Four Tools, Built for the Same Problem
The structural pressure on occupational health programs hasn't eased. Programs are being measured against frameworks that weren't built for the work. Employer accounts are being marketed away by orthopedic urgent care chains and direct-to-employer MSK vendors. APPs and early-career physicians are routing cases out the door because they don't have the orthopedic depth to manage them in. None of that gets solved by a single intervention.
Over the last several months we've built four tools, each aimed at a specific layer of that problem. If you've been following the Brief, you've seen them roll out one at a time. This issue puts them in one place — and surfaces a few patterns we've started to see when they get used together.
1. The Executive Diagnostic — for the structural cost problem
Most blended-model programs inside health systems run two distinct functions under one cost center: compliance-driven employee health work and revenue-generating occupational health services. When leadership reads the financials, the program looks like it's underperforming. What they're actually seeing is an accounting structure that was never set up to separate the two.
The Executive Diagnostic surfaces those cost allocation gaps. It models what the program would look like on paper if employee health and occ health were properly separated, identifies the compliance workload currently absorbed without attribution, and gives program directors the financial framework to bring to administration.
Applied recently to a program serving more than 80,000 employees, it identified where standard reporting was obscuring real performance — and what the program was actually worth.
If your program is heading into a CMO transition, a strategic review, or a budget conversation, this is the analysis to have done before the meeting.
2. The Market Analyzer — for the competitive and account-retention problem
Most programs know their three or four obvious competitors. What they don't have is a hyperlocal map of every entity competing for the same employer accounts within a defined radius — orthopedic urgent care chains, direct-to-employer MSK vendors, retail clinics with occ med add-ons, physical therapy direct-access providers, telehealth platforms running workers' comp.
The Market Analyzer pulls that map together for a specific clinic address. The output is a weighted, sortable competitor table categorized by service type and competitive threat level. It's the input that should drive pricing, employer outreach, service expansion, and where to position your program against the local landscape.
What we're seeing across recent multi-clinic engagements (redacted)
A few patterns are consistent enough to share:
The "dominant competitor" is often the most structurally exploitable. In a recent multi-clinic network analysis, one national full-service occupational health chain appeared as a primary-radius competitor in roughly three-quarters of the trade areas — and at every one of those sites it operated Monday through Friday only. A seven-day, extended-hours posture isn't just a convenience story; it's a real differentiation handle for weekend injuries, Monday-morning post-incident drug testing, and after-hours pre-employment processing — and in most cases it wasn't being actively marketed against the competitor's hours gap.
Drug screen volume is the leading indicator of unconverted accounts — not WC visits or revenue. Multiple clinics in that same engagement were generating 1,700 to 2,500 employer-funded drug screen collections per year while returning less than $40 of employer services revenue per screen. That's a clear pattern of high-volume collection-only relationships sitting unconverted as protocol accounts (pre-employment physicals, WC care designation, DOT bundles). The drug-screen-to-employer-services ratio turned out to be a sharper diagnostic of BDM under-deployment than any visit-count or revenue metric the operator was already tracking.
Competitive density did not predict market share — execution did. Aggregate network capture was running at roughly half of the analyzer-modeled opportunity given local workforce density, industry mix, and verified competitive load. But within the network, the trade areas with the heaviest weighted competitive load varied wildly in actual performance — including one site that materially outperformed its model and others that underperformed by half. The "we're losing share because the market is saturated" narrative didn't hold up at the clinic level. Account development cadence, protocol file depth, and hours posture explained the variance — not competitor count.
Employer mix inside a single chain's footprint varies enough to break a uniform BDM playbook. Trade-area workforces in one network ranged roughly 6× in size from smallest to largest, and the industry composition shifted from logistics and transportation corridors (DOT-mandated physicals and drug testing, the highest BLS injury rates) to construction-heavy submarkets (audiometric, PFT, and WC injury volume) to white-collar finance and professional services (pre-employment and drug screening at scale, low injury volume). The same outreach script and the same service prioritization don't work across that range — and most networks are running them as if they did.
The pattern across markets matters more than any single finding. If you haven't mapped your competitive landscape this way, the picture is rarely what program leadership expects.
3. The Virtual Ortho Calculator — for the MSK case retention problem
The clinical premise is straightforward: get orthopedic specialist input before the referral decision, not after. The Upswing Health virtual curbside model puts a board-certified ortho specialist alongside the treating clinician at the point of clinical uncertainty — which is where APPs and early-career physicians default to referral, and where the case starts to leak out of the program.
The Connecticut pilot: 35.9% MSK cost reduction. Zero MSK-related ER visits among participants. Run on your own program's volumes and footprint, those numbers translate directly into employer cost savings and program revenue retention. For a multi-site program, the calculator typically produces a revenue impact figure north of $2 million annually.
The calculator session takes about 15 minutes.
4. The OccMed Provider Course & Office Hours — for the upstream clinical depth problem
The three tools above all assume a program with the clinical capability to actually manage the work that comes in. That capability is the upstream variable, and it's where APP-heavy front-line staffing has the most exposure.
The OccMed Provider Course is built for the front-line clinicians doing the work — MDs, DOs, NPs, and PAs managing work injuries, navigating OSHA, handling DOT physicals, and serving as the clinical backbone of the program. Provider Office Hours kicked off April 15 and now run twice monthly, with Dr. John Koehler anchoring and special guests including Dr. Jay Kimmel from the virtual ortho program.
