VISIONSVolume 21, Number 3

November/December 2010

The Periodical of the

National Association

o f O c c u p a t i o n a l

Health Professionals

“I keep the subject of

my inquiry constantly

before me, and wait

till the first dawning

opens gradually, by

little and little, into a

full and clear light.”—Sir Isaac Newton,

1642-1727

By Karen O’Hara

The Year of the Rabbitbegins Feb. 3, 2011.

According to the Chinesezodiac, the rabbit year isexpected to usher in a periodof relative calm following thetumultuous Year of the Tiger.

The placid rabbit symbol-izes luck and negotiationskills, which are both usefulin business. On the otherhand, the rabbit can be pro-tective and insular, suggestingchallenges in the quest fororganizational change.

In the event that astrologydoes not provide sufficient

insight for occupationalhealth professionals as theyprepare for the New Year,VISIONS asked some industryexperts for their own forecastsand, interestingly, got a simi-lar yin-yang response.

AbundantOpportunities

Peter Rousmaniere, anationally known workers’compensation industry consultant and journalist, says he is “not fatalistic”about the future of occupa-tional medicine – whether itis practiced within a largerhealth care organization or ina standalone facility.

“Occupational medicine

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2011 Shaping Up as Promising Year;Experts Predict It Will be a Mixed Bag

INSIDE

2 NAOHP News

3 Member Mentions

10 Trendsetters

Workers’ CompensationGains Momentum

11 In the Numbers

12 OutcomesHealth Management Data Research

14 Legal AdvisoryJob Discrimination

15 Recommended Resourcess

16 RegulatoryAgenda

19 Calendar

20 Vendor Program

24 Job Bank

Humana Acquires Concentrain Diversification Move

By Karen O’Hara

Humana Inc. has agreed to acquire privately held

Concentra, a leading nationalclinic network, for $790 mil-lion in a cash transaction thatwas expected to close inDecember pending regulatoryapproval.

Concentra provides occupa-tional medicine, urgent care,rehabilitation and wellnessservices through more than300 centers in 42 states and240 onsite clinics. The com-pany, with headquarters inAddison, Texas, reportsapproximately $800 million inannual revenue.

Concentra CEO Jim Greenwood

To: NAOHP MembersRe: Annual Board MeetingFrom: Karen O’Hara

The NAOHP Board held its annuallive meeting Oct. 13, 2010, in conjunc-tion with RYAN Associates’ 24thannual national conference in Boston.

All Board members attended themeeting, with the exception of RickRankin, who recently resigned from theBoard because of a career change. At-Large Member Denia Lash participatedby phone. Others in attendanceincluded Executive Director FrankLeone, staff members Karen O’Hara andRachel Stengel, and RYAN Associates’Senior Principals Roy Gerber andDonna Lee Gardner.

Opening CommentsBoard President Jewels Merckling and

Mr. Leone thanked Board members fortheir participation at the conferenceand for their continued commitmentand support.

National Conference 2010 Debriefing

It was agreed the conference was wellorchestrated and that participantsseemed engaged in learning and net-working. Ms. Merckling reported theBoard’s involvement as faculty and indiscussion sessions was an effective wayto exchange information. She said theopen membership breakfast meetingwith the Board was particularly helpfulin providing strategic direction.

For the first time, the conference fea-tured two weekend pre-conference ses-sions sponsored in conjunction with theAmerican College of Occupational andEnvironmental Medicine (ACOEM).Ms. Stengel noted positive attendancefor a two-day Medical Review Officer(MRO) course.

Board Member Dr. Steven Crawfordreminded the Board that it had discussed

a gradual phase-in of cooperation withACOEM, and that the pre-conferencecourses were the first step in that process.

National Conference 2011 Planning

Ms. O’Hara said there appears to be agrowing demand for metrics and sug-gested that next year’s conference cur-riculum highlight performance measure-ment and benchmarking.

Ms. Gardner and Dr. Crawford sug-gested developing an educational trackfor physicians that would effectively inte-grate clinical topics with occupationalhealth business management concepts,using ACOEM members as faculty.

Ms. O’Hara mentioned using theAtlanta-based Centers for DiseaseControl and Prevention (CDC), as afaculty source for next year’s conference,which will be held in Atlanta.

Board Member Leonard Bevill saidthere is a demand for a billing, codingand documentation course. Mr. Bevillalso offered to reach out to his contactsat the Occupational Safety and HealthAdministration and the Department of Transportation in Georgia to serve as faculty.

Board and staff members supportedthe concept of offering a full-day pre-conference coding-related course with

2

Outreach, Benchmarking on Board Agenda

Executive EditorFrank H. Leone

Editor in ChiefKaren O’Hara

Graphic DesignErin Strother • Studio E Design

PrintingOjai Printing

VISIONS is published bi-monthly by the National Association of

Occupational Health Professionals,226 East Canon Perdido, Suite M

Santa Barbara, CA 93101(800) 666-7926 • Fax: (805) 512-9534

Email: info@naohp.com • www.naohp.com

NAOHP and RYAN Associates are divisions of Santa Barbara Health Care, Inc. © pending VISIONS may not be copied in whole or in

part without written permission from NAOHP.

Volume 21, Number 3Nov/Dec 2010

continued on page 9

Members of the NAOHP Board and RYAN Associates' staff members applaud Rachel Stengel (in hat) forher contributions. Ms. Stengel recently resigned from her position coordinating NAOHP-related activitiesto move to northern California.

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Stacey Hart is the newDirector of Operations forRYAN Associates/NAOHP in Santa Barbara,CA. Ms. Hart is responsi-ble for office and associa-tion functions includingconsulting coordination,event planning andNAOHP member activi-ties. She has experience in office and event management as the Lead

Academic Event Coordinator for Fielding GraduateUniversity. Ms. Hart earned her BA degree from theUniversity of California, Santa Barbara and her MA degreein Organization Management and Development at Fielding.She can be reached at 800-666-7926, ext. 12 or by email:shart@naohp.com.

u u uElection results are in and the NAOHP Board will have

two new members starting Jan. 1, 2011: John Braddock,

M.D., and Troy Overholt, RN, COHN-S. Tom Brink, pres-ident and CEO of Methodist Occupational Health Centers,Indianapolis, an incumbent representing the MidwestRegion, was re-elected.

Dr. Braddock, CEO and Medical Director of CascadeOccupational Medicine, Oswego, OR, will represent theWest Region. He replaces Rick Rankin, who resigned fromthe Board when he made a career change. Dr. Braddock hasmore than 20 years of experience in occupational medicineand 30 years of experience in emergency medicine.

Mr. Overholt is the new at-large member, replacing DeniaLash, whose non-renewable term is expiring. Mr. Overholt isDirector of Work Well Solutions, the Occupational andEmployee Health Branch of St. Luke's Hospital, CedarRapids, Iowa. His experience includes departmental andregional management and onsite medical services in severalstates. He has degrees in health services and in management.

Board members serve as advisers to the NAOHP in a voluntary capacity.

u u uJoanne Beyer, Executive Director, Corporate Relations

and Marketing for Physicians Immediate Care, Loves Park,IL, was selected by her peers as Most Valuable Participant at RYAN Associates’ sales training program in December. Ms. Beyer has more than 25 years of medical and insuranceexperience. Using a creative, client-focused approach tomarketing, she has been instrumental in helping establishPhysicians Immediate Care as a national leader in urgent care.

NAOHP Certificate of Competency Recipients

Congratulations to the following individuals whorecently passed the NAOHP’s examination to obtain a Certificate of Competency in Occupational HealthPractice Management:

Gary Barlow, Western Medical Group, Torrance, CA

Kristina Gambitta, Cayuga Medical Center/CortlandImmediate Care, Ithaca, NY

Mitch Goddard, JobCare, Selma, CA

Jared Hill, Asante Work Health, Medford, OR

Dawn Jackson, Bayhealth Occupational Health, Dover, DE

Kim Lehman, Bayhealth Occupational Health, Dover, DE

Loren Rufino, Inova Occupational Health, Fairfax, VA

Jennifer Sutter, Bayhealth Occupational Health, Dover, DE

Joe Trannel, Tri-State Occupational Health, Dubuque, IA

Agility EHR 10 ARRA CertifiedIntegritas, Inc., a member of the NAOHP Vendor Program,announced that its Agility EHR 10 is ONC-ATCB 2011/2012compliant and was certified as a Complete EHR on Dec. 1 bythe Certification Commission for Health InformationTechnology (CCHIT®), an ONC-ATCB, in accordance withcriteria adopted by the Secretary of Health and HumanServices. The 2011/2012 criteria support Stage 1 meaningfuluse measures required to qualify eligible providers and hospitalsfor funding under the American Recovery and ReinvestmentAct (ARRA).

“We promised our clients and prospective clients that wewould achieve ARRA certification in 2010, and we are proudto have kept that promise,” said Ed Stroupe, vice president.“Agility EHR 10 is now both CCHIT 2011 CertifiedAmbulatory EHR and ONC-ATCB 2011/2012 certified. Webelieve this dual certification has been accomplished by veryfew Complete EHR vendors in the urgent care/occupationalmedicine specialties, and we are proud to be among those few.”

In related news, NAOHP Board President Jewels Merckling

has been named Vice President of Enterprise Sales forIntegritas, Inc. Her new responsibilities include national salesfor employee health departments. Prior to joining Integritas,Inc., Ms. Merckling was Vice President of ProviderDevelopment for StoneRiver P2P Link. She has 15 years ofexperience in health care, including seven years managingoccupational medicine facilities. Ms. Merckling’s addition to the Integritas team will capitalize on her tenure in theindustry, company officers said. See page 24 for her new contact information.

practitioners have a great opportunityfor better recognition in the payer community,” he said.

For example, he cited occupationalmedicine physicians’ ability to detectdelayed recovery risk (which is largelypsycho-social in nature) and make refer-rals to specialists who get consistentlypositive results – “at least from an anec-dotal perspective” – as two importantattributes.

Conversely, he noted, these attributesare difficult to quantify, and there is adearth of benchmarks for out-come reporting in occupationalmedicine clinics.

“Another part of the problemis that the payer community israther fitful about what it wantsand how much it will use withregard to outcome reports,” Mr.Rousmaniere said.

The first step for providers is totalk with payers to address anyperceived communication prob-lems. “The occupational medi-cine clinic needs to be able toidentify and close any gaps incommunication by sitting downwith the claims administratorsand nurse case managers to dis-cuss the situation,” he said.

Looking ahead, Mr.Rousmaniere expects managedcare networks to place moreemphasis on provider quality andless emphasis on provider quantity

in response to outcome-drivenexpectations. He said the con-cept of quality care might beapproached in three ways thatare not mutually exclusive:1. Attempt to increase perform-

ance, e.g., lower medical costsand improve return-to-work

success rates for the “average”provider in a network.

2. Focus much more proactively on the5-10 percent of network providerswhose performance is rated “sub par.”

3. Identify top providers and expertmedical advisers who can work withother less-effective providers on per-formance issues.

