The Path to a Better Bottom Line

Author: Harvey Warren, Co-Founder, Optimized Outcome Solutions

Date: September 5, 2025

Can your injured worker help you drive down the cost of workers’ compensation? Yes, they can, but typically, they are the wildcard in the recovery process, driving up costs, not reducing them. 

Over the last five years, we have learned that patient education and patient engagement are key factors in helping injured workers get better faster and stay better longer. “Get better faster and stay better longer” reduces costs by improving outcomes. 

Leaders in the industry are asking the right questions when it comes to this approach: 

• What does education and engagement look like in the workers’ comp model?

• Is this another expense, or does this really save money? 

Doctors have been considering this exact same concern and have begun to address the medical aspects of the answer to these questions. Their strategy to improve outcomes has several moving parts under the heading of Enhanced Recovery After Surgery, known by the acronym ERAS. Aligned with that strategy from the patient or injured workers’ perspective is the goal of optimizing outcomes.

What Is Enhanced Recovery After Surgery (ERAS)?

If you don’t know what ERAS is about, you are not alone. At the closing session of National Comp 2024, I asked a group of a few hundred attendees if anyone knew what ERAS was.  

One or two hands went up. That was a little surprising to me because it would seem to be the Holy Grail on how to reduce workers’ compensation costs when surgery is part of the recovery plan.

If you look up a textbook definition of ERAS, here’s what you get:

A methodology to minimize the body’s stress response to surgery and actively support the patient’s return to normal function as quickly and safely as possible, using a standardized, multidisciplinary, evidence-based care pathway that spans pre-op, intra-op, and post-op phases.

Here’s how it looks when you map it out:

ERAS is about replacing the old “rest and recover” model with an “optimize and activate” model, guiding patients through surgery with less stress, faster function, and better outcomes.

Better Outcomes. Lower Costs… for Everyone.

For those of you who have read previous articles of mine as well as those written by other Optimized Outcome founders, the words “optimized” and “outcome” do stand out in this improved medical strategy, which not only benefits the patient but saves money by improving outcomes.  

Improving outcomes in simple English means faster recovery and fewer re-admissions. 

My focus is on the fourth part of the infographic, patient education and engagement. Writing the Optimized Patient book over six years ago, I offered guidance on “How to Prepare for, Survive, and Recover from Spine Surgery.” The updated version directly addresses the complications people face in a workers’ comp setting: “How to Prepare for, Survive, and Recover from Any Surgery and Major Injury.” 

Discovering the Four Pillars of Recovery

What I learned in my own recovery from spine surgery was that there are four pillars that optimize recovery. The most important of these is mindset. If your head is not in the right place, if you feel defeated, broken, abandoned, depressed, chances are you are not going to be working very hard on your recovery. All those feelings are common during injury recovery and, perhaps, more so when sidelined from work.

A little elementary research reveals a second pillar, nutrition. There are foods, nutrients, that can either support healing or impede it. The challenge is sorting out what is supplement marketing or crazy theory from what is sound nutritional guidance. There is a high probability that your injured worker has never heard of their microbiome, let alone have a clue about how to optimize it for a speedy recovery.

Activity is a third component in ERAS, just as it is in an optimized recovery. Why? Activity, besides creating endorphins that help us feel good, also increases blood flow and oxygenation.  Moving oxygenated blood to the injured area is key to rapid healing. It is important to note that this activity is the kind of movement in the “motion is lotion” category of recovery strategies and is in addition to prescribed physical therapy. 

You will also see in the ERAS material the methodology that they make obsolete, the traditional “rest and recover” postoperative plan. Rest is a very broad term that often includes the use of opioids to allow the injured worker to get comfortable enough to sleep. 

Comfortable enough does not mean doping yourself into a stupor or zoning out in front of your TV and eating nutritionally empty snacks. Getting comfortable enough to get quality rest is essential to support the healing process; a fine point that is rarely addressed in literature provided as part of your discharge paperwork.

Optimizing a Better Approach That Helps Injured Workers Recover

Sadly, none of this was codified, from the patient perspective, before I wrote my book. Optimized Outcome has taken the Optimized Patient book along with the four pillars strategy and produced videos with a variety of celebrity personal development coaches, professional athletes, a PhD nutritionist, and a celebrity chef to engage and educate the injured worker about how to navigate the recovery process in the most informed and optimal way possible.

I started by suggesting the patient is the wildcard in the recovery process. What I mean by that is an injured worker doesn’t understand the impact they can have on their own recovery. This common blind spot means missing out on opportunities to improve their own outcomes, and, by extension, outcomes for their employer. It’s unfortunate that it never occurs to payers, who are focused on compensation and medical spend, that part of managing the cost of care also extends to how the injured worker participates- or doesn’t- in the recovery process.

Engaging a More Optimized Recovery Protocol

With Shannon Bahrke stepping on stage at National Comp on Veteran’s Day this year, having come back from serious injuries to take the Olympic podium, the critical role that the patient plays in their own recovery will be crystal clear. Her injuries by every measure should have been career-ending. Yet she went on to find success and happiness in life. 

Is it a coincidence that, completely separate and apart from each other that we learned and embraced the exact same path to getting well? I don’t think so, and neither does Shannon.

She, like hundreds of other injured workers, found her way to a complete recovery by the same path that I have been advocating. She got her head on straight, got back in the gym, nourished her body, and gave it quality rest. This helped it do what it is programmed to do – heal so it can succeed.

Controlling doctor fees, the duration of physical therapy, and the cost of meds is certainly an important consideration for payers. But, so is educating, engaging, and guiding the injured worker through the brand-new experience of getting injured and facing the fear and worry that comes with being sidelined from their work life.  

Without patient education, an optimized outcome is entirely left to chance and reliant on the hope that the injured worker can find their own way to getting better faster and staying better longer.

With Optimized Outcome, a clearer path to recovery and long-term wellness is more available than ever before to injured workers and, by extension, their employers and health insurers.