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Lisa Firestone
President
Lisa M. Firestone, MHSA President and Owner of Managed Care Advisors, Inc. has been involved in the healthcare industry for more than 30 years gaining recognition for her expertise in the areas of workers' compensation, disability management and employee benefit program development, management, evaluation and strategic planning. Ms. Firestone has been actively involved in the evolution of workers' compensation case management and disability management programs, most recently focusing on the federal workers' compensation and disability systems.
Ms. Firestone started her career in hospital administration at a large, university-based medical center, followed by more than six years as a health benefits consultant and practice manager with The Martin E. Segal Company and American International Healthcare. Prior to founding MCA in 1997, Ms. Firestone served as Vice President and Principal with Managed Care Options.
Ms. Firestone has recently been named to the Governing Board of Women Impacting Public Policy (WIPP), is a Co-Chair of the WIPP Procurement Committee, is a member of the WBENC Certification Committee, and is an at-large member of WPO. In addition, Ms. Firestone was named the 2011 VIP (Victory in Procurement) Teaming Government Contractor of the Year by American Express Open.
Ms. Firestone has an undergraduate degree from the University of Delaware and a Masters degree in Health Services Administration from George Washington University.
Susan Kappel
Vice President
Susan B. Kappel, MSHA, Vice President of Managed Care Advisors Inc., has oversight responsibility for MCA's consulting practice and account management services and provides direct consulting services. Ms. Kappel has been working in the benefits consulting industry for almost 20 years and has been with MCA since its inception in 1997. With over 25 years of experience in managed health care development and operations for governmental entities, employers, payers and providers, Ms. Kappel's experience encompasses virtually all aspects of health care including managed care program operations, employee benefits, workers' compensation, provider network development, evaluation and provider relations.
Prior to her career in consulting, Ms. Kappel worked several years in patient care, followed by more than eight years as Director of Provider Relations for a national managed care plan.
Ms. Kappel has an undergraduate degree in Health Care Policy from the University of Maryland and a masters of Science in Health Administration from the Medical College of Virginia.
Marianne Cloeren
Medical Director
Dr. Marianne Cloeren, MD, MPH, FACOEM is Medical Director of Managed Care Advisors. Her Occupational Medicine work experience includes several years managing employee health in the Veterans Administration system, private sector occupational health clinical practice and serving as Medical Director for several companies. Dr. Cloeren spent several years working for the Army's Center for Health Promotion and Preventive Medicine (USACHPPM), where her program focus was workers' compensation case management.
Dr. Cloeren received her Bachelor's degree at University of Pennsylvania, her medical degree from Temple University, and a Master's of Public Health from the Johns Hopkins School of Hygiene and Public Health; she trained as an Internist at Johns Hopkins Bayview and completed her fellowship in Occupational Medicine at Johns Hopkins.
As Medical Director for MCA, Dr. Cloeren supports its federal workers' compensation case management services, oversees quality assurance, provides expertise for consultation in disability and occupational health related projects, and develops educational offerings related to disability management and evaluation.
Barbara DeGray
Director of Nurse Case Management
Barbara DeGray, RN, Director of Case Management, is a registered nurse who has over 30 years of experience in the areas of clinical care, workers’ compensation, case management, and utilization review.
Ms. DeGray holds an undergraduate degree in Nursing from Georgetown University and a Masters of Business Administration degree in Health Administration from the University of Miami. In addition she is a Certified Rehabilitation Registered Nurse (CRRN) and holds a Certificate in Health Care Administration and a Certificate in Quality Assurance and Utilization Review.
Her current role with Managed Care Advisors (MCA) is as Director of Case Management for the nurse case management program. In this role, Ms. DeGray is responsible for supervising 17 nurse case managers in managing workers’ compensation cases of injured/ill workers. She also ensures FECA guidelines are adhered to and manages caseloads of the regional nurse case managers.
Early Intervention
Our Early Intervention (EI) nurse case managers expedite return to work, prompt access to medical care, shorten lengths of disability and lower costs per claim by initiating case management activities within the first 24 hours of notification of an injury.
