If You Haven't Read This Yet, Start Here
Last week we published one of the most substantive pieces we've put out in a while — and based on the response, it landed.
"The Bill Has Come Due: Acuity Degradation, Carbon Health, and What Comes Next for Urgent Care" uses Carbon Health's February bankruptcy as a lens on something most of us in occupational health have watched building for a decade: urgent care drifting so far from clinical capability that when the COVID tailwind faded, there wasn't much left to sustain the model.
The article covers:
What Alan Ayers and John Koehler identified years ago — and why it took a $3.3B bankruptcy to make it undeniable
Why MSK is ground zero for acuity degradation, and what that costs employers in real dollars
The virtual orthopedic curbside model NAOHP is developing with Upswing Health — and the Connecticut outcomes data behind it (35.9% reduction in MSK costs, zero MSK-related ER visits among participants)
If you're running an occupational health program and thinking about how to hold employer accounts as orthopedic urgent care chains market directly to your clients, this one is worth your time.
NAOHP Occupational Medicine Provider Course
Build the clinical and operational foundation your team needs — at a group rate.
The NAOHP OccMed Providers Course is built for the front-line clinicians doing the work: the MDs, DOs, NPs, and PAs managing work injuries, navigating OSHA requirements, handling DOT physicals, and serving as the clinical backbone of their program.
The course covers the core competencies of occupational medicine practice — from injury management and medical surveillance to employer communication and regulatory compliance — delivered in a format designed for busy practitioners.
Starting April 15th: Provider Office Hours
Enrolled providers get access to live monthly office hours beginning April 15th — a structured Q&A format where you can bring real cases, clinical questions, and operational challenges to an experienced occupational medicine physician.
Group discounts available. If you're enrolling multiple providers from the same program, reach out before registering to discuss group pricing.
Virtual Orthopedic Care: A Closer Look at the Model
The article above introduced the concept. Here's the operational picture.
MSK conditions are the top driver of workplace health costs — estimated at $400 billion annually in direct costs alone, approaching $1 trillion when you add lost productivity. One-third of that spend is attributable to waste, unnecessary surgery, and mismanaged care. Most of those cases walk through your door first.
The curbside consult model NAOHP is developing with Upswing Health doesn't replace your team — it backs them up. When you have an orthopedic finding that warrants specialist input, your team submits a consultation request. A board-certified orthopedic physician responds within 24 hours. Licensed athletic trainers support structured rehab in parallel. After every encounter, your team gets a detailed case update.
The injured worker never leaves your care. You stay the treating provider.
The outcome data from Connecticut's State Health Plan is independently validated:
35.9% reduction in MSK costs post-enrollment
73.4% decrease in MSK-related outpatient spending
Zero MSK-related ER visits among participants (vs. 38.3/1,000 in the control group)
51% average improvement in pain levels — without opioids
Net Promoter Score of 85
For occupational health programs competing with orthopedic urgent care chains for employer accounts, this is a concrete differentiator — not a concept.
We want to understand how this fits your operation.
👉 How many orthopedic referrals did your program make in the last 12 months? Do you offer in-house physical therapy?
— Larry
🫂 2026 conference plans 👉 Submit Your Conference Preferences Here Now
🏪 Occmarket
All corporate members are eligible to list your clinic locations on the Occmarket.
We’ve got a bit of “chicken or the egg” issue to fully launch -
Many members are ready right now for our first 2 use cases:
Your own health system hires from out of state - instead of relying on random TPA locations or competitors, now you can choose other qualified NAOHP members.
Existing employer clients asking if you can serve them in other locations outside your service area.
But we need to have enough locations listed for them/you to access.
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.
When ordering exams and testing employers (including you for out of state hires) will pay a transaction fee. This will be far less than going through a traditional TPA.
We have maybe 200-300 locations submitted so far, about half are vetted and up on the site. My goal is to have 1000 by year-end. Just NAOHP and affiliate organization members. Not 15k random “collection sites”.
When we talk to employers/payers about using our Occmarket network, we are looking for value based contracts - better outcomes, not cut rates.
🧑🤝🧑 OccNation
🎗 Reminder that all member resources are now in OccNation. Corporate/group members - you have a “main” member or account holder. Fill in your profile, then follow this guide to invite your submembers - you can swap them out as staffing changes dictate.
You’ve probably seen member-only practice briefs, guides and checklists posted here in the newsletter about every week, all in the OccNation Resource Library.
Non-member subscribers are welcome in the main discussion groups and some resources are available, please consider membership to access everything!
Revolutionize Employee Healthcare with Sensia Tech™
🗓 Upcoming Events
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
Health systems are increasingly hiring clinicians and staff from outside their immediate market, adding complexity to onboarding and clearance workflows.
In partnership with SensiaTech, we’ll discuss how to align governance with execution, reduce variability in immunization, TB, drug testing, and respirator clearance, and maintain compliance while improving onboarding velocity.
Thursday, April 2, 9 AM pacific (note date change)
Recent Events:
Advanced biomarker testing has become an area of growing interest for me, particularly as it relates to employee health, long-term resiliency, and disease prevention. The opportunity is not simply to collect more data, but to use more precise data to identify emerging risk patterns earlier—cardiometabolic strain, inflammatory burden, and in some cases cancer-related signals—before they evolve into disability, career interruption, or preventable claims.
This topic comes up frequently in workforce discussions, and especially in conversations surrounding firefighter medical surveillance. Important questions remain. Which biomarkers are clinically meaningful in asymptomatic populations? Which tests are appropriate for higher-exposure or safety-sensitive groups? How should testing differ across employee populations? And once results are obtained, what constitutes responsible follow-up, monitoring, and intervention?