Group enrollment pricing is available for programs running multiple providers through the course together.
The four tools, used together
The Executive Diagnostic surfaces what the program is worth. The Market Analyzer surfaces what's competing for the work — and where execution gaps are masking real opportunity. The Virtual Ortho Calculator surfaces what's leaking out clinically. The Provider Course surfaces what's coming in. Each one stands on its own. Used together, they give program leadership a complete operating picture — financial, competitive, clinical, and structural — that almost no program currently has.
If you want a conversation about which one fits where you are right now, the discovery call is the place to start.
— Larry
🫂 2026 conference plans 👉 Submit Your Conference Preferences Here Now
🏪 Occmarket
All corporate members are eligible to list your clinic locations on the Occmarket.
If you haven’t yet, PLEASE submit your locations using this template - make a copy, add your organization name to the title, then share or email back to me - [email protected], then we’ll meet to get your full account set up.
These listings are free for corporate members and will begin to attract outside business.
Revolutionize Employee Healthcare with Sensia Tech™
🗓 Upcoming Events
Sales & Marketing Office Hours
Many Occ Med accounts start with injury care, but the broader opportunity is often in helping employers prevent injuries, improve job fit, and manage workforce health more strategically.
In our next Occ Med Sales Office Hours, David Saslavsky and Ira Pasternack will be joined by Denise Dumont, PT, a Maine-based occupational health leader whose career has spanned physical therapy, onsite employer services, hospital-based occupational medicine, large private and national occupational medicine organizations, and urgent care employer strategy.
We’ll discuss how a PT-informed perspective can help practices expand employer relationships beyond reactive injury care, including prevention-minded services, smarter program design, and what is realistic to offer, build, or partner around.
Thursday, May 14 at 10 a.m. Pacific / 1 p.m. Eastern.
If you are responsible for growing employer relationships, this session will help you think more clearly about how to expand Occ Med accounts in a way your practice can actually deliver.
Becoming a Safety Leader in Healthcare
The Expanding Role of the Nurse in Health Care Safety
Goal: Master the evolving intersection of occupational health and safety leadership.
Key Topics:
• Shifting expectations of OHNs: from clinical care to system safety oversight.
• Understanding the dual lens of employee and patient safety.
• Introduction to Total Worker Health® principles in hospital settings.
• The business case for nurse-led safety programs (ROI, risk reduction, engagement).
Target Audience:
Registered Nurses, Occupational Health Nurses, and Employee Health professionals transitioning into or expanding safety leadership roles in healthcare systems.
Free Intro Class:
Speaker: Shanna Dunbar
The first cohort for the full course is coming this fall.
🏭 Occupational Health Industry News & Signals
OSHA Heat NEP Renewed and Sharpened. OSHA's National Emphasis Program on outdoor and indoor heat-related hazards expired April 8 and was reissued effective April 10, 2026, now in place for five years. The revised NEP directs OSHA inspection priorities to 55 high-risk industries across indoor and outdoor settings, eliminates the prior numerical inspection goal, and adds reorganized appendices for evaluating heat programs and issuing citations. Compliance officers will continue conducting random heat-focused inspections in high-risk industries on days when the National Weather Service issues a heat advisory or warning. With the proposed permanent heat illness prevention rule still stalled, the General Duty Clause and the NEP are the federal levers — and both just got sharper. For OHPs serving construction, manufacturing, agriculture, warehousing, landscaping, or food service clients, the runway to confirm employer Heat Illness and Injury Prevention Plans, acclimatization protocols, and medical surveillance pathways before peak heat season is now. HIPAA Journal
FMCSA NRII: Final Six-Month Paper MEC Exemption Runs Through October 11, 2026. The FMCSA issued a six-month exemption on April 11, 2026 allowing motor carriers and CDL/CLP drivers in all states to use a paper Medical Examiner's Certificate as proof of medical certification for up to 60 days after issuance. The exemption expires October 11, 2026, and the agency stated it does not anticipate granting additional nationwide NRII waivers or exemptions after that date. Five states have not fully implemented NRII electronic integration as of April 2026: Alaska, California, Kentucky, Louisiana, and New Hampshire. The operational implications for occ med programs running DOT exams are concrete: examiners must continue submitting results to the National Registry by midnight local time the next calendar day, every exam, every time. After October 11, the MVR becomes the sole source of truth for CDL holders — there will be no paper safety net for documentation gaps. Programs without a structured DOT exam audit process should not wait until October to find out what their error rate is. Heavy Duty TruckingHVI
NCCI Q1 Report: WC Medical Prices Set to Accelerate Later in 2026. NCCI's Q1 quarterly report on workers' compensation medical price trends found that price growth lagged behind broader economic inflation early in 2026, but the slower pace is unlikely to continue. Hospital outpatient care price increases are tracking a longer-term annual trend of about 3.5%, and medical equipment and supplies prices accelerated in early 2026, partly reflecting tariff effects. The implication for occ med programs is direct: the medical cost line in workers' comp is heading back up, and employer cost pressure will follow. The programs that capture MSK volume early — before specialty referrals, imaging, and downstream care drive the per-claim cost up — are the ones that hold the renewal conversation. The Virtual Ortho Curbside model is one of the cleanest interventions available against that trend. Business InsuranceBusiness Insurance