Our team conducts a quick professional assessment and identifies immediate needs, including diagnostics, guidance in selection of appropriate providers and assistance with implementing the treatment plan. Our team also establishes an environment of concern for the injured worker and creates an opportunity for reducing the injured workers fears and frustrations.
Early Intervention nurse case managers bring a wealth of knowledge and understanding of the healing process and constantly provide education to all parties, most importantly the injured worker. Our team facilitates collaboration among the injured worker, employer, health care providers and claims team. We provide assistance with authorizations, scheduling of appointments and clarifications of activity levels to avoid barriers often encountered in workers comp.
Our team establishes short and long term goals with frequent monitoring of progress and prompt intervention when confronted with barriers to recovery.
The EI team remains active on a case until the injured worker has returned to full duty or extended recovery leads to transfer to the CARE unit.
Legacy Claims Management
Our Concentrated Action for Recovery and Employment (CARE) unit is dedicated to resolving our clients' long term cases, including those that have been previously labeled as partially or totally disabled, using criteria to identify cases with the highest potential for resolution.
While every case is different, a CARE nurse often begins with a methodical review of up to 30 years of case records, with emphasis on identification of obstacles to resolution. The CARE team then works with the client to formulate a resolution strategy.
While plans are a good starting point, the CARE unit's real strength is finding creative ways to jump-start these stalled cases, and follow through on identified plans.
CARE helps our clients address one of the most important injured worker populations. These older cases make up a significant proportion of short and long-term costs, as well as lost production days, a key part of the POWER initiative.
A Boost for Wounded Warriors
July 21, 2011
In collaboration with the National Organization on Disability, MCA is pleased to have the opportunity to provide the Progressive Goal Attainment Program ( PGAP-Tel ) to Wounded Warriors. These veterans of Operation Enduring Freedom and Operation Iraqi Freedom have reemployment potential but are facing difficulty with career training or vocational placement.
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As the only company in the U.S. authorized to provide PGAP-Tel telephonically, MCA has the unique capability of offering this 10-week disability prevention program to veterans across the country.
Working with MCA's accredited PGAP-Tel specialists, the veterans will establish and track progress related to activity goals designed to promote re-integration into life-role activities and reduce psychosocial barriers to rehabilitation progress.
MCA PGAP Specialist
Linda Sposito, RN
LTCol, USAF, Retired
To learn more about MCA's PGAP-Tel services, please contact MCA's PGAP coordinator, Matthew Castner, at pgap_managedcareadvisors.com.
Two-Part Series on Return-to-Work
July 20, 2011
Return-to-work issues and terminology can be confusing: transitional work? alternative employment? active restrictions vs. preventive restrictions?
To shed light on these, MCA has developed a two-part series of commonly asked questions and answers.
The series is divided between the period before an injured worker has reached maximum medical improvement (MMI) and the period after. Part 1 covers definitions, processes and barriers while Part 2 provides information on the issues faced during the period of job placement and accommodation. Read the series at the Workers' Comp Cost Reduction Resource Center:
Part 1: Transitional Work
Part 2: Alternative Employment
Government Contracting
The POWER Initiative
Progressive Goal Attainment Program
Awards and Recognition
POWER Consulting MCA's consultants will review your agency's Chargeback and related injury and workers' compensation statistics and will provide targeted recommendations for process improvement in order to meet and/or exceed stated POWER goals.
Progressive Goal Attainment Program (PGAP) PGAP is a 10-week program designed to reduce psychosocial barriers to recovery, improve quality of life and facilitate return to work.
Workers' Comp. Case Management MCA's team of experienced Nurse Case Managers will assist injured workers, providers and agency personnel in navigating the federal workers' compensation system and facilitate safe and timely return to work.
Employee Health Benefits Consulting MCA consultants assist clients with the design, implementation, evaluation and management of a spectrum of employee benefit options.
Return to Work and Disability Management Our expertise in return to work and disability management is extensive, encompassing a wide range of public and private programs.
Chargeback Auditing Our team of experienced consultants will undertake a comprehensive review of your agency's current and historical chargebacks in order to identify errors and significant cost drivers.
