With the 4^th of July approaching we take a moment to honor our country and celebrate our independence as a nation. However, we can’t help thinking about how the concept of independence applies to our industry—specifically the role of independent case managers.

Like most, if not all companies in our industry, from time to time we employ independent case managers (in fact some companies employ nothing but independents) when we don’t have coverage in a specific region. Typically this happens when a client asks us to expand our services outside of areas where we employ full-time ICM case managers. While not ideal, we work with independents who have a proven track record delivering solid service.

However, we’re seeing a trend by clients who want their needs managed by employees of case management firms versus independents subcontracted by those companies. The reason—they are looking for more control and accountability. We couldn’t agree with them more.

As a company, we are committed to dedicating the appropriate level of care that each individual case requires versus focusing on billable hours. Our case managers are measured against this metric because it helps us close cases faster and return a healthy, productive worker back to the job as soon as possible. We’ve found that this practice results in a lower cost to the employer and an employee who feels connected to the company throughout the recovery process.

As much as we communicate this philosophy to the independent, it is far more challenging to get them to consistently practice what we preach. Let’s face it—an independent’s livelihood is based on how many hours she or he can bill. And while their skills and experience can be on par with our full-time case managers, they may not manage cases as effectively or as efficiently as our full-timers.

So how do we bridge the gap between delivering accountability and more control in regions where we do not have full-time coverage?

We do it in conjunction with our clients.

Recently several of our clients have provided us in advance the estimated number of cases they need managed in a specific area so that we can hire a full-time case manager there. We then train them to manage according to our practices which results in more control and accountability. We call that a win.

This July 4^th we’ll celebrate Independence Day, truly our most significant event as a country—a significant moment in our history—one that has spurred this nation on to bigger and better things. At the same time, we’ll take pause and wonder about the independents in our industry. Is it time to move on from a business model that includes independents as our industry continues to evolve for the good of the injured worker, the employer and everyone associated with the recovery process? We think the answer is self-evident. In our business model, all case managers are indeed not created equal.

There are certain professions that attract special people—those individuals who strive to make a difference in other people’s lives. In our business we believe that the true difference makers are our case managers. We’d like to take the opportunity to use this platform to recognize them for the work that they do.

The last 11 quarters have been very good to us—we’ve increased revenue every quarter for almost three years. While there are many people to thank, our most important assets are the people on the front lines every day, caring for the injured workers and helping our clients keep their costs down and their productivity up.

We know that the role of case manager comes with inherent challenges. At the same time, the job can be very rewarding. We asked a few of our case managers to share some of their insights and most memorable stories.

The Rewards

Rewards can come in all shapes and sizes. A simple thank you for a job well done goes a long way. Actually changing someone’s life is a nice reward like the experience one of our case managers had with a Spanish-speaking amputee who developed a neuroma on his stump after he had returned to work. He had been frustrated with his physician, didn’t understand his options and his depression caused by the situation adversely impacted him at work and at home. After the case manager explained that the workers’ comp process gave him the opportunity to choose another physician, his outlook changed dramatically once he switched doctors. He became a completely different man, re-engaged with his fellow employees and had a much brighter outlook on his prospects. The case manager had gained his trust which made the recovery process much smoother for everyone. Talk about a turnaround!

By its very nature, workers’ comp can sometimes carry a negative stigma. The injured worker might wonder if the employer has his or her best interests in mind while the employer may question the seriousness of the injury and the associated costs. There is no better outcome than when the injury actually builds a stronger bond between the employee and the employer because the case is handled so well from both ends of the spectrum.

Then there are the special experiences that stay with case managers forever. One case involved a person who lost his leg in a job accident. The adjuster had been extremely unresponsive and when he did respond, always said “no” regardless of the request. Naturally, the family was suspicious of anyone associated with the case—including the case manager. However, throughout the recovery process the case manager assisted the injured worker with everything—from obtaining his prostheses to customizing his vehicle to taking his daughter’s calls on weekends, holidays and evenings due to the complications associated with his injury and subsequent comorbidities.

Eventually the man passed away and a few months later the daughters asked to meet with the case manager. It was during that get together that she truly understood the impact she had had on the man and his family.

When she arrived, she was presented with a bird house that the man had crafted while recovering at home. It was such a personal gift that the case manager made an exception to her rule of never accepting gifts from claimants. Today, the bird house sits in her yard as a reminder that when she gets challenging cases like this she knows that this is the work she was meant to do and that she truly can make a difference in people’s lives.

These are just a few of the experiences and insights shared by ICM case managers. If you are a case manager and would like to share your story, please submit it to Jamie Slotten at jslotten@integratedcare.com and we’ll feature it on a future post.