While the medical care an injured worker receives immediately following a workplace accident can make all the difference, it’s important to remember that much of the recuperation process occurs in the home. Providing injured workers with clinically appropriate medical supplies and equipment to support their safety, healing and quality of life at home can be just as essential to promoting recovery. As many employers look for ways to improve employees’ claim experience and to control workers’ compensation costs, the effective management of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) offers a prime opportunity to simultaneously achieve both objectives.
Effective DMEPOS management matters
Employers are responsible for providing injured workers with the care they need to become whole again (or, at least, to achieve maximum medical recovery) — and that includes the related equipment and supplies. There are several reasons why DMEPOS should be part of a successful workers’ compensation program:
- Promptly and efficiently providing injured workers with the right medical equipment and supplies improves the likelihood they’ll follow doctors’ orders. Consider an individual who is in pain or struggling to adapt to their post-injury reality; what are the chances they’ll have the strength or make the effort to procure medical supplies? They shouldn’t have to. Having those needs met without having to think about it alleviates one impediment from an already challenging process. Delays in securing DMEPOS can prolong recovery, and an extended claim duration is bad for the employer’s bottom line and the injured worker’s well-being.
- Oversight of DMEPOS is critical to controlling costs. For instance, most equipment and supplies can be purchased wholesale rather than at retail prices, and many items are available in generic versions that are lower-cost and just as clinically effective as the name brands.
- Without the right equipment, injured workers may be at-risk of incurring additional injuries. For example: Mobility supports like crutches and walkers can prevent falls, and use of an appropriate prosthetic device reduces the amount of stress on an amputee’s other body parts.
- Smooth coordination of DMEPOS demonstrates employers’ commitment to holistic caring for their injured workers. At a time when many aspects of the employee’s life have gotten more difficult, getting the medical equipment and supplies they need should be easy and hassle-free. It’s an important part of the overall claim experience.
Benefits of having the right partner
Many employers partner with an ancillary care provider to help them manage their DMEPOS programs. The current post-COVID period of inflation — which has driven up the prices of materials like rubber, plastic and metal — has given rise to additional vendor partnerships as companies seek new opportunities to curb costs.
Ancillary care providers can offer employers a wealth of expertise in the types of equipment and supplies on the market and how to get the right items for the best price. They can help their customers control DMEPOS-related claim expenses by applying a variety of tactics, such as:
- Pre-negotiating rates with the lowest-price wholesale suppliers of high-quality products.
- Identifying equally effective generic alternatives to prescribed name-brand products and working with prescribers to secure approval for the lower-cost versions.
- Exploring whether purchasing a device may be cheaper for the employer than covering an extended month-to-month rental.
- Conducting retrospective reviews of DMEPOS billing to reprice out-of-network purchases and direct recurring orders to network providers. This practice can help employers enjoy savings of as much as 15% below state fee schedules and usual and customary reimbursement rates.
- Reaching out to injured workers to validate their ongoing need for supplies and implementing other system-driven controls to limit fraud, waste and abuse.
- Bundling devices with supplies and support services at all-inclusive pricing, eliminating the need for additional approvals and claim reserves. As an example, Sedgwick’s ancillary care network offers an audiology programthat enables workers with occupational hearing loss to receive audiology testing, as well as hearing aids and their batteries, filters and domes, and any provider support they may need, for one flat price. These comprehensive bundles can save employers as much as $675 per claim over five years.
The right partner can bring talent, scale, resources and innovation to employer programs — helping them to systemically reduce costs, improve operational efficiencies, ensure compliance, and provide employees with clinical and logistical support.
Showing injured workers how caring counts
At the heart of all workers’ compensation managed care programs is supporting the needs of injured employees during a vulnerable and challenging time. Everyone who is a part of our DMEPOS ancillary care program — from the leadership and medical network liaisons to the customer service agents and care coordinators — is committed to providing our clients’ injured employees with top-quality equipment and supplies and a seamless user experience.
Nearly 60% of our DMEPOS volume is drop-shipped directly from our wholesale vendors to injured workers’ homes (or wherever they are choosing to recover). We take great pride in acknowledging all drop-ship requests within hours, processing orders the same day, and having products delivered within two days. When it comes to equipment, we always look for the best options that require only toolless assembly and can quickly and easily be put to proper use. Our job as the DMEPOS provider is to take care of things in the background, so injured workers can focus on taking care of themselves and their families.
Recently, we received a letter from the widow of an injured worker for whom we provided DMEPOS. She shared how much it meant to their family that her husband’s medical supplies arrived at their doorstep each month without them having to give it any thought. The touching letter was a poignant reminder of how much the work we do each day matters to the people on the receiving end. DMEPOS is about so much more than medical equipment and supplies; it’s about improving people’s quality of life and helping employers take good care of their valued employees.
> Learn more — read about Sedgwick’s best-in-class ancillary care solutions, including the effective management of DMEPOS, for workers’ compensation programs