Mr. Rousmaniere believes chronicpain management also will be a criticalissue for employers and payers in 2011and beyond.

“Chronic pain is associated withabout 50 percent of workers’ compensa-tion losses and involves a relativelysmall number of cases,” he said.

Expect ScorecardsOne of the positive impacts of

national health care reform (assumingthat aspect of the legislation is notrepealed) for occupational health programs will be widespread adoption of provider scorecards, says MaddyBowling, a seasoned workers’ compensa-tion industry consultant with her own

firm, Maddy Bowling and AssociatesConsulting, Inc.

Affirming Mr. Rousmaniere’s observa-tions, she advises occupational healthprofessionals to follow two complemen-tary trends:• The market is starting to move away

from large preferred provider organ-izations (PPOs) and toward moreselective outcome-based networks inworkers’ compensation.

• Physicians, in general, will start toget used to profiling and scorecards,and occupational medicine providerswho demonstrate positive resultswill see benefits in terms of relaxedutilization review requirements andpossibly performance bonuses.

“We are seeing a push from ourclients in support of outcome-based net-works and making sure employers gettheir injured employees to the best doc-tors from the start,” Ms. Bowling said.“Payers, especially third party adminis-trators (TPAs) are saying, ‘There reallyare outstanding physicians in this area,they know what they are doing and youcan tell by their results.’ With appropri-

ate data analysis, youwould be surprised howquickly you can figure that out.”

Ms. Bowling has consid-erable experience withintegrating workers’ com-pensation data to facilitateprovider comparisons. Keyfactors include claim andjurisdictional details,employer and providerdemographics, medicaltreatment and return-to-work history. She citedcost, disability duration,medical-only, lost worktime and prescription pat-terns as commonly usedmetrics in workers’ com-pensation, but noted thather clients prefer to cus-tomize their approach.

Ms. Bowling said themetrics trend also is signif-icant given that the indus-try has had an “addictionto PPOs,” which aredriven by volumes and dol-lars rather than relation-ships with physicians andtheir performance.

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Who knows what the future may hold in medicine and in life?

VISIONS

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In addition, she noted that PPOs areno longer as competitive as they oncewere because consolidation has createda situation in which Coventry HealthCare dominates. (Coventry reports itserves more than 5 million memberswith group and individual health insur-ance, Medicare and Medicaid programs,and coverage for specialty services suchas workers’ compensation.)

“After all these years in the industry, Iam thrilled there appear to be employersand payers who are finally focused onoutcomes-driven networks,” she said.

Metrics in Our Future

While remaining cautious, KarenWolfe, president and CEO ofMedMetrics® and former software devel-oper, said she is optimistic about indus-try observer forecasts of business inno-vation, astute use of technology and jobgrowth for the coming year.

MedMetrics supports best practices inworkers’ compensation claims and med-ical case management by insurers, self-insured employers, TPAs and managedcare organizations with a web-based system that tracks utilization and costs,flags at-risk cases and outliers in need of intervention. Analytical tools areused to support provider and outcomecomparisons.

MedMetrics’ ramp-up has been evenmore a labor of love than Ms. Wolfeanticipated when the company was firstlaunched six years ago: Educatingprospective users about the value of datamining in the relatively traditionalworkers’ compensation world has provedto be a significant undertaking.

“There is a gap between issues peopleface on the front line and the perspec-tive of the powers that be within anorganization,” she said. “I get so frus-

trated when people don’t effectively usethe tools and resources they have attheir disposal. My goal is to get theindustry to learn how to leverage datain a practical way - not an esotericway – and give it real meaning at theoperational level.

“(The industry) needs to make theeffort to streamline and standardizeprocesses to quantitatively value med-ical case management and improve out-comes. It sounds simple; it is simple. Butpeople don’t do it because it is differentfrom what they are accustomed todoing. It takes a long time to makechanges in this industry. But once peo-ple make the change, they are amazedwith the results.”

Now, with the light bulb clicking on,MedMetrics’ adopters seem to be partic-ularly interested in provider perform-ance analysis.

“The interest is coming from networkproviders looking at their ownproviders’ performance and from payersinterested in outcomes,” she said.“Network managers are being forced tolook at different reimbursement struc-tures and pay based on performance, notjust on volume of services provided.

“This is good news for occupationalhealth providers, who typically showbetter in comparison to other, non-occupational providers.”

Moving forward, Ms. Wolfe antici-pates the development of analytics toaccommodate a deeper dive into ratingsbased on injury severity and other indi-cators that affect outcomes.

Focus on PhysicianEducation

In the context of national health carereform, 2011 will be a year devoted todeveloping the role of prevention andhelping clinicians understand how theycan contribute to the integration ofhealth, safety and productivity manage-ment in the workplace, predicts NatalieHartenbaum, M.D., a consulting occupational medicine physician andpresident of the American College ofOccupational and EnvironmentalMedicine (ACOEM) Board of Directors.

Dr. Hartenbaum has established sev-eral ACOEM task forces to help raiseawareness of occupational medicine as apreventive specialty. Initiatives includeenhanced education and training for

practicing physicians, cultivating con-tacts with medical students and devel-oping fatigue risk management inter-ventions for employers.

“Our role in the workplace is atremendous asset,” she said. “Our goal isto provide the tools physicians need toleverage their knowledge and contactsso they can take full advantage of thatopportunity.”

Among noteworthy trends in thecoming year, Dr. Hartenbaum advisesoccupational health professionals to beon the lookout for:• State workers’ compensation

regulatory reform and endorsementof medical practice guidelines as part of efforts to promote evidence-based practice, includingdetailed assessments by qualifiedprofessionals.

• Collaboration among organizationsto develop high-value products andphysician services in workers’ compensation.

• An emphasis on physician trainingand credentialing in response tochanges in Accreditation Council forGraduate Medical Education andAmerican Board of PreventiveMedicine requirements for complet-ing preventive medicine residencies,pursuing complementary pathwaysand obtaining board certification.

• Medical Review Officer activity inresponse to more restrictive federalregulations governing laboratorytesting procedures.

“At the end of my term, I hope peo-ple will feel we got a lot accomplished,”she said.

Urgent Care InterfaceOccupational medicine will continue

to be “a great service line” for urgentcare clinics in 2011, but clinic operators

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need to carefully consider the kindsof services they are capable of provid-ing before expanding, advises DonDillahunty, D.O., chief executiveofficer/president of PrimaCareMedical Centers, Dallas, Texas, andpresident of the Urgent CareAssociation of America (UCAOA)Board of Directors. Established in1979, PrimaCare is one of the largestgroups of ambulatory medical centersin the Dallas metro area.

Dr. Dillahunty advises clinic opera-tors and clinicians to focus on thefundamentals: quality care, accessibil-

ity (hours and location), affordability and customer service. With respectto expansion opportunities, he sees potential for the development ofchronic disease management and prevention programs for at-riskpatients in acute care and even retail clinic settings. He also recom-mends cross-selling to walk-in patients. For example, a worker who has apositive experience with injury care on the occupational health side islikely to come back for personal care.

Whatever the clinic or medical office setting, he anticipates increaseddemand for experienced mid-level practitioners in urgent care and occu-pational medicine facilities.

Nationally, Dr. Dillahunty is following Accountable CareOrganization (ACO) pilot projects with interest. While it is too early topredict the results, he describes a possible scenario as one in whichmega-ACOs become quasi-public monopolies in major markets. (AnACO is a model for managing the continuum of care across institutionalsettings. The Patient Protection and Affordable Care Act encouragesthe development of ACOs on a voluntary basis, and a number of healthsystems are involved in ACO pilot projects.)

“The ACO consolidates providers within a system, which reducescompetition,” he said.

Appealing to EmployersHeartland Health in St. Joseph,

MO, is an example of a progressivehealth system engaged in developingan ACO model. Heartland has cre-ated an entity, Community HealthImprovement Solutions, to workclosely with partners such as Aetna,one of the nation’s leaders in healthand disability insurance, and its ownHeartland Corporate HealthServices/Occupational Medicine(HOM) program to address the needsof target populations.

Heading into 2011, the organiza-tion’s overriding objective is to lever-

age the ACO model to “capture the population in our service area,”improve community health, reduce employers’ costs and maintain a rea-sonable margin system-wide, said David Cathcart, D.O., CorporateHealth Services/HOM medical director. As envisioned, self-insuredemployers would have the option of selecting a globally priced packageof services designed to improve workforce health and productivity andreduce work-related injury, illness and disability.

HospitalExecutivesIdentify 10Trends for 2011

1. Lower reimbursements. In additionto lower Medicare reimbursementsin the fiscal year starting Oct. 1,Congress is considering recommen-dations from the NationalCommission on Fiscal Responsibilityand Reform and more cuts for hospitals.

2. Hospitals can expect lower revenuesand increased administrative costsin 2011 as Medicare recovery auditcontractors gather momentum.

3. More uncompensated care. Thenumber of uninsured patients continues to rise. An estimated 59.1million Americans were uninsuredat some point in the 12 monthsending April 1, 2010 – 9 millionmore than were estimated in a previous Census Bureau study.

4. Anticipated gridlock on Capitol Hill.

5. Uncertain fate of health carereform. Hospitals face the possibilitythat some parts of the reform lawmay be discarded.

6. Anticipated Accountable CareOrganization (ACO) rules may spurmajor changes if hospitals respondfavorably to the regulations.

7. Experimentation will be spurred bythe Center for Medicare andMedicaid Innovation and funding totest aspects of ACOs and othermodels designed to reduce costsand improve quality.

8. States will further cut Medicaidspending.

9. Information technology require-ments will require major investments.

10. More hospital consolidation isexpected in response to ACO-type models and declining reimbursement.

Source: Becker’s Hospital Review, Nov. 22, 2010: www.beckershospitalreview.com/

hospital-financial-and-business-news

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VISIONS

“We believe that capturing our ownpopulation is the only way for anAccountable Care Organization to besuccessful within the context of commu-nity health,” he said. “Right now every-one is trying to figure out how they fitwithin the ACO.

“Our major clients understand thelong-term benefits of disease manage-ment and wellness,” he said. “The insur-ance companies also understandit…Aetna is promoting preventionthrough Heartland so employers get thewellness connections piece.”

One of the barriers to success withthe ACO approach is free will, orpatient choice. If a patient opts out ofone system to try another, “we can’toffer them the kind of savings or qualitywe think would exist when workingwithin one system with an ACOmodel,” Dr. Cathcart said.

Decisions emanating from theCenters of Medicare and MedicaidServices will be key drivers in theprocess, Dr. Cathcart said. For example,if Medicare introduces a reimbursementformula allocating a lump-sum paymentfor taking care of a large population ofpeople, it will be incumbent on healthsystems to develop similar formulae forthe delivery of services to smaller targetpopulations, such as the workforce.

Despite the magnitude of the under-taking, Dr. Cathcart remains passionateabout the possibilities.