Latest News
January 18, 2012 - MCA has been named one of the Top 50 Women Owned Businesses in Maryland by DiversityBusiness.com
December 19, 2011 - The Washington Post publishes an articly by MCA president, Lisa Firestone: Exchanges will help firms amid uncertainty
November 11, 2011 - FECA changes related to USPS bill open way for more sorely needed second opinion exams Read more >>
November 4, 2011 - MCA has developed an Activity Prescription and Patient Log to assist workers recovering from painful injuriesRead more >>
Empowering Productivity
Managed Care Advisors, Inc. (MCA) is an innovative, woman-owned business specializing in workers' compensation, employee health benefits and disability management.
Read more about us >>
MCA's mission is to empower individuals and organizations to attain and sustain health and productivity.
Care is Our Middle Name
MCA principals have participated in the evolution of managed care including workers' compensation for more than 30 years. Since 1997, MCA has successfully designed, implemented, and managed employee health and welfare and workers' compensation programs for large public and private corporations, and local, state and federal government entities.
Our team of consultants and clinical professionals are in the business of maximizing health and productivity. Whether evaluating an existing health benefit program, improving access to care or ensuring the safe rehabilitation and return to work for an injured employee, MCA creates practical solutions with measurable goals and objectives.
MCA is named one of the Top 50 Women Owned Businesses in Maryland by DiversityBusiness.com
January 18, 2012
The Washington Post publishes an article by MCA President Lisa Firestone
December 16, 2011
Exchanges will help firms amid uncertainty: "The Patient Protection and Affordable Care Act was signed into law by President Obama on March 23, 2010, with provisions of the bill scheduled to be phased in through January 2018. The next round of significant and material changes is scheduled to take effect..." Read more >>
FECA changes related to USPS bill open way for more second opinion exams
November 11, 2011
The Senate Homeland Security and Government Affairs Committee passed S. 1789, THE 21ST CENTURY POSTAL SERVICE ACT OF 2011. Although the bill focuses primarily on the Postal Service, the bill does amend FECA, requiring "an independent medical assessment of disability and potential for return to work for beneficiaries after six months into the program..."
Read more >>
MCA develops Acitivity Prescription and Patient Log
November 4, 2011
In addition to helping treating doctors prescribe physical activities to patients recovering from painful injuries, this tool also helps these injured workers track their progress... Read More >>
MCA President Awarded VIP Teaming Government Contractor of the Year
October 19, 2011
MCA's president, Lisa Firestone, has been awarded the VIP Teaming Government Contractor of the Year by American Express OPEN, the small business division...Read More>>
Occupational Health Role Q & A
September 29, 2011
The MCA Occupational Health team answers questions about the role of occupational health and medicine in the federal workers' compensation system... Read More >>
In collaboration with the National Organization on Disability, MCA is pleased to have the opportunity to provide the Progressive Goal Attainment Program (PGAP) to Wounded Warriors... Read More >>
Return-to-work issues and terminology can be confusing: transitional work? alternative employment? active restrictions vs. preventive restrictions? To shed light on these, MCA has developed a two-part series... Read More >>
New Analyst for Account Management Team
MCA is pleased to welcome Will Verbarg, who joined MCA as an analyst for the account management team.
Washington State Implements Historic Stay-at-Work Program
June 15, 2011
"Washington employers who provide temporary work that allows an injured worker to 'Stay at Work' while recovering from an injury will be elligible to be reimbursed for half of the worker's wages..." Read More >>
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MCA President awarded VIP Teaming Government Contractor of the Year
MCA's president, Lisa Firestone, has been awarded the VIP Teaming Government Contractor of the Year by American Express OPEN, the small business division of the financial services company. Candidates were evaluated based on criteria such as growth, strategy and community involvement.
See the following links for press coverage related to the award:
Businesswire.com
YFS Magazine
The Baltimore Sun
The Washington Business Journal
Gazette.net
Advantage Business Magazine
National Association for Moms in Business
MCA name one of the Top 50 Women Owned Businesses in Maryland by DiversityBusiness.com
The Federal Workers' Compensation and Disability Management Specialists
As recognized technical experts, MCA has successfully integrated industry best practices for workers' compensation, disability management and employee health benefits into the federal government and military environments.
