Tennessee Adopts ODG

Tennessee Bureau of Workers’ Compensation adoption of the Work Loss Date Institute’s ODG Guidelines and Drug Formulary officially took effect this past February. The volunteer state joins 32 other states to officially apply the ODG Treatment Guidelines in some capacity and is the third state to nationally to adopt the ODG’s close drug formulary.

What is ODG

A publication of evidence-based treatment and Return-To-Work guidelines that support managing medical treatment and utilization review for workers’ compensation.

The first edition of ODG Guidelines was published in 2003 and is currently on its 20th edition. Web text is updated continuously in real time to reflect findings of the most current studies and the text version is published annually.

ODG's Purpose?

According to WLDI, the purpose of these guidelines are “to set health policy in workers’ compensation using evidence-based medicine to safeguard access to quality care while limiting unnecessary utilization of medical services.”

Carriers, Self-Insures, and Managed Care companies refer the guidelines as a benchmarking resource to ensure employees are receiving the most effective medical treatment appropriate to their compensable injury.

Why States choose ODG?

ODG is widely used by states as it is considered to be one of the most complete and comprehensive guidelines for treatment recommendations. It cover over 99% of workers comp’ related costs and ODG’s RTW guidelines cover all 10,000 ICD9 diagnosis codes.

Each ODG recommendation includes direct links to data/text and supporting medical evidence of the studies that were applied in determining the treatment recommendations.

ODG’s Impact?
  • Improve recovery outcomes and quality of care by focusing on restoration of workers functional capacity through the delivery of appropriate evidence based treatment.
  • Reduce excessive and unrelated utilization of medical services
  • Identify and refute ineffective procedures
  • Automate approval for supported effective treatment reducing delays in necessary medical care
  • Efficiently process UR by automating first-line approvalAccording to WLDI, the Adoption of ODG has led to:
    • Medical cost-savings of 25%-60% (by state, payer, TPA, and health plan)
    • Average disability duration down 34%-66%
    • Treatment delay (from DOI to initial treatment) down 77%
    • Insurance premiums down 40%-49% as a result of improved health outcomes
    • Access to care up 42% (more treating providers accepting patients under ODG)

    **Source: Work Loss Data Institute

Fast Facts:

  • Adopted by more states than any other guideline.
  • Utilized by the top 10 WC Insurers.
  • ODG includes the most used chronic pain guidelines in workers’ comp.
  • In February 2016, WLDI, the publisher of ODG, was awarded a GSA contract. Allowing all government agencies the ability to purchase and utilize guidelines.

To learn more about the Official Disability Guidelines, visit ODG or ODG FAQ.

Review Med has been subscriber of ODG since 2007, utilizing these guidelines for our clients in Texas and nationwide for managed care services including Medical Case Management, Life Care Planning, Peer Record Review, and Utilization Review. For more questions on how we can help you with ODG, contact us today!