“It is really hard to make an impactone patient at a time,” he said.“Occupational medicine is a preventivespecialty. If I leave a legacy, it will beimpacting a large population for thebetter in terms of their health whilereining in costs.

“Occupational medicine

is a preventive specialty.

If I leave a legacy, it will

be impacting a large

population for the better

in terms of their health

while reining in costs.”

“There is not any single group ofphysicians in a better position than weare to pull that off, because occupa-tional medicine physicians have the

ability to impact large populations ofpeople using well-designed contracts and programs.”

Primary Care Impetus

Jewels Merckling, NAOHP Boardpresident, advises occupational healthcolleagues to keep an eye on activity onthe group health side of the equation.Ms. Merckling has a somewhat uniqueperspective, having recently accepted aposition as vice president of enterprisesales for software developer Integritas,Inc., after serving as vice president ofprovider development for StoneriverP2P Link (both companies are membersof the NAOHP Vendor Program), andas director of a hospital-affiliated occu-pational health program in Missouri.

“We are seeing health care reform-driven activity from group health insur-ers and benefits administrators that arelikely to affect occupational health programs,” she said.

Her advice to occupational healthprofessionals is twofold:1. Carefully evaluate the technology

your program is using and make sureyour vendors are moving in thedirection of data sharing and management.

2. Be proactive with product development.

“You cannot continue to sit on thesame service line,” she said. “You haveto expand your thinking. Talk to yourdoctors. Tap into existing expertise andbuild a service around it. For example,why is pain management so often astandalone practice when it is a logicalextension of occupational health?”

Along with other industry observers,she anticipates the health care delivery

model may evolve into one featuringgreater integration of primary care intoblended urgent care-occupational medi-cine practices. She cited two develop-ments on the horizon as an illustration:Humana’s acquisition of Concentra, thenation’s leading national occupationalmedicine-urgent care clinic network(see related article) and Aetna’s acquisi-tion of Medicity, Inc.

Medicity’s health information plat-form enables the transmission of diag-nostic test results, face sheets and tran-scribed documents from hospitalsdirectly into physicians’ electronichealth records (EHRs) and practicemanagement systems. When the acqui-sition was announced, Aetna’s ChiefFinancial Officer Joseph Zubretsky saidAetna was entering the “new frontier”of information technology to help doc-tors and clients control costs.

The Aetna-Medicity deal follows asimilar move by UnitedHealth GroupInc., the nation’s largest insurer by sales,another sign that insurance companiesare diversifying to cope with the health-care overhaul law.

In August, Ingenix, a UnitedHealthGroup company, reported it agreed toacquire Axolotl Corp., a company spe-cializing in the health informationexchange (HIE) services. The Axolotlmanagement team reports it will helplead Ingenix’s health care communityconnectivity efforts.

Ingenix already has an establishedpresence in workers’ compensation anddisability management. For instance, itsEmployer Services division has morethan 20 years of experience in dataanalysis to support improved manage-ment of health care costs, workforcehealth and productivity. And, its “inte-grated disability business case develop-ment” product reportedly identifies suchkey factors as the nature and cause ofinjuries regardless of the payment type,injury and re-injury rates, and workers’compensation and non-occupationalexperience for similar diagnoses.

Disability and workers’ compensationnorms used by Ingenix are derived fromcustomer experience and informationobtained from the Work Loss DataInstitute’s Official Disability Guidelines.(For more on WLDI data, refer to theOutcomes column on Page 12).

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Concentra announced it would oper-ate as a Humana business unit whileretaining its brand name, leadershipteam, Auto Injury Solutions divisionand headquarters in Texas.

“We are extremely impressed withHumana’s leadership team,” ConcentraCEO Jim Greenwood said in an inter-view. “Of all the organizations weencountered during this process, thecultural fit was the best with Humana.They want to make a difference and arevery innovative.”

Humana, based in Louisville, KY, isone of the nation’s largest publiclytraded health benefits companies. Itoffers a broad range of health, pharmacyand supplemental benefit plans foremployer groups, individuals and gov-ernment programs, including a largeMedicare population. Humana reports ithas more than 10 million medical mem-bers and 7 million specialty members,approximately 3 million of whom livenear a Concentra center.

“They are focused on the Medicarespace in terms of overall membership,but also are big believers in wellness,prevention and urgent care,” Mr.Greenwood said.

Concentra made a major change in itsdelivery model in 2008 when the com-pany added urgent care services to itsoccupational medicine centers. At thetime, W. Tom Fogarty, M.D., chief med-ical officer, said the company wanted toprovide a convenient, lower-cost optionfor personal care and non-emergentcases that often default to busy hospitalemergency departments.

Mr. Greenwood said potential acquisi-tion by a major health benefits organiza-tion such as Humana was not envi-sioned when the delivery model wastransitioned.

“We added urgent care because therewas a real need and there was so muchcapital flowing into that area,” heexplained. “Urgent care is a very frag-mented market. In a lot of ways, itreminds me of how occupational healthwas not all that long ago. The fact thatwe expanded into urgent care clearlyhelped Humana be interested in us.”

Expansion PlansWhile some changes are expected as

the two organizations align processes,the companies offered the assurancethat most clients and patients “should

not experience any disruption in service.” Humana reportedly wants Concentra

to grow occupational health and urgentcare market share in a “prudent man-ner” while further leveraging the expert-ise of its medical and leadership teams.Mr. Greenwood said Humana valuesConcentra’s ability to manage medicalpractices, along with its focus on evidence-based medicine and outcomesmeasurement and its geographic footprint.

Conversely, the pending sale willrelieve Concentra of its equity debt loadand open up access to Humana’s deepresources, which will enable the com-pany to invest more aggressively intechnological infrastructure, strategicexpansion and product line development.

“For example, as leases expire, we areevaluating every single clinic to see ifwe can relocate it, keep the core occu-pational medicine business intact byputting it on a busy street and also growthe urgent care side of the practice,” Mr.Greenwood said. “As a private equitypractice, we had financial constraints.(Humana) will give us an opportunityto accelerate more quickly, becomemore visible in our current markets andfollow up on promising acquisitions,”such as in regions where Humana has astrong presence and Concentra does not.

Mr. Greenwood said it was prematureto discuss specific locations whereConcentra could potentially establishclinics.

With respect to wellness offerings,Concentra is experiencing the mosttraction in companies where it hasworksite-based operations. Mr.Greenwood said he anticipates anincrease in requests for populationhealth and disease management initiatives from employers, brokers and consultants.

Meanwhile, the company will con-tinue to cultivate relationships withlocal specialists and hospitals.“Specialists and family physicians wantto have close relationships with usbecause we are a referral source,” saidMr. Greenwood. He also noted thatHumana’s positive reputation should bean attribute in dealings with localhealth systems.

Eye on DiversificationCompany representatives and analysts

said the acquisition is intended to help

Humana diversify in response tonational health reform and demand foraccess to primary care providers. In gen-eral, health plans improve their profitmargin when patients are effectivelytreated at the primary care level, reduc-ing the need for specialty care and high-end diagnostics.

Revenue diversification will helpHumana reduce its exposure to healthcare overhaul regulations, which com-press insurers’ profits from the sale ofbenefit plans, according to ZacksInvestment Research (www.zacks.com).

A key aspect of Humana’s strategy isto manage medical costs below those ofgovernment-run Medicare. Greaterinvolvement with clinics such as thoserun by Concentra could help it achievethis goal by encouraging members toseek preventive services, analysts said.

MichaelMcCallister,Humana’schairman ofthe boardand chiefexecutiveofficer, saidConcentra’sdeliverymodel fitswell withHumana’s

consumer-driven focus and will allowboth organizations to provide “conve-nient and affordable high-quality health care.”

In a statement, Mr. McCallister said:“We are excited about the opportunityto acquire a strong standalone businessthat reinforces our core businesses whileproviding both revenue diversificationand opportunities for strategic expan-sion long term.”

Prior to announcing the acquisition,Mr. McCallister indicated to analysts atthe company’s investor day thatHumana, which once ran hospitals, maybe interested in returning to the busi-ness of providing care, Business

Insurance reported. The Concentratransaction was expected to add slightlyto Humana’s earnings in 2011.

VISIONS’ request for an interviewwith Mr. McCallister was referred toHumana’s public relations department,which agreed to answer some questionsin writing (see next page).

Concentra, continued from page 1

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VISIONS

Q:What percentage of theapproximately 3 million

Humana members in proximity toConcentra centers do you expect toaccess them in the first year and subsequent years, i.e., what impactis the acquisition expected to haveon patient volumes?

A:We intend to promoteConcentra locations to

Humana members. This will be agradual process.

Q:Do you anticipateHumana/Concentra will be

acquiring additional clinics in keymarkets, and if so, how aggressivedo you expect that growth to be?

A:Concentra has historicallybeen an acquirer of small

occupational medicine practices. Wewill evaluate the pace and characterof future acquisition plans forstrategic fit with Humana.

Q:How does Humana/Concentraplan to compete? What will

be emphasized in terms products,services and marketing messages?

A:Concentra will continue tooperate as it does today.

Humana will work with Concentra’smanagement team (which is stayingwith Concentra) to explore oppor-tunities to leverage each organiza-tion’s strengths.

Q:How do you envision the delivery model evolving in

the next five years?

A:Concentra will continue to bea leader in the occupational

health field.

Q:What impact do you believethe Concentra acquisition will

have on the national trend towardconsolidating occupational healthand urgent care services?

A:Occupational health andurgent care are natural com-

plements. We don’t anticipate thatHumana’s acquisition of Concentrawould change that market dynamic.

Source: Jim Tucker, Humana’s directorof medical and public relations

Q&A WithHumana

Ms. Gardner and Board Member Michelle McGuire serving as faculty. Ms.McGuire reported she is training to become a certified professional coder.

Ms. Merckling said there is interest in education on staff developmentissues. She reported she would like to explore the topic of developing moreeffective clinical-administrative staff relationships in greater depth than time allowed this year.

The Board suggested asking prospective conference participants to ratetheir degree of interest in a number of potential topics. The following proposed topics were included in the 2010 Conference Evaluation: bench-marking, total health management, integrating the clinical perspective with the business of occupational health and transitioning to electronicmedical records.

Program CertificationMs. O’Hara and Ms. Gardner reported several programs that were

awarded NAOHP Quality-Certification nearly three years ago will be up forrenewal in 2011 and asked the Board to establish a re-certification policy.

After considerable discussion, it was agreed that the re-certificationprocess should be conducted remotely via the submission of electronic documentation, except in circumstances requiring a site visit, such as theaddition of a new delivery location. A motion by Mr. Brink to have Ms.Gardner prepare a detailed list of re-certification deliverables was unani-mously passed. Key components will include documentation to demonstratecontinued use of polices, procedures and protocols; chart review; the use ofquality monitors; and benchmarking activities.

Ms. Gardner said some programs need guidance for program improve-ments prior to applying for an NAOHP certification review. It was gener-ally agreed to consider the development of a “certification package” in two phases: obtaining onsite assistance to develop a work plan to help prepare for certification on a specified date and the actual site certification visit.

