Approved Rehabilitation Provider Renewal outcomes for providers and case managers Alex O’Shea –...

Approved Rehabilitation Provider Renewal

outcomes for providers and case managers

Alex O’Shea – Director SRC Policy Section

Comcare’s Strategic Framework

• The framework identifies a range of connected strategies delivered by Comcare to achieve the employer objectives. These strategies include providing advice and education, investigating compliance and supporting rehabilitation.

Provider renewal - The SRC Act requires it

• approved rehabilitation providers (ARPs) must apply every 3 years.

• it takes up resources – for Comcare and providers

• allows for review of standards

• Comcare must be satisfied that . . .

3 stage process of renewal1. Application

– self-audit of closed cases against standards– approach to managing complex cases

2. Assessment of past performance against:- RTW outcome - 90%, median cost - $1,590 (now $1,890), median duration - 19 weeks, service standards (timeframes etc) future performance assessment 3. Written decision

The outcome…• There were 180 ARPs in the system at December

2006. Comcare received 130 renewal applications and most were renewed

• a small number of applicants were not renewed • about 20%, including large and multi-state ARPs,

were granted ‘conditional’ re-approval.

Other outcomes

• Comcare strengthened its communications with ARPs

Other outcomes (continued)

• Comcare observed successful and unsuccessful ARP – employer service delivery models

Other outcomes (continued)

• Comcare observed strengths and weaknesses in its RTW model

Messages for case managers

• know the ARP outcome and service delivery standards

• engage ARPs who deliver

• develop Service Level Agreements with ARPs

Messages for case managers

• build robust RTW management systems which:– Build strong employer commitment– Have clear policies and procedures– Plan and implement actions and get resources– Are regularly reviewed– Allow for continuous improvement

Messages for ARPs• Understand role of ARP in this jurisdiction• Develop service level agreements (SLAs)• Use audit checklists and report on

performance• Seek feedback from case managers• Have management systems• Undertake Comcare training

Messages for Comcare• Comcare will work with conditionally

approved providers to ensure their performance meets standards

• Monitoring performance is important for everyone – Comcare, employers and ARPs

• Work is being conducted through HWCA on a model of national provider approval

Website: www.comcare.gov.au

Phone: 1300 366 979

Enquiries:

src.policy@comcare.gov.aurehab.approval@comcare.gov.au

claims.help@comcare.gov.au