Company Nurse Retrospective: Genesis of Nurse Triage in Workers’ Compensation Industry

Blazing a trail 20 years ago to fulfill employers’ need to better manage workplace injury

By Paul Binsfeld, president and founder of Company Nurse, LLC

Parents of firstborns are a nervous wreck. My wife, Donna and I were no exception. In the mid-1990’s, my daughter – who was about one year old at the time – was in and out of emergency rooms, usually during the middle of the night! As overly cautious parents, we sought medical attention any time the level of fussing seemed too high. One such evening, a magnet on the refrigerator from our healthcare insurer, advertising a nurse helpline, caught my eye.  Rather than rushing to the emergency room, we called the nurse helpline offered by our health insurance company.  Within minutes, we were given information on how to take care of our daughter…and avoided yet another trip to the hospital.  And that is when the opportunity dawned on me.

At the time, I was a workers’ compensation and risk management consultant, and realized this type of service could fill a niche in that industry. I vigorously wrote a business plan to explain how to apply the novel concept of nurse triage in private healthcare practice, to the workers’ compensation claims business. I again called the phone number of the nurse helpline on the magnet, navigated my way to the appropriate executive leader and later spent an afternoon at their office to discuss my big idea.

At the time, a variety of employers hired “on-call” nurses using pagers and cell phones. Company Nurse, established in 1997, was an early innovator in nurse triage services available to employers for their workplace injuries. We paved the way to fill a niche for employers from a workers’ compensation insurance standpoint.

Now – as we celebrate our 18th anniversary – I am proud to say that the reasons for why it was successful in 1997 are the same reasons for why it is successful today. However, there were certain benefits of the service I had not anticipated.

What we found out over time is that when empathy is delivered to an injured employee at the onset, the level and type of care received positively impacted and influenced the outcome of the claim; thus decreasing litigation incidence rates for example. In fact, for 37 percent of all calls we receive, the injured worker does not even seek care, cutting claims significantly.

The first beta test was with a company that operated IHOP restaurants throughout the State of Arizona. I spoke with the CEO about my idea and we rolled out a beta test 18 years ago. This company is now operating in multiple states throughout the U.S. and is still our client today. “Company Nurse has been an integral part of our workers’ compensation program for many years,” said Chris Milisci, CEO/Owner of Romulus Holdings. “Their programs have resulted in not just saved premiums but a piece of mind for our managers our HR department and most importantly the injured employee.”

Then – as what I believed to be a natural progression for this service – I segued into the public entity segment. The City of Little Rock in Arkansas became my first client in this sector in the early 2000’s. Then, the Arkansas Department of Corrections came on board as a separate account after hearing of our success with other public entity accounts in the state. After that other Arkansas state agencies followed suit. As it stands today, 50 percent of our business services public entities – including state governments, cities, counties and school districts nationwide.

Like any startup, there were numerous bumps along the road. At one point, I was the sole employee – and outsourced the nurse function. At the time, I leased a small executive suite. Today, we operate nationwide helping thousands of injured workers each month. Why is business picking up? Companies are now looking for triage. It’s in demand.

When I first started, I had to explain to employers why they needed nurse triage. Now, people get it and don’t need to be convinced that triage works: it provides more efficiency in a time-sensitive process, gets employees on their way to appropriate care faster, allows employees in management roles to be more efficient in their job and, above all, there is a better result for the injured employee.

Company Nurse is a testament to the belief that most ideas are spurred when you are least expecting them. And it’s safe to say our daughter turned out to be a healthy, ambitious and bright young woman – even with her overly cautious parents.

About Paul Binsfeld

Paul Binsfeld is the founder and president of Company Nurse, LLC, a firm established in 1997 that specializes in medical triage and injury management for workers’ compensation. Binsfeld has over 25 years of experience in the workers’ compensation industry. His early work at the industry’s genesis lead him to become one of the most influential leaders in the workers’ compensation market.