BenchmarkingMr. Brink noted progress with Press Ganey for the development of

occupational health patient satisfaction surveys and a foundation for benchmarking. The price structure would vary depending on the number of participants. He reported that Press Ganey currently works with 75 to 80 occupational health programs and is open to survey customization. As proposed, participants would receive annual access to an unlimited number of email surveys (or clinic-based kiosks), with all results compiled andreported electronically by Press Ganey. Mr. Leone said any income acquired through an arrangement with Press Ganey would be earmarked for NAOHP activities such as membership recruitment and national benchmarking efforts.

Affiliations and PartnershipsMr. Leone reported continued cultivation of relationships with the

American Association of Occupational Health Nurses and ACOEM,including the possibility of reciprocal exhibits and speaking engagements ateach organization’s conferences. The Board expressed the desire to promotethe NAOHP Vendor Member Program and add to the number of VendorMembers. Mr. Bevill suggested querying members for products and servicesof interest.

ScheduleThe next telephonic Board meeting was tentatively scheduled for

February 2011.

NAOHP news, continued from page 2

10

The workers’ compensation marketappears to be gaining strengthheading into 2011.

More claimants entered the system in2010 following a decline in 2008 and2009, and that trend is expected to con-tinue, according to Don Duford, presi-dent of One Call Medical (OCM).

A national company with a specificniche, OCM specializes in diagnostictest scheduling for workers’ compensa-tion payers including MRI, CT scans,electromyography and nerve-conductionstudies.

“Improved productivity and greaterefficiency in workers’ compensationclaims operations will be priorities forthe coming year,” Mr. Duford predicts.“As claimant numbers increase, we aregoing to see claims administrators tryingto manage a bigger load with fewerresources. We anticipate they are goingto be more dependent on partners tohelp them get workers’ compensationpatients to the best available providersas early as possible.”

In 2009, OCM conducted marketresearch to identify industry challengesfor 2010. In surveys of claims managers,examiners and nurse case managers,

three primary challenges were cited –and they still hold true, Mr. Duford said.They are:

Cost Control: While claim frequency has declined,

there has been a corresponding increasein medical costs, creating an ongoingneed for effective cost-containmentmeasures.

Accountability: Workers’ compensation professionals

report they are under pressure todemonstrate a high level of perform-ance. Clients require audits and detailedstatus reports on claims, provider net-work utilization and early return-to-work outcomes.

Education: Claims administrators and nurse case

mangers must keep abreast of complexissues in the industry, including medicalprocedures and regulatory requirements.

“Management of major medical dol-lars is key,” he said. “We are seeingmore employers and claims managerspeeling back resources. Their challengeis figuring out how to get better claimresults with fewer resources. Our goal isto offer claims professionals services andtools to help them offload and managespecialized functions so they can focuson tasks that directly impact client serv-ice, costs and outcomes.”

For example, OCM offers a servicecalled MD Direct, which streamlinesinteractions when obtaining diagnosticservices in workers’ compensation casesby preloading physician preferences in acomputerized system.

Looking forward, OCM is exploringadditional ways to reduce redundancyand improve linkages between payersand medical providers through the useof electronic referral authorizations andother mechanisms to reduce delays

inherent to fax, mail and phone trans-actions, which are difficult to consis-tently document and track.

Patient transportation and languagetranslation are two other services OCMadded to its armamentarium in 2010through the acquisition of a companycalled STOPS.

“Our experience shows that

rapid and accurate diagnoses,

together with a comprehen-

sive treatment plan, are the

critical elements to achieve

the best claim outcomes

for both injured workers

and payers.”

“We found these services to be a realneed, not just for improved access but toensure the receipt of reliable, high-qual-ity services,” Mr. Duford said. “We feelSTOPS is the perfect fit for One CallMedical’s strategy of building a broadersuite of value-added cost-containmentservices for workers’ compensation pay-ers. Our experience shows that rapidand accurate diagnoses, together with acomprehensive treatment plan, are thecritical elements to achieve the bestclaim outcomes for both injured workersand payers.”

STOPS reports a 99.5 percent successrate in completing transportation ofinjured workers to their medicalappointments. The firm also providesin-person and telephonic translationservices, which are increasingly indemand given cultural diversity in theU.S. workforce.

“We were a little surprised to discoverhow broad-based the need for culturallysensitive translation is,” Mr. Dufordsaid. “It is so important to have someone who can translate well andaccurately.”

Workers’ Compensation Market Gaining Momentum

11

VISIONS

Planning for 2011 andbeyond, it is helpful tobe aware of challenges

others in the industry believeoccupational health providersare likely to encounter.

Asked about 17 anticipatedchallenges, economic concernstopped the list, according toresults from the NationalAssociation of OccupationalHealth Professionals’ 2010national survey of provider-based programs (Table 1).

Interestingly, while “compet-ing on price” is considered byproviders to be a significantanticipated challenge, employ-ers rank price as the seventhmost important attribute intheir selection of an occupa-tional health program in market surveys conducted byRYAN Associates/NAOHP(4,000 responding companies).Employers are much morelikely to rank prompt care andearly return to work as leadingfactors in their choice of aprovider of clinical services fortheir workforce.

In other financially relatedfindings, Table 2 featuresapproximate total gross rev-enue generated in the pastyear. Table 3 features currentprofitability and profitabilityprojected for five years hence.The majority of respondentsrepresent hospital or healthsystem-affiliated programs,independent clinics and medical practices that haveprovided occupational healthservices for at least 10 years.

Providers Anticipate Ongoing Economic Challenges

Table 1-Top eight of 17 challenges: How much of a challenge do you expect each of the following to be as you

strive for optimal programmatic quality and cost-effectiveness over the nextfew years? 5=Considerable challenge and 1=No barrier. N=135

Challenge Scaled Score

The overall economy 4.01

Competing on price 3.15

National health care reform 2.97

Introducing additional revenue-generating products and services 2.91

Inadequate commitment to sales 2.89

Transitioning to electronic medical records/billing 2.78

Incorporating health promotion/wellness into our program 2.50

Internal communication 2.35

Table 2-Gross Revenue: What is the approximate total gross revenue generated by your program

during your most recent year? N=132

Approx. Total Gross Revenue % Respondents

Less than $1 million 24.2%

$1 million to $1.5 million 21.2%

$1.5 million to $2 million 11.4%

$2 million to $2.5 million 11.4%

$2.5 million to $3 million 5.3%

$3 million to $10 million 22.7%

More than $10 million 3.8%

Table 3-Profitability: On a standalone basis, how profitable do you believe your program is at the

present time and how profitable do you believe it will be five years from now?N=140 and 142, respectively.

Current Current % Projected Projected % Profitability Respondents Profitability RespondentsVery profitable (10% orgreater profit margin) 14.3% Much more 22.4%Somewhat profitable (0-10% profit margin) 30.7% Somewhat more 53.8%

About break even 26.4% About the same 22.4%

Experiencing small loss 20.7% Somewhat less 0.7%

Experiencing significant loss 7.9% Out of business 0.7%

12

This edition of Outcomes

features findings from studies onworkforce health and productivitymanagement measures and interventions.

Calculating Employers’Health Management Costs

To help U.S. employers better under-stand all of their health and productiv-ity costs, the non-profit IntegratedBenefits Institute (IBI) has developed asophisticated new model – the Full CostEstimator.

Because most employers manage ben-efits programs in multiple departmentsand through numerous suppliers, criticaldata often are missing or scattered.Additionally, real but often unmeasuredcosts of health-related underperfor-mance and lost productivity are consid-ered so complex that most organizationsdon’t know how to quantify them,according to IBI researchers.

The estimator enables an employer toconsolidate disparate components into asingle application to evaluate the effec-tiveness of interventions. Benchmarkingparameters include industry type, work-force size and demographics, health andabsence policies and the employer’s ben-efits experience data. Using the estima-tor, a single report may feature data on: • sick-day absences and disability wage

replacements;

• non-concurrent family and medicalleave absences;

• occupational and non-occupationalmedical and pharmacy claim costs;

• lost output due to presenteeism; and

• lost productivity burdens fromemployee underperformance andlost workdays.

“As employers navigate health carereform and make the business case forhealth improvement, it’s important thatthey understand the real impact ofhealth and its business-relevant out-

comes,” said Thomas Parry, Ph.D., IBIpresident. “This tool can play an impor-tant role in helping employers maximizethe data they do have and fill in theblanks when data are unavailable.”

The estimator draws on a number ofsources including millions of disabilityclaims in IBI’s benchmarking databases,results from a validated health assess-ment survey (HPQ-Select) developed inpartnership with Ron Kessler, Ph.D., aprofessor of health care policy atHarvard Medical School, and nationallyrepresentative databases such as theCenters for Disease Control andPrevention’s National Health InterviewSurvey, AHRQ’s Medical ExpenditurePanel Survey and the U.S. Bureau ofLabor Statistics’ Injuries, Illnesses andFatalities program.

The estimator will be used byemployer participants in the AmericanHealth Strategy Project, a program ofthe National Business Coalition onHealth in cooperation with Pfizer Inc.,which assists participating employers intaking a strategic approach to value-based health benefits.

Source: visit: ibiweb.org

u u u

Presenteeism StudyHiatus Proposed

Experts say a shift in focus from indi-vidual health behaviors to lost produc-tivity in working populations may beneeded to develop more meaningfulmetrics on cost impacts.

In recent years, presenteeism – reducedproductivity at work because of health-related issues – has become a buzzwordin connection with workforce healthmanagement strategies. But now a groupof experts has proposed a moratoriumon presenteeism research while tools aredeveloped to more accurately measurelost-productivity costs and savings asso-

ciated with efforts to improve health,such as employee wellness programs.

An extensive literature search of pre-senteeism studies suggests “substantivequestions remain about the measure-ment of presenteeism, its conversioninto lost productivity and the transla-tion of presenteeism into financialequivalents,” Dee W. Edington, Ph.D.,and colleagues at the University ofMichigan Health ManagementResearch Center say in an article pub-lished in the November Journal of

Occupational and Environmental

Medicine. “Many aspects of presenteeismstill warrant caution, especially whenusing presenteeism measurements toquantify economic outcomes.”

Until more reliable tools are devel-oped, Dr. Edington’s group plans to sus-pend studies of presenteeism and itseconomic impact.

Meanwhile, they present a list of limi-tations and assumptions to help guidefurther development of tools for measur-ing presenteeism impacts. They alsosuggest that employers consider placinga greater emphasis on workforce popula-tions (such as across a company ordepartment) rather than on individualswhen evaluating lost productivity costsand the value of health interventions.

In the article, Presenteeism: Critical

Issues, they pose some key questions:• Is there one best way to measure

presenteeism?

• Are all instruments measuring quality in the same way?

• Can results be validated againstobjective measures of productivity?

They say these questions need to beanswered before two other key issuescan be addressed: the expression of lostwork time converted into lost productiv-

ity and the translation of lost productiv-ity into dollar costs.