MCA has been assisting federal agencies in the management of their Federal Employees' Compensation Act (FECA) programs since 2002. Recognizing the nuances associated with FECA, MCA has focused on the development and implementation of highly specialized workers' compensation case management services specifically for federal government agencies.
As experienced government contractors, all of our clinical staff, support staff and partners have received Confidential-level security clearance.
Federal Supply Schedule
MOBIS Contract GS10F0323P
HREEO Contract GS02F0128W
2011 American Express Victory in Procurement (VIP) Award Winner
Careers at MCA
We are always seeking qualified candidates to join our team at Managed Care Advisors. If you are interested in job opportunities for Health Care Consultants, Account Managers, Data Analysts, Medical Records Technicians, Telephonic Nurse Case Managers and Sales Professionals please email your resume and specific inquiry to
careers_managedcareadvisors.com.
Analytics and Reporting
The MCA team brings an uncommon and valuable perspective to managing workers' compensation claims. We capitalize on our roots in management consulting to offer our clients solid outcomes, in-depth analysis, and strategic insights. Our strong reporting capabilities bring value to our customers, through Chargeback Audits, POWER initiative reviews and periodic utilization and trend reports, among others.
MCA stands apart in providing not only topnotch case management services, but also the comprehensive, reliable data with which to pinpoint opportunities for process enhancement and improved outcomes.
Federal Workers' Compensation Chargeback Audits
Our experience in the fields of federal workers compensation and case management has given us extensive knowledge of chargeback cost drivers and the steps necessary to reduce or eliminate them.
One of MCA’'s chargeback consultants will review your agency’'s current and prior chargebacks to identify errors, significant cost-drivers and opportunities for reducing long-term costs without sacrificing quality and/or clinical and vocational outcomes.
This service can be contracted on a stand-alone basis, in concert with POWER Consulting services or as part of a comprehensive case management program.
Employee Health Benefits Consulting
Our experienced consultants bring market, health plan, public policy, human resources, property/casualty and clinical expertise to our employer clients.
This depth of knowledge is highly effective in assisting our clients with the design, implementation and evaluation of a spectrum of health-related employee benefit options. From vendor solicitation and selection to the comprehensive assessment of plan and vendor performance, MCA adds value to employee-sponsored health benefit programs.
One cornerstone of our employee benefits practice is a strong focus on improving plan performance. For those clients who have an existing health benefit program in place, we recommend a periodic operational assessment to evaluate total program performance. This assessment measures the effectiveness of policies, procedures and workflows, vendor performance, and compliance with stated performance benchmarks.
For this highly specialized service we rely on a dedicated team and on proprietary evaluation tools customized to client contracts, programs, and infrastructure.
First Reports of Injury
First Reports of Injury can be accepted electronically through a state-of-the-art case management system, telephonically through a 24/7 Injury Reporting Hotline or via EDI interface with existing safety and/or workers' compensation systems.
How the injury is reported is less important
than the timeliness of the report. We work
closely with our clients to implement, promote
and monitor immediate injury notification and case management intervention.
Physician Reviews
An MCA Board-Certified Occupational Medicine physician will analyze clinical information and provide a thorough written review.
MCA's Occupational Medicine physicians have performed more than 4200 file reviews related to causation, access to care, treatment authorization, work capacity and return to work planning.
Reviews may be used by federal agencies to support claim challenges based on medical evidence, obtain second opinion exams, help resolve treatment authorization problems and help plan for safe return to work.
POWER Consulting
The Protecting Our Workers and Ensuring Reemployment (POWER) initiative requires federal agencies to reduce injury and illness case rates, analyze lost time injury and illness data, reduce lost production days, increase timely filing of compensation claims and speed return to work.
MCA can help your agency meet its POWER goals.
An MCA POWER consultant will conduct an audit of your POWER statistics and internal practices. Using this information, they will identify potential problems and resolutions, including targeted training and safety interventions.