These are complex issues that deserve careful, evidence-based discussion. I am exploring them more deeply in my new publication, Elucidate, where I focus on biomarker science and its practical application to workforce health, prevention strategy, and long-term resiliency.
If this topic is of interest to you, I invite you to read and subscribe to Elucidate.
The first post is: A Physician Looks at His Own Biomarker Data
🏭 Occupational Health Industry News & Signals
OSHA Pivots to Compliance Assistance with Two New Initiatives
OSHA launched two voluntary programs in March that signal a notable shift in tone — from enforcement-first to something more collaborative. The OSHA Cares initiative is an agency-wide effort aimed at helping businesses — particularly small and medium-sized operations — meet federal safety requirements by increasing access to OSHA experts, improving access to training materials, and expanding compliance assistance during enforcement visits. On its heels, the Safety Champions Program takes employers through three progressive levels of preparing a worker safety and health plan, incorporating OSHA's recommended best practices with the assistance of special government employees working alongside the agency.
Neither program changes what OSHA requires. But both represent an opening for occupational health programs to position themselves as the compliance partner employers didn't know they needed.
What This Means for You: Employers walking through OSHA's Safety Champions framework will surface gaps in their safety and health programs — including medical surveillance, injury management protocols, and return-to-work procedures. That's your lane. If you're not already positioned as your clients' occupational health resource for program development questions, this is a good moment to make that offer explicit.
👉 The NAOHP OccMed Providers Course covers the clinical and regulatory competencies that make you a credible partner in exactly these conversations. Enroll or request group pricing →
NIOSH Is Back — But the Rebuilding Work Has Barely Started
Earlier this year, the Trump administration reversed course on one of the more damaging decisions it had made for occupational health: the mass layoff of NIOSH staff. HHS sent reduction-in-force notices to roughly 1,000 NIOSH employees last April — approximately 90% of the agency's workforce — before ultimately revoking all of those notices in January 2026. The reinstatement was welcomed, but cautiously. NIOSH employees noted that many had been on paid administrative leave for nine months, preventing hundreds of federal scientists from carrying out their research, and that substantial rebuilding lies ahead.
The National Safety Council called the reinstatement a positive step while urging a full restoration, noting that NIOSH's research informs policy and industry practices that prevent work-related injuries, illnesses, and fatalities.
Sources: Federal News Network | NSC / OHS Online
What This Means for You: The NIOSH disruption created a genuine gap in the occupational health knowledge infrastructure — respirator certification programs, Total Worker Health research, chemical exposure guidance, and training pipelines all took hits. Even with reinstatement, that research backlog doesn't clear overnight. Practitioners who've been leaning on NIOSH databases and guidelines as clinical references should be aware that updates may be delayed. It also reinforces the case for provider-level training that doesn't depend on federal infrastructure to stay current.
👉 The NAOHP OccMed Providers Course — and Provider Office Hours starting April 15th — keep your team sharp regardless of what happens in Washington. Group discounts available.
HazCom Deadline Extended — But Don't Mistake Extension for Relief
OSHA published a final rule in January 2026 extending several Hazard Communication Standard compliance deadlines by four months. The employer deadline for updating workplace labeling, written programs, and training — originally set for July 20, 2026 — has been pushed to November 20, 2026. The extension was granted because OSHA had not completed key guidance materials with sufficient time for the regulated community to review them before the original deadline.
The HazCom update itself is substantive. The revised standard aligns U.S. chemical safety requirements with GHS Revision 7, adding required pictograms, hazard signal words, and hazard statements for revised hazard categories, and updating container labeling requirements for small containers.
Source: Morgan Lewis LawFlash | Federal Register
What This Means for You: For programs with chemical exposure surveillance responsibilities — particularly in manufacturing, construction, and agriculture — the November deadline is the one to track. The extension doesn't change the compliance obligation; it just moves the date. Employers who haven't started updating SDSs, container labels, and employee training are now on a shorter runway than they realize. Your role in workplace chemical exposure programs makes you a credible voice to flag this proactively.
👉 Chemical exposure and medical surveillance are core competencies in the NAOHP OccMed Providers Course. See what's covered →
OSHA Heat Rule: Still Proposed, Still Enforced
A federal heat illness prevention standard remains in the proposed stage — OSHA published its Notice of Proposed Rulemaking in August 2024, and the informal public hearing concluded in July 2025, with post-hearing comments accepted through October 2025. No final rule has been issued. But enforcement hasn't waited. OSHA's Heat-Related Hazards National Emphasis Program has been in effect and runs through April 2026, under which inspectors proactively target high-risk industries and employers may face General Duty Clause citations for insufficient heat protections even without a finalized standard.
Eight states currently have official heat safety requirements, and several others — including Virginia, with a standard going into effect by May 1, 2026 — are implementing new worker protections ahead of any federal rule.
What This Means for You: The absence of a final federal rule doesn't mean your employer clients are off the hook — particularly in construction, agriculture, warehousing, and manufacturing. If a worker presents with a heat-related illness and OSHA investigates, the General Duty Clause is the enforcement mechanism right now. Occupational health providers who help clients build acclimatization protocols, heat illness recognition training, and return-to-work procedures for heat-related conditions are adding real compliance value before the rule even lands.
👉 The OccNation Resource Library has clinical and employer-facing resources for heat illness prevention and medical surveillance program design. Access the library →