While the “general and intuitive con-cept” of presenteeism has entered the

Research Lifts Veil on Health Management Data

13

VISIONS

mainstream, corporate leaders continueto be skeptical about it, according to Dr.Edington and his colleagues. “If health-related presenteeism is truly an impor-tant construct, then the issues raised inthis paper need to be addressed andresolved.”

Reference: Brooks A, Hagen SE,Sathyanarayanan S, Schultz AB, EdingtonDW. Presenteeism: Critical Issues; J Occup

Environ Med. 2010;52(11):1055-67.

u u u

Prevention ReducesHealth Risks, Study Shows

Another newly published study inwhich Dr. Edington of the University ofMichigan served as a co-author foundprevention can be effective.

Ronald Loeppke, M.D., lead author,presented selected findings at RYANAssociates’ annual national conference,just one day before the study, Prevention

Plan on Employee Health Risk Reduction,was published in Population Health

Management. He said the study ”demon-strates compelling health risk reductionin employee populations.”

The study evaluated the impact ofThe Prevention Plan™ on employeehealth risks after one year of primary(wellness and health promotion) andsecondary (biometric and lab screeningand early detection) preventive inter-ventions. The Prevention Plan, a prod-uct of U.S. Preventive Medicine, Inc., isa benefit program that provides its

members with health management toolssuch as a 24-hour nurse hotline, per-sonal health coaching, health-orientedevents and incentives.

For the study, researchers measuredchanges in 15 health risk categoriesamong a cohort of 2,606 employeesfrom multiple employer groups.Participants completed a baseline healthrisk appraisal, blood tests and biometricscreening in 2008 and underwent areassessment in 2009.

Program participants were separatedinto one of three groups based on healthrisks such as high cholesterol, bloodpressure or stress levels. Low-riskemployees were defined as having zeroto two health risks, medium-riskemployees three to four risks and high-risk employees five or more risks. Thefindings were then compared to a “nat-ural flow of risk transitions” model created by Dr. Edington.

Overall, there was a positive healthrisk transition, with net movement fromhigher-risk levels to lower-risk levels.The cohort showed significant reduc-tions in 10 of the 15 health risk cate-gories, most notably in the proportion ofemployees with high-risk blood pressure,fasting blood sugar and stress levels—allrisks that can be addressed through acomprehensive approach to individualand workforce health management.

In addition, participants showedimprovement in cholesterol levels andphysical activity, and reductions in fattyfood consumption and heavy drinking.

The population also achieved a reduc-tion in health-related illness days andimproved personal health perceptions.After one year, 42 percent of study par-ticipants experienced a decrease in thenumber of health risks they faced, with64 percent of high-risk participants low-ering their risk status and 87 percent oflow-risk participants maintaining theirhealth status.

“This is scientific proof that wellnessworks when structured on the pillar ofprevention,” Dr. Loeppke said.

Reference: Impact of the Prevention Planon Employee Health Risk Reduction; RLoeppke, D Edington, S Beg; Population

Health Management, Vol. 13, No. 5, 2010; ©Mary Ann Liebert, Inc.

u u u

Medical TreatmentLeading RTW Indicator

The leading predictor of return towork (RTW) is medical treatment—farexceeding other influencing factors suchas job type, co-morbidities, age andseverity, according to a Work Loss DataInstitute study on disability durationsconducted for a leading insurance carrier.

“Different return-to-work pathwaysevolve within the same diagnosis,depending on the type of treatmentadministered,” said Pat Whelan, insti-tute director and publisher of ODG

Treatment, including Official Disability

Guidelines. “Return-to-work durationsare not self-defined but directlyimpacted by treatment; the study quantifies that impact.”

For example, the study shows that forspinal fusion for low back pain (not rec-ommended in ODG), return-to-worktime is more than 100 times as long as itis for exercise (recommended in ODG).For low back pain, job class (sedentary,light, heavy, etc.) makes almost no dif-ference in disability duration.

Ms. Whelan said RTW guidelines“must be integrated with evidence-basedmedical treatment guidelines (EBM) inorder to be a fair, accurate and effectiveRTW management tool. Further, trueEBM must link to and mirror today’sscience. Treatment recommendationsshould not vary based on the prefer-ences of different jurisdictions, politicalinfluences or economic agendas.”

Source: www.worklossdata.com

14

Job Discrimination Claims Keep Agency Busy

The federal Equal EmploymentOpportunity Commission (EEOC)received a record number of

charges this fiscal year under laws thatmake it illegal to discriminate against ajob applicant or an employee because ofa person’s race, color, religion, sex, preg-nancy, national origin, age (40 orolder), disability or genetic information.

Case Load Catch-UpUnder the Obama administration the

agency reports it has made progresstoward rebuilding its enforcement capa-bilities by putting more resources intohiring and training its employees. Itended the fiscal year Sept. 30, 2010,with 86,338 pending charges—anincrease of 570 charges, or less than 1percent, compared to 2009. Between fis-cal years 2008 and 2009, the EEOC’spending inventory increased 16 percent.

The agency also reports it: • intervened to secure a record $319

million in monetary benefits for indi-viduals through administrativeenforcement.

• ended the year with a record 9,370

mediated resolutions, 10 percentmore than FY 2009 levels, and morethan $142 million in monetary benefits.

• expanded its reach to underservedcommunities by providing educa-tional training and public outreachevents to approximately 250,000people.

• continued a concerted effort to build a strong national systemicenforcement program.

• resolved 7,213 requests for hearingsin the federal sector, obtaining morethan $63 million in relief for partieswho requested hearings and morethan 66 percent of federal sectorappeals.

Genetic Information Non-discrimination Act

The EEOC issued final regulations forenforcement of Title II of the GeneticInformation Non-discrimination Act(GINA) in November. The rules gointo effect Jan. 10, 2011.

Title II represents the first legislativeexpansion of the EEOC’s jurisdiction

since the Americans with DisabilitiesAct of 1990 (ADA). It prohibitsemployment discrimination based ongenetic information and restricts theacquisition and disclosure of genetictests. The final regulations:• provide examples of genetic tests;

• more fully explain GINA’s prohibitionagainst requesting, requiring or pur-chasing genetic information;

• feature model language employerscan use when requesting medicalinformation from employees toavoid acquiring genetic information;and

• describe how GINA applies togenetic information obtained viaelectronic media, including websitesand social networking sites.

• interpret the law with regard to the provision of voluntary wellnessprograms.

Under GINA, employers and othercovered entities are required to treatgenetic information as confidential. Theconfidentiality standards are similar tothose required under the ADA for thehandling for medical records: Geneticinformation may be kept in the samefile as medical information but not withother personnel files. Genetic informa-tion placed in personnel files prior tothe enforcement date need not beremoved, but disclosing the informationto a third party is prohibited.

The commission reports it received asignificant number of public commentsexpressing concern about the law’sapplication to employer requests formedical information. Employers saidthey do not have control over what isreceived and that they should not besubject to liability if health careproviders report genetic informationthat was not requested. In response, theEEOC added language for employers toprotect them from liability. The finalrule suggests covered entities use thefollowing language:

VISIONS

...“(GINA) prohibits employersand other entities covered byGINA Title II from requesting orrequiring genetic information ofemployees or their family members.In order to comply with this law,we are asking that you not provideany genetic information whenresponding to this request for med-ical information.”

To view the regulations, visitwww.federalregister.gov (search forGINA, 11-9-2010). To view question-and-answer documents:http://eeoc.gov/laws/types/genetic.cfm.

Age DiscriminationAge discrimination is an area of par-

ticular interest for the EEOC. The com-mission recently heard testimony thatage discrimination makes it difficult forthe nation’s growing segment of olderworkers to maintain and find newemployment, particularly in a downeconomy. The number of age discrimi-nation charges filed with the EEOCgrew from 16,548 (21.8 percent) of allcharges filed in FY 2006 to 22,778 (24.4percent) in FY 2009.

At a hearing, William Spriggs, assis-tant secretary for policy in theDepartment of Labor, testified that therate of unemployment for people age 55and over rose from a pre-recession lowof 3 percent (November 2007) to 7.3percent in August 2010, making thepast 22 months the longest period ofhigh unemployment workers in this agegroup have experienced in 60 years.Older workers also spend far more timesearching for work and are jobless for farlonger periods of time compared toworkers under 55, he said.

In prepared testimony, Scott Oswald,managing principal at The EmploymentLaw Group, Washington, D.C., advisedthe EEOC to “advocate legal theoriesthat prevent an employer from beingable to avoid liability under the AgeDiscrimination in Employment Act(ADEA) by pointing to our challengingeconomic conditions to mask unlawfulage discrimination.”

He said the “EEOC should prepare forthe likely increase in age discriminationclaims by identifying vocational andeconomic professionals who have theexpertise necessary to evaluate andidentify the true economic hardship

older employees endure when they aresubject to unlawful age discrimination.”

According to Mary Anne Sedey, apartner with Sedey Harper P.C. andexperienced employment law attorney,said older workers rarely file hiring dis-crimination claims because it is difficultto prove why they are not interviewedor hired and most lawyers who practicein this area cannot afford to bring cases.

Michael Foreman, director of theCivil Rights Appellate Clinic at thePennsylvania State UniversityDickinson School of Law, testified onwhat he described as a significantSupreme Court decision in the caseGross v. FBL Financial Services, Inc. Hesaid “Gross has significantly altered thelegal framework for proving discrimina-tion” and that “plaintiffs now face novelrequirements in the pleading stage,unpredictable summary judgment standards and onerous burdens attrial…the EEOC will have to be especially vigilant and proactive if it isgoing to help curtail the harmful impactof the Gross decision.”

Source: www.eeoc.gov/eeoc/meetings/11-17-10/index.cfm.

15

Recommended Resources

Costs of Obesity in the

Workplace; E Finkelstein, et al.; firststudy to quantify the total value oflost job productivity as a result ofobesity-related health problems findsproductivity loss costs more thanmedical expenditures; Journal of

Occupational and Environmental

Medicine, Vol. 53, Issue 10, October 2010.

Emergency Preparedness for

Persons With Disabilities and

Special Needs; American NationalStandards Institute HomelandSecurities Panel report discusses challenges, approaches and standardization gaps in the emergency preparedness lifecycle;October 2010; www.ansi.org/hssp.

Future Fit Recruitment Report:

Confidence and Change; humanresource executives cite innovationas an essential business objective for2011; survey conducted by AlexanderMann Solutions, a recruiting company; www.alexandermannsolu-tions.com

Manpower Employment Outlook

Survey, first quarter 2011; data sug-gest improved hiring expectationscompared to 12 months ago in 28 of39 countries and territories, includingCanada, France, Germany, Italy,Japan the United Kingdom and theUnited States; www.manpower.com.

National Survey on Drug Use and

Health; Substance Abuse andMental Health Services Administra-tion reports nearly 20 percent of

American adults experienced a diag-nosable mental illness in the pastyear, including one-fifth of who alsohad a substance use disorder; manydid not receive treatment;http://oas.samhsa.gov/NSDUH.