As a part of our comprehensive case management services, we can work to reduce lost production days and facilitate return to work.
Progressive Goal Attainment Program (PGAP)
The Progressive Goal Attainment Program ( PGAP-Tel ) is a 10-week treatment program designed to reduce disability associated with chronic health conditions.
PGAP-Tel aims to reduce psychosocial barriers to rehabilitation progress, promote re-integration into life-role activities, and increase quality of life. Each client meets weekly with a MCA accredited PGAP-Tel Specialist to develop and track progress related to activity goals. This assists the client in resuming activities that have been adversely impacted by injury or illness and facilitates re-integration into the workplace.
As the only company in the U.S. currently providing PGAP-Tel telephonically for workers compensation cases, MCA has the unique capability of offering this program to clients across the country. MCA also offers PGAP-Tel to individuals in other systems, such as short- or long-term disability, veterans, and vocational rehabilitation programs.
For more information, please email pgap_managedcareadvisors.com
Return to Work and Disability Management
All MCA products and services are designed to maximize productivity and employment. Our participation in return to work activities begins immediately following the report of an incident or upon referral and continues until an employee is safely returned to their pre-injury position, or a permanent alternative job.
Our clinical team, with expertise in ergonomics and vocational rehabilitation, works with the employing agency and indirectly with the claims examiner to develop and review appropriate job assignments for employees returning to work with restrictions.
Workers' Compensation Case Management
First and foremost, case managers are advocates for the injured employee, assisting them and their selected physicians in navigating the maze of their workers' compensation system with a focus on full recovery and safe and timely return to work. Injured workers are empowered to take responsibility for their own recovery, while we work to remove barriers to a safe return to work.
Our team expedites necessary medical care by assisting the treating provider's office staff in understanding and navigating the claim authorization and billing process. Additionally, our relationships with ancillary service networks provide injured workers and their providers immediate access to diagnostic radiology, physical therapy, durable medical equipment and prescription drug services.
For more information on any of our services, please contact us.
Contact Us
Managed Care Advisors
10411 Motor City Drive
Suite 475
Bethesda, MD 20817
Phone: (301) 469-1660
Fax: (301) 469-1668
Email: contact_managedcareadvisors.com
LinkedIn Company Profile
Resources
Use the menu to the left to browse the articles and tools compiled here by the MCA team for your convenience. Contact us with any questions or concerns, and check back here for frequent updates.
Protecting Our Workers and Ensuring Reemployment (POWER)
Are you prepared for POWER? This federal initiative, which stands for "Protecting Our Workers and Ensuring Reemployment," picks up where SHARE left off, but with more aggressive performance targets than ever. The initiative encourages more data collection and analysis, and prioritization of safety and health management programs that have been proven to be effective.
Under POWER, each federal agency will be expected to
Click here or Contact us for information on how Managed Care Advisors can help you achieve and exceed your agency's POWER goals.
White House Press Release Announcing POWER
Key points:
•Occupational health professionals play several roles in WC process
•Studies link use of occupational health practitioners to positive outcomes
•Being injured is not required for employee to use occupational health services
Occupational health encompasses much more than identifying hazards
By Elizabeth A. Morrow, Esq., cyber FEDS® Special Projects Editor
ASK THE EXPERT : Occupational health is a term that generally refers to all aspects of health and safety in the workplace, with a focus on preventing hazards that can lead to an array of illnesses and injuries. But the term encompasses much more, especially in the federal workers' compensation arena. From identifying risk factors that can prolong disability to offering insight into the suitability of a selected position for a returning worker, occupational health professionals bring cross-disciplinary knowledge and experience to the table, which is a win-win for employee and agency alike.
cyber FEDS® asked the Occupational Health team at Managed Care Advisors Inc. in Bethesda, Md., to answer some questions about the role that occupational health and medicine plays in the federal workers' compensation system. Managed Care Advisor's medical director, Dr. Marianne Cloeren, will be presenting several sessions at the 6th Annual Workers' Compensation in the Federal Workplace Conference in Las Vegas Nov. 8-10, including one with colleague, Barbara DeGray, RN-BC, CRRN, regarding modifying disability behaviors using telephonic intervention. Visit www.fedwcconference.com to view the complete conference agenda.
