Although the benefits of using evidence-based medicine (EBM) are often touted due to dramatic improvement in outcomes in states that have adopted ODG, up until last year there had never been an academic study published in a peer-reviewed medical journal that examined whether or not EBM could deliver these results from a compliance standpoint on a closed claim file. In May 2016, the independent, retrospective study, entitled, “A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes” (Bernacki, et al), was published, with results that demonstrated what ODG users have been saying all along: It works.
The study compared the relationship between outcomes for 45,951 indemnity claims filed between 2008 and 2013 in terms of duration and medical utilization costs, to their adherence to EBM guidelines - specifically defined by the authors as ODG, “the most widely adopted guideline in workers’ compensation.” The question the investigation assessed was, “If injured workers are managed under EBM guidelines as defined by ODG, do they have better outcomes in terms of absence from work and total medical care cost?” As it turns out, they do.
The low ODG compliance group exceeded the high ODG compliance group by 37.8% in medical costs and 13.2% in claim duration across all levels of medical complexity. Also, as medical complexity increased, so did the difference in duration and medial spend between the low and high compliance group. Lastly, there was a striking difference in the number of inappropriate procedures performed by the low compliance group as compared to the high compliance group, demonstrating that inappropriate care to the injured worker is a primary driver of claim duration and medical costs. The results coincide with the intention of EBM guidelines, which is to combine best practice protocols and optimal care pathways while avoiding potentially harmful, inappropriate care to the injured worker.
Even better, actual outcomes data from ODG users and state adoptions mirror the study results. For example, since the state of Texas adopted ODG, they have experienced 34% savings in lost time, 30% drop in medical costs, and a 51% drop in premiums. A report by CompManagement, Inc, for the state of Ohio showed savings of 66% in absence, 60% in medical cost, and 77% in treatment delay for the top 30 workers’ comp conditions, all with 84% provider approval. Oklahoma experienced a cumulative 44% drop in loss-cost rates since adopting ODG, and North Dakota has become the perennial #1 in Oregon’s widely followed National Workers' Comp Premium Ranking, with 40% premium reductions.
There’s no better way to champion evidence based medicine than to use actual evidence. Although “A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes” was the first academic study of its nature, the conclusion made by Bernacki, et al, demonstrates what many have known all along: Evidence-based medicine works.