time and maximize individual contacts with employees and physicians
Enhance areas of expertise with comprehensive clinical and non-clinical information
• Positively impact employee relations and communications during a disability period
Reed Group. Ltd.© 2007
MDA benefits
• Create greater internal efficiencies
• More accurate Case Management
• More consistent Claims Administration
• Credibility with Employee and other Stakeholders
• Ease of implementation
Reed Group. Ltd.© 2007
Time saving from Claims Managers using the MDA
rather than using Internet searches and library
research
Current number of Claims Managers
Minutes saved per day
Labour hours saved per year
Average hourly rate per employee
Potential direct savings
19 10 791 $25 $19,791
Reed Group. Ltd.© 2007
Results from using the MDA in every case
Accident Compensation Corporation of New Zealand decreased days lost from work by 40% over 5 yrs using the MDA
The Nova Scotia Workers Compensation Board of Canada decreased days lost by 50% over a 9 month period by requiring both Claims Managers and Certifying Doctors to incorporate MDA data in their Injury Management plans.
How can you use the MDA data to better manage your own cases?
Reed Group. Ltd.© 2007
The Three Areas covered in Topic Sections:
1. The orientation sections, which provides the most basic information about a condition or procedure to put it in context, and include:
* Related Terms * Illustration* Definition * Medical Codes* Reasons for Procedure * Cited / General
References* How Procedure is Performed
2. The medical sections, which provide guidelines to evaluate appropriateness of medical and rehabilitation care, and include:
* Diagnosis * Specialists* Treatment * Rehabilitation* Differential Diagnosis * Co-morbid
Conditions* Prognosis * Complications
3. The recovery and disability sections, which provide guidelines to evaluate the appropriateness of length of disability, and include:
* Factors Influencing Duration * Return to Work* Length of Disability / Duration Tables * Failure to Recover
* Reference Data Trends
Reed Group. Ltd.© 2007
Disability Management
1. Understanding the Duration Tables:
There are three categories of duration tables, i.e., Minimum, Optimum and Maximum.
Definitions and interpretation of the three duration tables.
Classification of Work (sedentary, light, medium, heavy and very heavy).
2. Understanding Duration Trends:
Mean: The average disability duration – the sum of all durations divided by the number of cases.
Median: The time at which 50% of cases have returned to work
Reed Group. Ltd.© 2007
Managing Risk vs. Setting Expectations
Re-active management. Managing Risks.
Pro-active management. Creating Stay At Work/Return To Work (SAW/RTW) expectations.
The more stakeholders are familiar with the MDA
disability duration guidelines, the easier it is to set RTW expectations and the greater chance of
returning a worker to work in an appropriate time frame.
Reed Group’s the
Medical Disability Advisor (MDA)
Comcare National Conference Oct 24th-25th 2007, Canberra, Australia
Setting Return to WorkExpectations
The Business case
Reed Group. Ltd.© 2007
Reed Group. Ltd.© 2007
The Reed Group Limited
Established 1981 by Dr Presley Reed an industry-leading provider of:
disability duration guidelines, software and services that streamline
absence operations for the Employer, TPA, Insurers, Benefits Administrators, Workers' Compensation Boards, and Government Agencies nationally and internationally
2005 – Reed Group Asia Pacific (RGAP) established
Reed Group. Ltd.© 2007
The Reed GroupProducts & Services
• Medical Disability Advisor• Disability, FMLA, Absence
Tracking & Workers Compensation Case Management Services
• Absence & Disability Management Software
• Education Services
Reed Group. Ltd.© 2007
MDA Version 5 - options•MDA5 – Internet;•MDA5 – Internet with
ACOEM’S UMK•MDA5 – PC version for
Windows•MDA5 – 2 volume Text•MDA101 – How to use The
Medical Disability Advisor in Disability Case Management.
Reed Group. Ltd.© 2007
Reed Group’s the Medical Disability Advisor is a
return to work guideline that is used to set return
to work (RTW) expectations
Managing disability without setting RTW expectations is like shutting the door
after the horse has bolted
Reed Group. Ltd.© 2007
MDA at a glance
• The Medical Disability Advisor has been in existence for 15 years • It combines actuarial data from multiple world-wide sources
• The data is then reviewed by multiple eminent physicians to arrive at the duration tables
• The method of review is detailed and the data is updated twice a year
• The MDA is used in 38 countries by about 25,000 organisations
• In Australia the MDA is used by Workcover authorities, Workers Comp insurers, Self Insurers and Life Insurers.
• The NZ Accident Compensation Corporation has been a user for over 6 years
• Since the Daubert decision in the Supreme Court of the United States in 1993, judges are required to inform themselves of the evidentiary basis of a doctor’s opinion. American courts are not at liberty to rely upon a doctor’s experience in reaching a decision. The same approach is being adopted in Australia.