Q: What do occupational health professionals do in the context of workers' compensation cases?
A: Occupational health professionals, including nurses, physicians, and physician assistants, have a wide range of important roles in workers' compensation cases. Many occupational health professionals assist agencies with case management, offering clinical insight that supports return-to-work planning, as well as credibility that helps in communicating with community treating providers. The training of occupational health professionals includes not just clinical management, but also a public health perspective, which helps them view an occupational injury as a sentinel event -- one that points to a potential problem that may affect others if not addressed.
Q: Why should employees choose an occupational health doctor or provider as opposed to a different type of doctor?
A: Studies have shown better outcomes for injured workers who choose occupational medicine providers. Occupational medicine providers are less likely to prescribe opioid analgesics if not clinically indicated, and are more successful in working with injured workers and their employers in finding appropriate modified-duty work. Research on work disability has shown that injured workers who return to work as soon as they are able to perform some kind of work have much better long-term clinical and financial outcomes. Early return to work in a suitable modified-duty job is good for the patient and the employer.
Q: Is it possible for an employee without a workplace injury to use an agency occupational health provider?
A: Yes. Agency occupational health providers are responsible for ensuring that the agency's employees are fit to carry out their jobs, and that their health is not endangered by the job. The first role includes evaluating employees whose jobs require annual physicals (for example, firefighters, police officers, or staff transporting clients, such as patients) and also performing examinations to determine whether an employee with a health problem is still (or again) able to perform the job. Employees with acute health problems that may impact their ability to work may be evaluated in the occupational health clinic, and may be offered treatment (if policy permits) if this treatment would help them stay at work. Employees with chronic health problems that may be impacting the ability to continue performing their jobs may be evaluated in the occupational health clinic as part of an agency-directed medical exam. The occupational health clinic is also responsible for "medical surveillance" of employees with specific potential hazardous exposures, for example, tuberculosis or excess noise. Federal agency occupational health clinics are increasingly offering health-promotion-related visits (for example, blood pressure and cholesterol screening, and lifestyle counseling).
Resources on cyber FEDS®:
•Quick Start Guide: Return to Work
•FECA Procedure Manual 2-0600 Disability Management
•Use available tools, resources to maximize RTW efforts (10/14/10)
Reprinted with permission from cyber FEDS®, 360 Hiatt Dr., Palm Beach Gardens, FL 33418. Copyright 2011. All rights reserved. For more information on cyber FEDS® or other LRP resources, visit www.shoplrp.com/fed or call 1-800-341-7874.
Preventing Opioid Misuse in Federal Workers Compensation
Dr. Marianne Cloeren, MCA Medical Director
As we see repeatedly in the media, prescription opioid use and abuse in workers compensation is epidemic. What can federal agencies do about the escalating use of opioids escalating prescriptions, escalating dose, escalating costs, escalating disability and even accidental death? Although at times it may seem as though your hands are tied, there are creative approaches that agencies can take to mitigate the risks associated with opioid prescription abuse.
When we think of opioid misuse, we usually think about people taking drugs prescribed to others, or using prescribed opioids in ways different than recommended by the prescribing doctor and these are real problems that are not unusual in workers compensation cases. There is a bigger problem, however, with injured workers taking opioids exactly as their doctors prescribed. When these opioids are prescribed in the wrong way, or for the wrong patients, or with the wrong monitoring and follow-up, this is also misuse the difference is, the blame lies with the system rather than the injured workers.
In response to escalating problems with addiction and accidental overdose, and in recognition of the fact that opioids don't help everyone and often make things worse, several organizations have come out with treatment guidelines for prescribing opioids to patients with chronic non-cancer pain. One of the best such guidelines is the one developed by the State of Washington: http://www.agencymeddirectors.wa.gov/opioiddosing.asp . This document includes great templates that can be shared with treating doctors, to help them screen, monitor and manage their patients who are prescribed opioids.