Prevention Through Design: Planfor the National Initiative; NIOSHreport on risk reduction throughworkplace design; November 2010;www.cdc.gov/niosh/docs/2011-121.

Reviews of Human Factors and

Ergonomics, Vol. 6; new chapters inthis annual series discuss human per-formance in space and transportationaccident investigation as it relates tothe development of human factorsresearch and practice; published byThe Human Factors and ErgonomicsSociety; www.hfes.org.

16

Commercial Driver SafetyThe Federal Motor Carrier Safety

Administration (FMCSA) has launcheda Compliance Safety Accountabilityprogram that uses a safety measurementsystem to evaluate commercial motorcarriers’ performance. The program willallow FMCSA to deploy targeted inter-ventions including early warning letters,roadside inspections and compliancereviews. Visit http://csa.fmcsa.dot.gov.

Controlled SubstancesThe Drug Enforcement Administra-

tion issued a notice of intent to tem-porarily add five synthetic cannabinoidsto the Controlled Substances Act in aneffort to prevent an “imminent hazardto the public safety.” Once finalized, theaction would impose criminal sanctionsand regulatory controls of Schedule Isubstances for the manufacture, distribu-tion, possession, importation and expor-tation of the synthetic cannabinoids.

Court OverrulesEmployees in ADA-DrugTesting Case

In an unusual case, the 6th U.S.Circuit Court of Appeals ruled againstseven plaintiffs who challenged theiremployer’s drug testing policy under theAmericans with Disabilities Act. Thecourt found the plaintiffs did not qualifyas disabled under a section which barsdiscrimination against a “qualified indi-vidual with a disability because of thedisability.” Each plaintiff tested positivefor one of 12 substances contained inprescription drugs. The company hadbanned the substances for safety rea-

sons. The employees were given anopportunity to transition to other med-ications; when they continued to takethe same drugs, the company firedthem. Refer to www.ca6.uscourts.gov/opinions.pdf.

Chronic ConditionsA new Strategic Framework on Multiple

Chronic Conditions from the Departmentof Health and Human Services outlinesa public/private collaboration to .reduce complications and improve theoverall health of individuals with multi-ple chronic conditions. According toHHS, treatment of people with multiplechronic conditions such as asthma, dia-betes, heart disease and hypertensionrepresents 66 percent of U.S. healthcare spending.

Food InspectionsThe U.S. Senate passed the Food and

Drug Administration Food SafetyModernization Act, S-510, sponsored bySen. Dick Durbin, D-Ill., and passed itto the House for consideration. As pro-posed, the act would increase inspec-tions of food facilities, give the govern-ment more authority to order recallsand make it easier for the FDA to closetainted facilities.

Insurance ExchangesThe National Association of

Insurance Commissioners’ (NAIC)Health Insurance and Managed CareCommittee has approved the AmericanHealth Benefit Exchange Model Act. Ifapproved by the full NAIC, the act willbe used by states as they developexchanges, which are intended to createa more organized and competitive mar-ket for health insurance by offering achoice of plans.

Manufacturing OutreachThe National Occupational Research

Agenda (NORA) Manufacturing SectorCouncil is seeking partners in industry,labor, academia and government to col-laborate on topic areas including con-tact with objects and equipment, falls,

musculoskeletal disorders, hearing loss,cancer, health disparities, small busi-nesses and catastrophic incidents. Visitwww.cdc.gov/niosh/nora.

Mine SafetyThe U.S. Department of Labor’s Mine

Safety and Health Administration isholding a series of six public hearings ona proposed rule on “Lowering Miners’Exposure to Respirable Coal Mine Dust,Including Continuous Personal DustMonitors.” The meeting notice waspublished in the Nov. 15 Federal

Register.

NIOSH GovernanceIn a recent report on federal develop-

ments, Katherine Kirkland, executivedirector of the Washington, D.C.,-basedAssociation for Occupational andEnvironmental Clinics(www.AOEC.org), said “one issue beingbrought forward again is the effort tohave the Government AccountabilityOffice do a study on whether theNational Institute for OccupationalSafety and Health should remain withinthe organizational structure of theCenters for Disease Control andPrevention (CDC).”

Pain Management Run Amuck

A recent New Jersey Star-Ledger

investigation found at least 248 officersand firefighters obtained steroids,growth hormone and other testosterone-boosting drugs from a physician with apain management practice in NewJersey before the doctor’s death inAugust 2007. In addition, the newspa-

VISIONS

17

per found Dr. Joseph Colao falsely diagnosed hor-mone deficiencies to justify prescriptions. A Star-

Ledger analysis suggests the total cost to taxpayersruns into the millions of dollars.

OSHA ActionsIn a recent telephonic briefing for members of

the American College of Occupational andEnvironmental Medicine, OSHA Director DavidMichaels, Ph.D., described a number of initiativesintended to encourage employers to take greaterresponsibility for recognizing and correcting work-place hazards:

Hazard Identification and Abatement: Theagency has proposed that all employers have aninjury and illness prevention or risk-based programapplicable to their own unique circumstances. Dr. Michaels said OSHA plans to publish a noticeof proposed rulemaking to trigger additional opportunities for public discourse beyond stake-holder meetings that have already been held onthe concept.

Permissible Exposure Limits: Many of OSHA’schemical exposure standards/permissible exposurelimits (PELs) need to be updated. In the mean-time, one way to improve chemical hazard protec-tion is to use the general duty clause as an enforce-ment tool. Under the general duty clause, employ-ers are required to provide a work environmentfree of recognized hazards that cause or are likely tocause death or serious physical harm to employees.

Ergonomics: This is a critical area to which thegeneral duty clause also is likely to be more rigor-ously applied.

Heat Exposure/Long Work Hours: The generalduty clause will also be used to enforce abatementof two other hazards: heat exposure and excessivework hours.

Recordkeeping: One of the agency’s major regu-latory shifts involves modernization of workplaceinjury tracking and record-keeping systems, withthe goal of having employers record injuries elec-tronically and in a way that provides useful infor-mation for hazard investigation and abatement.

Under-represented Workers: Dr. Michaels saidOSHA is “very much focused on reaching out tothe most vulnerable workers and their employers”via consultation and enforcement.

Government Reports Decline in Work Injury, Illness Rates

There were about 400,000 fewer non-fatal occupational illnessesand injuries reported by private industry employers in 2009 com-pared to 2008, according to the latest Bureau of Labor Statistics’(BLS) Survey of Occupational Injuries and Illnesses.

Of the 3.3 million illnesses and injuries reported in all industries,the manufacturing sector showed the largest decline in cases since2003 (23 percent); the rate of reportable injuries and illnesses forevery 100 workers dropped by 14 percent. The construction industry reported a 22 percent decline (71,700 fewer cases) with a corresponding drop of more than 6 percent in the injury and illness rate.

Some of the overall decrease in case counts may be attributed toeconomic factors, including a decrease in employment and totalhours worked, particularly in construction and manufacturing, officials said.

In other findings, the number of reported injury and illness casesthat required days away from work to recuperate decreased by 9percent to 1.2 million cases in private industry, and state and localgovernment. Workers in the mining industry suffered the longestabsences from work - a median of 26 days compared to eight daysfor all industries.

Seven occupations in which the incidence rate per 10,000 full-time workers was greater than 300 and the number of cases withdays away from work was greater than 20,000 were identified:police and sheriff’s patrol officers; nursing aides, orderlies andattendants; light or delivery service truck drivers; laborers andfreight, stock and material movers; construction laborers; tractor-trailer truck drivers; and janitors and cleaners. For more data, visitwww.bls.gov.

10 State Rates ReportedMeanwhile, another study reveals disparities in the number of

reported cases requiring medical treatment versus cases covered byworkers’ compensation.

In 2007, 10 states added questions about work-related injuries toannual random telephone surveys of the adult population to sup-plement BLS data, better estimate the number of workers injuredon the job during the preceding 12 months and determine the per-centage of cases covered by workers’ compensation insurance. Inthe study:• Injury incident rates ranged from 4.0 per 100 employed adults

in Kentucky to 6.9 per 100 in New York, with a median of 5.0 per 100.

• The proportion of self-reported work-injured persons for whommedical treatment was paid by workers’ compensation insuranceranged from 47 percent in Texas to 77 percent in Kentucky, witha median of 61 percent.

The other seven states in the study are California, Connecticut,Massachusetts, Michigan, New Jersey, Oregon, and Washington,where workers’ compensation insurance is provided through thestate Department of Labor and Industries.

Researchers said more information is needed to identify whymedical treatment for a work-related injury might not result inpayment by workers’ compensation. Officials believe additionalresearch also could help identify characteristics of worker-reportedoccupational injuries that were likely recordable under OSHArecordkeeping rules but were not reported.

The study supports the use of population-based surveys as a sup-plementary injury reporting method, officials said. To learn moreabout the Behavioral Risk Factor Surveillance System (BRFSS) surveymethodology used in the study, refer to MMWR 2010; 59:897-900.

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Frank H. LeonePresident and CEO

Since 1985

Karen J. O’HaraSenior Vice President

Since 1990

Roy K. GerberSenior Principal

Since 1998

Donna Lee GardnerSenior Principal

Since 1997

RYAN Associates’ Consulting Services

650 OCCUPATIONAL HEALTH-SPECIFIC ENGAGEMENTS SINCE 1985

1-800-666-7926, X16 • WWW.NAOHP.COM

I N C H A L L E N G I N G T I M E S

experience reigns

RYAN Associates’ 2010 National Conference Maine Outing

An impromptu band

Denise Eastham, Front Royal, VA

Chris Vanni and husband, Michigan City, IN Mike Schmidt, South Sioux City, Iowa, and crew at lobster fest/clam bake.

Save the date! Oct. 17-19, 2011, RYAN Associates’ Silver Anniversary Conference in Atlanta

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VISIONS

To list your event, email information to Karen O’Hara,VISIONS Editor: kohara@naohp.com

FEB

JAN

MAR

APR

March 2-4Occupational HearingConservationist Certification andRe-Certification Courses; spon-sored by University of IowaCollege of Nursing, Iowa City, IA;www.public-health.uiowa.edu/heartland/ce/courses.asp.

March 26-29American Occupational HealthConference; annual meetingsponsored by the AmericanCollege of Occupational andEnvironmental Medicine; Grand Hyatt, Washington, D.C.;www.acoem.org.

March 28-30 Management and LeadershipSkills for Environmental Healthand Safety Professionals; sponsored by Harvard School of Public Health; Boston, MA;https://ccpe.sph.harvard.edu/programs.

February 10-12Musculoskeletal Disorders andChronic Pain: Evidence-basedApproaches for Clinical Care,Disability Prevention and ClaimsManagement; sponsored byAmerican College of Occupa-tional and EnvironmentalMedicine, Canadian Institute forthe Relief of Pain and Disabilityand other professional organiza-tions; Los Angeles, CA;www.cirpd.org/conference2011.

