Copic’s 3Rs (Recognize, Respond, and Resolve) Program is a disclosure and early intervention program designed to help preserve the physician-patient relationship and foster ongoing communication after an adverse outcome.
As the first private sector early intervention program in the country, we have partnered with our insured providers and facilities to offer assistance to more than 9,500 patients since 2000 when the program was launched.
The 3Rs Program focuses on supporting the physician-patient relationship through the disclosure process and reimbursement for the patient’s out-of-pocket medical expenses and extended recovery time related to the unanticipated portion of their care. The process is overseen by a team of Copic nurses and physicians who assess a case, apply any exclusions, coach the disclosure and communication with the patient, and reimburse the patient in a timely manner. Copic was not only a pioneer in disclosure and reimbursement programs, it remains heavily resourced to timely assist patients, providers, and the systems they work in.
3Rs case example: A 47-year-old male with rectal cancer underwent an uneventful low anterior resection. Subsequently, the patient developed an anastomotic leak necessitating a return to the OR for exploratory lap, loop ileostomy, and drainage of abscess. The 3Rs Program facilitated physician-patient communication and reimbursed unanticipated out-of-pocket medical expenses for ER, infectious disease, hospital, radiology, and anesthesiology services associated with the care needed for the anastomotic leak. Additionally, travel expenses were reimbursed and the patient’s extended recovery period was recognized.
When working with a physician and their patient, a significant amount of time is spent dealing with the reimbursement aspect of the case. Through experience over time, we have found that 3Rs cases are usually multifaceted. While the reimbursement of out-of-pocket medical expenses is an objective tool in meeting the financial needs of the patient, it is also important to recognize that there are often times other aspects of resolution. These aspects are more subjective and yet can be just as important.
The emotional piece of the unexpected outcome is not as tangible as a bill, a receipt, or extended recovery, but still may require time and support from the 3Rs nurse specialist and the involved physician.
Patients are not the only ones who experience an emotional toll when an unexpected outcome happens. Physicians can also receive support from the 3Rs Program and coaching to help get through the difficult conversations with the patient. There are times when an unexpected outcome that occurred with the patient leaves the physician feeling upset or frustrated. 3Rs nurse specialists can offer suggestions on how to handle these situations or refer those physicians to peers who are risk managers and can provide support.
Early reporting remains key in successful resolution when using the 3Rs Program. Our experience continues to reinforce that incidents that are reported early to Copic allow us to consider and offer assistance through the 3Rs Program, and patients involved are less likely to pursue legal action. While patients retain the right to pursue legal action after participating in the 3Rs Program, of the cases that are paid, less than 5% pursue legal action.
To have an incident reviewed for the 3Rs Program, please call our incident reporting line, 720.858.6395 and a nurse specialist will assist you.
Information in this article is for general educational purposes and is not intended to establish practice guidelines or provide legal advice.
Article originally published in 4Q24 Copiscope.
