Jerry E. Strohkorb, MD and Nancy Welch, MD MHA MBA. Occupational Health Services, Chesapeake Health Department, 748 N. Battlefield Blvd, Chesapeake, VA 23320, 757-382-8637, Jerry.Strohkorb@vdh.virginia.gov

As a result of increasing workers' compensation expenditures utilizing traditional case management, the City of Chesapeake municipality implemented a holistic public health approach to solve the problem of rising costs. The strategies implemented to produce these results included public health strategies, community provider involvement, and expanded case management.

Public Health Strategies included: (1)City physician interactions with employees which fostered advocacy, and emphasized the emotional and medical value of returning to work as soon as possible, (2)Administrative Regulations endorsing and requiring interdepartmental sharing of information, (3)Monthly data report of injuries and costs to the public safety departments and city management, and (4)Monthly educational information relevant to appropriate risks to prevent injury

Community Provider Involvement included: (1)Community Provider Advisory Committee (most are workers' comp city panel providers) developed and implemented standards of care for common injuries, (2)Committee reviewed and made recommendations on difficult cases outside of the acceptable standards.

Expanded Case Management included: (1)Nurses provided the first line of case management. The city physician corresponded directly with employees and providers with cases greater than 7 days duration, and (2)The city physician verbally conferred with the care provider if time off-duty exceeded acceptable community standards.

RESULTS: The additional cost to the City of Chesapeake to implement this progressive strategy was $147,406. Costs saved in the first four months fully paid for the advanced program. Twelve months analyses project that municipality workers' compensation costs will be: (1)53% lower than the projected costs of the previous fiscal year, and (2)The average annual cost rate (cost/employee) should be 44% lower (decreased from $816.84/employee to $416.28/employee).

Learning Objectives:

• Apply public health methodologies to solve municipal concerns.
• Apply these strategies to control municipal workers' comp costs.
• Understand the concept of expanded case management
• Apply these strategies to develop new methods for reducing workers' comp costs

Keywords: Workers' Compensation, Case Management

Presenting author's disclosure statement:
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.