February 16-18NIOSH-Approved SpirometryCourse; Johns Hopkins UniversitySchool of Nursing, Baltimore,MD; sponsored by JohnsHopkins Education and ResearchCenter and M.C. TownsendAssociates; contact MaryTownsend, course director, 412-343-9946; www.jhsph.edu/erc/spirometry.html.

April 29-May 5American Association ofOccupational Health Nursesannual conference; Atlanta, GA;www.aaohn.org.

January 30-February 4 31st Annual Occupational Safetyand Health Winter Institute; sponsored by North CarolinaOccupational Safety and HealthEducation and Research Center;Fort Lauderdale, FL;http://osherc.sph.unc.edu.

February 23-27 11th World Congress on Stress,Trauma & Coping; sponsored byInternational Critical IncidentStress Foundation; HiltonBaltimore Hotel; www.icisf.org.

MAYMay 1-5Risk and Insurance ManagementSociety annual conference;Vancouver, Canada;www.rims.org/annualconference.

May 10-132011 National Urgent CareConvention; sponsored by UrgentCare Association of America;Chicago; www.ucaoa.org.

May 14-19Innovate. Integrate. Inspire:annual American IndustrialHygiene Association conferenceand exposition; sponsored byAIHA® and ACGIH®; Portland, OR;www.aihce2011.org.

May 24-26Drug and Alcohol TestingIndustry Association annual conference; sponsored by DATIA;Doral Resort & Spa, FL:www.Datia.org/conference2011.

ASSOCIATIONS

Urgent Care Association of America(UCAOA) UCAOA serves over 9,000 urgent care centers.We provide education and information inclinical care and practice management, andpublish the Journal of Urgent Care Medicine.Our two national conferences draw hundredsof urgent care leaders together each year.Lou Ellen Horwitz • Executive DirectorPhone: (813) 657-0508lhorwitz@ucaoa.orgwww.ucaoa.org

BACKGROUND SCREENING SERVICES

Acxiom You can’t afford to take unnecessary risks.That’s where Acxiom can help. We providethe highest hit rates and most comprehensivecompliance support available–all from anunparalleled, single-source solution. It’s a customer-centric approach to backgroundscreening, giving you the most accurate information available to protect your company and its brand.Michael Briggs • Sales LeaderPhone: (216) 685-7678 • (800) 853-3228Fax: (216) 370-5656michael.briggs@acxiom.comwww.acxiombackgroundscreening.com

CONSULTANTS

Advanced Plan for HealthAdvanced Plan for Health has a plan and aprocess to reduce the rising costs of healthcare. By partnering with APH, you can providecustomized plans to help employees of thecompanies, school systems and governmentoffices in your market. You can show theorganizations how to improve their healthplan, finances and employee productivity.Rich Williams Phone: (888) 600-7566 Fax: (972) 741-0400 richwilliams@aph-online.comwww.aph-online.com

Bill Dunbar and Associates BDA provides revenue growth strategies toclinics and hospitals throughout the U.S.BDA’s team of professionals and certifiedcoders increase the reimbursement to itsclients by improving documentation, coding,and billing. BDA offers a comprehensive, cus-tomized, budget-neutral program designed tofocus on improving compliance along withnet revenue per patient encounter.Terri Scales Phone: (800) 783-8014Fax: (317) 247-0499 ts@billdunbar.com • www.billdunbar.com

Medical Doctor Associates Searching for Occupational Medicine Staffingor Placement? Need exceptional service andpeace of mind? MDA is the only staffingagency with a dedicated Occ Med team ANDwe provide the best coverage in the industry:occurrence form. Call us today.Joe WoddailPhone: (800) 780-3500 x2161Fax: (770) 248-6701woddailj@mdainc.comwww.mdainc.com

Reed Group, Ltd.The ACOEM Utilization ManagementKnowledgebase (UMK) is a state-of-the-art solution providing practice guidelines infor-mation to those involved in patient care, uti-lization management and other facets of theworkers’ compensation delivery system. TheAmerican College of Occupational andEnvironmental Medicine has selected ReedGroup and The Medical Disability Advisor asits delivery organization for this easy-to-useresource. The UMK features treatment modelsbased on clinical considerations and four lev-els of care. Other features include ClinicalVignette – a description of a typical treatmentencounter, and Clinical Pathway – an abbrevi-ated description of evaluation, management,diagnostic and treatment planning associatedwith a given case. The UMK is integrated withthe MDA for a total return-to-work solution. Ginny Landes Phone: (303) 407-0692 Fax: (303) 404-6616 glandes@reedgroup.com www.reedgroup.com

Refer aVendor— Earn $100

Vendor, individual

and institutional

members of the

NAOHP will receive a

$100 commission for

every referral they

make that results in a

new vendor member-

ship. The commission

will be paid directly to

the referring individual

or their organization.

There is no limit to the

number of referrals.

In other words, if five

referrals result in five

new memberships, the

referring party will

receive $500.

If you know of a

vendor who would

benefit from joining

the NAOHP Vendor

Program, please contact

Rachel Stengel at

800-666-7926 x12.

The following organizations and consultants participate in the vendor program of the NAOHP,including many who offer discounts to members. Please refer to the vendor program sectionof our website at: http://www.naohp.com/menu/naohp/vendor/ for more information.

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RYAN AssociatesServices include feasibility studies,financial analysis, joint venture devel-opment, focus, groups, employer sur-veys, mature program audits, MISanalysis, operational efficiencies, prac-tice acquisition, staffing leadership,conflict resolution and professionalplacement services.Roy GerberPhone: (800) 666-7926x16Fax: (805) 512-9534rgerber@naohp.comwww.naohp.com

ELECTRONIC CLAIMMANAGEMENTSERVICES

StoneRiver P2P LinkP2P Link provides electronic connectiv-ity between workers’ compensationpayers and medical providers. Since1999, P2P Link has been deliveringmedical bills and supporting documen-tation electronically. P2P Link facilitates faster payments to medical providers while reducingadministrative costs.Jewels MercklingPhone: (901) 653-2619julie.merckling@stoneriver.comwww.stoneriver.com/solutions/p2p-link

Unified Health Services, LLCUnified Health Services provides com-plete electronic work comp revenuecycle management services from“patient registration to cash applica-tion” for medical groups, clinics, andhospitals across the country. Thisincludes verification and treatmentauthorization systems, electronicbilling, collections, and EOB/denialmanagement. Provider reimburse-ments are guaranteed.Don KilgorePhone: (888) 510-2667Fax: (901) 255-6797dkilgore@uhsweb.comwww.uhsweb.com

WorkCompEDI, Inc.WorkComp EDI is a leading supplier of workers’ compensation EDI clear-inghouse services, bringing togetherPayors, Providers, and Vendors to promote the open exchange of EDI for accelerating revenue cycles, lower-ing costs and increasing operationalefficiencies. Marc MenendezPhone: (800)297-6906Fax: (888) 454-2681MMenendez@WorkCompEDI.comwww.workcompedi.com

LABORATORIES &TESTING FACILITIES

Clinical Reference Laboratory Clinical Reference Laboratory is a pri-vately held reference laboratory withmore than 20 years experience part-nering with corporations in establish-ing employee substance abuse pro-grams and wellness programs. In addi-tion, CRL offers leading-edge testingservices in the areas of Insurance,Clinic Trials and Molecular Diagnostics.At CRL we consistently deliver rapidturnaround times while maintainingthe quality our clients expect.Dan WittmanPhone: (800) 445-6917Fax: (913) 492-0208wittmand@crlcorp.comwww.crlcorp.com

eScreen, Inc. eScreen is committed to delivering innovative products and services whichautomate the employee screeningprocess. eScreen has deployed propri-etary rapid testing technology in over1,500 occupational health clinicsnationwide. This technology createsthe only paperless, web-based, nation-wide network of collection sites foremployers seeking faster drug testresults.Robert ThompsonPhone: (800) 881-0722Fax: (913) 327-8606 marketing@escreen.comwww.escreen.com

MedDirectMedDirect provides drug testing products for point-of-care testing, lab confirmation services and DOTturnkey programs.Don EwingPhone: (479) 649-8614Fax: (479) 648-3246dewing@gomeddirect.comwww.gomeddirect.com

MedTox Scientific, Inc.MEDTOX is committed to providingthe best service/testing quality in theindustry. MEDTOX is a SAMHSA certi-fied lab and manufactures our owninstant drug testing products–the PRO-FILE® line. Our expertise also includeswellness testing, biological monitor-ing, exposure testing and many moreservices needed by the occupationalhealth industry.Jim PedersonPhone: (651) 286-6277Fax: (651) 286-6295jpederson@medtox.comwww.medtox.com

National Jewish HealthNational Jewish Health, world leaderin diagnosis, treatment and preventionof diseases due to workplace and envi-ronmental exposures offers practical,cost effective solutions for workplacehealth and safety. We specialize inberyllium sensitization testing, diagnosis and treatment, exposureassessment, industrial hygiene consultation, medical surveillance and respiratory protection. Visit www.NationalJewish.org. Other metal sensitivity testing is available. Wendy NeubergerPhone: (303) 398-1367800.550.6227 opt. 6neubergerw@njhealth.orgwww.njlabs.org

Oxford ImmunotecTB Screening Just Got Easier withOxford Diagnostic Laboratories, aNational TB Testing Service dedicatedto the T-SPOT.TB test. The T-SPOT.TBtest is an accurate and cost-effectivesolution compared to other methodsof TB screening. Blood specimens areaccepted Monday through Saturdayand results are reported within 36-48 hours.Noelle SneiderPhone: (508) 481-4648Fax: (508) 481-4672nsneider@oxfordimmunotec.comwww.tbtestingservices.com

VISIONS

VENDOR PROGRAM, cont.