Reed Group. Ltd.© 2007
An Overview of The Medical Disability Advisor (MDA)
• It provides claims personnel with medical information on more than 10,000 reference codes for injuries and illness of working people.
• The guidelines provide evidence-based, objective expectancy figures for normal recovery from a medical condition, injury or procedure in its renowned disability duration tables.
• It does not replace the need for medical opinion, but can assist in establishing a framework for dialogue among all stakeholders to help ensure consistent and fair treatment and recovery for all injured and ill workers.
• The MDA is based on actual normative case data gathered from more than 5 million case records.
• It is the world’s most widely used information resource for disability
Reed Group. Ltd.© 2007
Key benefits of the Medical Disability Advisor
(MDA)
Key Benefits:
1. Gives you rapid, flexible, and easy access to a huge body of relevant information so you can quickly find the information you need.
2. Helps you quickly explore subjects of interest and develop and refine inquiries through cross-linkages in the data.
3. Lets you copy, paste, print, and even email pertinent portions of the authoritative topic materials to other stakeholders.
4. Keeps you abreast of what the Claims Manager knows
Reed Group. Ltd.© 2007
Making the MDA work for your business
“Enabling case managers to benchmark organisational rehabilitation performance
through use of an evidence-based tool”
Reed Group. Ltd.© 2007
Organisational PerformanceBenchmarking
• The Medical Disability Advisor provides evidence based disability duration guidelines that assist in
setting RTW expectations.
• Case managers drive organisational performance by benchmarking days lost against industry standards.
• The MDA benchmarks provider performance in over
1300 individual conditions.
Reed Group. Ltd.© 2007
MDA Duration Guidelines allow users to:
• Impart a non-biased, medically objective approach with each case
• Provide consistency across departments and throughout the company
• Save time and maximize individual contacts with employees and physicians
• Enhance areas of expertise with comprehensive clinical and non-clinical information
• Positively impact employee relations and communications during a disability period
Reed Group. Ltd.© 2007
Time saving from Claims Managers using the MDA
rather than using Internet searches and library
research
An example of one company’s savings:Current number of Claims Managers
Minutes saved per day
Labour hours saved per year
Average hourly rate per employee
Potential direct savings
19 10 791 $25 $19,791
Reed Group. Ltd.© 2007
Results from using the MDA in every case
Accident Compensation Corporation of New Zealand decreased days lost from work by 40% over 5 yrs using the MDA
The Nova Scotia Workers Compensation Board of Canada decreased days lost by 50% over a 9 month period by requiring both Claims Managers and Certifying Doctors to incorporate MDA data in their Injury Management plans.
Reed Group. Ltd.© 2007
The Three Areas covered in Topic Sections:
1. Orientation sections provide the most basic information about a condition or procedure to put it in context, and include:
* Related Terms * Illustration* Definition * Medical Codes* Reasons for Procedure * Cited / General
References* How Procedure is Performed
2. Medical sections provide guidelines to evaluate appropriateness of medical and rehabilitation care, and include:
* Diagnosis * Specialists* Treatment * Rehabilitation* Differential Diagnosis * Co-morbid Conditions* Prognosis * Complications
3. Recovery and disability sections provide guidelines to evaluate the appropriateness of length of disability, and include:
* Factors Influencing Duration * Return to Work* Length of Disability / Duration Tables * Failure to Recover
* Reference Data Trends
Reed Group. Ltd.© 2007
Disability Management
1. Understanding the Duration Tables:
There are three categories of duration tables, i.e., Minimum, Optimum and Maximum.
Definitions and interpretation of the three duration tables.
Classification of Work (sedentary, light, medium, heavy and very heavy).
2. Understanding Duration Trends:
Mean: The average disability duration – the sum of all durations divided by the number of cases.
Median: The time at which 50% of cases have returned to work
Reed Group. Ltd.© 2007
Summary• The MDA is the leading return to work guide
• Usage of the MDA is capable of markedly reducing costs by:
Reducing work days lost through disability
Streamlining Claims Management
• The MDA facilitates early RTW
• Early RTW facilitates healing
• By facilitating SAW / RTW using the MDA, Claims Managers drive business profitability
Reed Group. Ltd.© 2007
Contacts• RGAP - Sydney – John Harrison
• Tel: 0429 007 059• [email protected]
• RGAP - Melbourne – John Jenner• Tel: 0421 227 391• [email protected]
• The Reed Group Limited• Reed Group
10155 Westmoor Drive, Suite 210Westminster, CO 80021 USA
• www.rgl.net