Quest Diagnostics Inc.Quest Diagnostics is the nation’s lead-ing provider of diagnostic testing,information and services. OurEmployer Solutions Division provides a comprehensive assortment of pro-grams and services to manage yourpre-employment employee drug test-ing, background checks, health andwellness services and OSHA requirements.Aaron AtkinsonPhone: (913) 577-1646Fax: (913) 859-6949aaron.j.atkinson@questdiagnostics.comwww.employersolutions.com

MEDICAL EQUIPMENT,PHARMACEUTICALS,SUPPLIES AND SERVICES

Abaxis®

Abaxis® provides the portable PiccoloXpress™ Chemistry Analyzer. The analyzer provides on-the-spot multi chemistry panel results with compara-ble performance to larger systems inabout 12 minutes using 100uL ofwhole blood, serum, or plasma. TheXpress features operator touchscreens, onboard iQC, self calibration,data storage and LIS/EMR transfercapabilities.Joanna AthwalPhone: (510) 675-6619 Fax: (736) 262-6973joannaathwal@abaxis.comwww.abaxis.com/index.asp

AlignMedAlignMed introduces the functional and dynamic S3 Brace (Spine andScapula Stabilizer). This rehabilitationtool improves shoulder and spine func-tion by optimizing spinal and shoulderalignment, scapula stabilization andproprioceptive retraining. The S3 isperfect for pre- and post- operativerehabilitation and compliments physical therapy. Paul JacksonPhone: (800) 916-2544 Fax: (949) 251-5121pjackson@alignmed.comwww.alignmed.com

Alpha Pro Solutions, Inc.Internationally recognized leader ofDrug Free Workplace and handhygiene training and consulting.Occupational Health clinics make greatre-sellers to employers (DERs, supervi-sor signs and symptoms, employeeawareness). Drug Collector, BAT and

Instructor training via WEB andClassroom. Breathalyzer and screeningdevices. Instructor tools: WEB,PowerPoint, Manuals, Tests, Videos. Sue ClarkPhone: (800) 277-1997 x700Fax: (727) 688-2727sue@alphaprosolutions.comwww.alphaprosolutions.com

A-S Medication Solutions LLCASM, official Allscripts partner, intro-duces PedigreeRx Easy Scripts (PRX), aweb-based medication dispensingsolution. Allowing physicians to elec-tronically dispense medications at thepoint-of-care with unique ability tointegrate with EHR or be used stand-alone. PRX will improve patient care,safety and convenience, while gener-ating additional revenue streams forthe practice.Lauren McElroyPhone: (888) 990-6510info@a-smeds.comwww.a-smeds.com

Automated Health CareSolutionsAHCS is a physician-owned companythat has a fully automated in-office rx-dispensing system for workers’ com-pensation patients. This program is avalue-added service for your workers’compensation patients. It helpsincrease patient compliance with med-ication use and creates an ancillaryservice for the practice. Shaun Jacob, MBAPhone: (312) 823-4080Fax: (786) 594-4645sjacob@ahcs.com

Dispensing SolutionsDispensing Solutions offers a conven-ient, proven method for supplyingyour patients with the medicationsthey need at the time of their officevisit. For nearly 20 years, DispensingSolutions has been a trusted supplierof pre-packaged medications to physi-cian offices and clinics throughout theUnited States. Bernie TalleyPhone: (800) 999-9378Fax: (800) 874-3784 btalley@dispensingsolutions.com www.dispensingsolutions.com

Keltman Pharmaceuticals, Inc. Keltman is a medical practice serviceprovider that focuses on bringinginnovative practice solutions toenhance patient care, creating alterna-tive revenue sources for physicians.Keltman’s core service is a customiz-

able point of care dispensing system.This program allows physicians to setup an in-office dispensing systembased on a formulary of pre-packagedmedications selected by the physician.Wyatt WaltmanPhone: (601) 936-7533Fax: (601) 936-7787wwaltman@keltman.comwww.keltman.com

Lake Erie Medical & SurgicalSupply, Inc./QCP For 24 years Lake Erie Medical hasserved as a full-line medical supply,medication, orthopedic and equip-ment company. Representing morethan 1,000 manufacturers, includingGeneral Motors, Ford and Daimler-Chrysler, our bio-medical inspectionand repair department allows us tooffer cradle-to-grave service for yourmedical equipment and instruments. Michael HolmesPhone: (734) 847-3847Fax: (734) 847-7921Mikeh@LakeErieMedical.com www.LakeErieMedical.com

PD-Rx PD-Rx offers NAOHP members a com-plete line of prepackaged medicationsfor all Point of Care and Urgent CareCenters. So if it’s Orals Medications,Unit Dose, Unit of Use, Injectables, IV,Creams, and Ointments or SurgicalSupplies that you need, let PD-Rx fillyour orders. 100% Pedigreed. Jack McCallPhone: (800) 299-7379 Fax: (405) 942-5471jlm@pdrx.comwww.pdrx.com

U.S. Preventive MedicineUS Preventive Medicine offers ThePrevention Plan(tm), a suite of com-prehensive health management prod-ucts to improve the health, productiv-ity and quality of life for members,while reducing health care costs foremployers, insurers and governmententities. Health systems across thecountry are realizing the value of ThePrevention Plan.Richard Maguire-GonzalezSr. Vice President, NetworkDevelopmentPhone: (866) 665-0096rgonzalez@USPreventiveMedicine.comwww.USPreventiveMedicine.com orwww.ThePreventionPlan.com

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VISIONS

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PROVIDERS

Methodist Occupational Health CentersMethodist Occupational HealthCenters (MOHC) is an Indiana basedprovider of clinic based occupationalhealthcare and a national provider ofworkplace health services for employ-ers looking to reduce overall employeehealthcare costs. In addition, MOHCIprovides revenue cycle services nation-ally to other occupational health programs and health systems.Thomas BrinkPhone: (317) 216-2526 Fax: (317) 216-2839tbrink@clarian.orgwww.mohci.com

New England Baptist HospitalOccupational Medicine CenterNew England’s largest hospital based occupational health network offers a full continuum of care. Areas ofexpertise include biotechnology,orthopedics, drug and alcohol testing,immunizations, medical surveillanceand physical examinations.Irene AndersonPhone: (617) 754-6786 Fax: (617) 754-6453Ianderso@caregroup.harvard.edu

PUBLICATIONS

Center for Drug TestInformationWe are here to help you find theanswers to your questions about alcohol and drug testing and the StateLaws that apply. We provide specificstate information and court cases youcan use to protect your organizationand save money by knowing yourstate’s incentives and workers’ compensation rules.Keith DevinePhone: (877) 423-8422Fax: (415) 383-5031info@centerfordrugtestinformation.comwww.centerfordrugtestinformation.com

REHABILITATION

Stretch It Out!©

Stretch It Out!© (SIO!) is a comprehen-sive safety resource designed to assistemployers in developing, implement-ing, and sustaining an effective work-place stretching program. SIO! can beutilized in a variety of work environ-ments for both large and smallemployers. SIO! can be utilized as acomponent of a wellness initiative oras part of a more comprehensiveapproach to preventing musculoskele-tal injuries. SIO! licenses are offeredfor both single and multi-siteemployer users. A SIO! ConsultantLicense is also available. Go towww.egesolutions.com for moredetails.Scott EgePhone: 815-988-7588Fax: 815-624-6216scott@egesolutions.comwww.egesolutions.com

SOFTWARE PROVIDERS

Integritas, Inc. Agility EHR 10 is both CCHIT Certified®

2011 Ambulatory EHR, and certified asan ONC-ATCB 2011/2012 CompleteEHR, enabling government incentivesfor eligible providers. Designed tomeet specific needs of high volumeOcc Med/Urgent Care clinics, chartingis fast and thorough, coding is auto-mated, customer support is notoriouslyoutstanding. Genevieve MusonPhone: (800) 458-24862011sales@integritas.comwww.integritas.com

MeditraxMediTrax™ is a user-friendly softwarethat meets real-world information management needs. Features includepoint-and-click appointment schedul-ing, workflow-driven-data entry, “one-minute” patient registration andcheckout, voice-recognition supportfor clinical dictation, automated ICD9and CPT4 coding, integrated workers’comp and OSHA reporting, testing-equipment interfaces, and occupation-specific surveillance programs. Joe Fanucchi, MDPhone: (925) 820-7758Fax: (925) 820-7650drjoe@meditrax.com www.meditrax.com

Occupational Health Research SYSTOC SYSTOC® is a powerful, comprehensivepractice management EMR softwarewithtap2chartTM technology forurgent/ primary care, occupationalhealth, rehabilitation, and wellness.SYSTOC® provides quick, accurate doc-umentation, sophisticated billing, andflexible reporting, along with out-standing support and training.OHR Sales & Marketing TeamPhone: (800) 444-8432Fax: (207) 474-7944sales@systoc.comwww.systoc.com

OHM/Pure Safety Get empowered to do more – withmore. Put the industry’s most compre-hensive and effective OH&S softwaresolution at your fingertips: OHM fromPureSafety. Experience the Power ofOHM® – from PureSafety OHM is theoriginal “total solution” for your occupational safety, health and med-ical management needs.Tom GaudreauPhone: (888) 202-3016Fax: (615) 367-3887tom.gaudreau@puresafety.comhttp://www.puresafety.com

Practice VelocityWith over 600 clinics using our soft-ware solutions, Practice Velocity offersthe VelociDoc™—tablet PC EMR forurgent care and occupational medi-cine. Integrated practice managementsoftware automates the entire rev-enue cycle with corporate protocols,automated code entry, and automatedcorporate invoicing.David Stern, MDPhone: (815) 544-7480Fax: (815) 544-7485info@practicevelocity.comwww.practicevelocity.com

Medical Director/ Staff Physicians

• Northwest (Medical Director)—NEW POSITION

• Southwest Ohio (Medical Director)—NEW POSITION

• Georgia (Medical Director)—NEW POSITION

• South Carolina (Medical Director)—NEW POSITION

• D.C. Area (Medical Director)—NEW POSITION

• Chicagoland (Medical Director)

• Central Texas (Staff Physician)

• Northern California-Monterey Area (Staff Physician)

• Southern Oregon (Medical Director)

• Northern California (Medical Director)

For details, visit www.naohp.com/menu/pro-placement.

The NAOHP/RYAN Associates Professional Placement Service is seeking qualified candidates for the following positions:

226 East Canon PerdidoSuite M

Santa Barbara, CA 93101

1-800-666-7926www.naohp.com

PresidentJewels Merckling, Vice President,Enterprise SalesIntegritas, Inc.Kansas City, MO816-399-3951Jewelsm1210@integritas.com

Northeast – DE, MD, New England states, NJ, NY, PA, Washington D.C., WVDr. Steven CrawfordCorporate Medical DirectorMeridian Occupational HealthWest Long Branch, NJ 732-263-7950scrawford@meridianhealth.com

Southeast – AL, FL, GA, MS, NC, SC, TN, VALeonard Bevill, CEOMacon Occupational MedicineMacon, GA478-751-2925; lbevill@maconoccmedicine.org

Great Lakes - KY, MI, OH, WIKaren Bergen, R.N., AdministratorMarshfield Clinic Marshfield, WI715-847-3465kosidowski-bergen.karen@marshfieldclinic.org

Midwest - IL, INTom Brink, President and CEOMethodist Occupational Health CentersIndianapolis, IN317-216-2520; tbrink@clarian.org

Heartland – AR, IA, KS, LA, MN, MO, MT, NE, ND, OK, SD, TXMike Schmidt, Director of OperationsSt. Luke’s Occupational Health ServicesSioux City, IA 712-279-3470; schmidMS@stlukes.org

West – AK, AZ, CA, CO, HI, ID, NM, NV, OR, UT, WA, WYVacant until Jan. 1, 2011

AT LARGEMichelle McGuire, Software Solutions SpecialistOccupational Health Research/SystocLawrence, Kansas207-474-8432; mcguire@systoc.com

Denia Lash, R.N. Director, Occupational HealthBlount Memorial HospitalMaryville, TN865-273-1707; dlash@bmnet.com

NAOHP Regional BoardRepresentatives and

Territories

Board Roster