Roberto Ceniceros

Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

2015 NWCDC


By: | November 11, 2015 • 2 min read
Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

If you have come to Las Vegas seeking to learn about the latest trends, challenges and proven mitigation strategies in workers’ compensation and disability management, you’ve landed in the right place.

The 24th Annual National Workers’ Compensation and Disability Conference® & Expo promises content delivered by speakers who have tested solutions for today’s toughest challenges or have established their ability to decipher and relate the impact of current trends.

But the conference offers much more.

You will have an opportunity to network with colleagues and leaders representing every profession serving injured workers and companies employing or insuring those workers.

NWCDC is regarded as our industry’s top gathering event. You will have an opportunity to network with colleagues and leaders representing every profession serving injured workers and companies employing or insuring those workers.

You can do this in the expo hall with more than 275 vendors, during session breaks, or at evening receptions and parties.

Welcome to the conference!

I hope you take advantage of every opportunity for work and fun, and find the event as exciting as I believe you will.

As conference chairman responsible for speaker and content selection, I can tell you that many of your peers have put great effort into developing presentations aimed at helping attendees acquire the knowledge necessary to succeed in an increasingly complex workers’ comp world.

Take for example a Program Management track breakout session scheduled for today and featuring speakers form Southwest Airlines, Ernst & Young and Pinnacol Assurance. Titled “Improve Outcomes With a Quality Assurance Program for Managing Service Providers,” the session will provide strategies for selecting and overseeing the vendors servicing workers’ comp programs. (Download the app.)

Conversely, vendors will want to attend to hear about the level of service quality some leading-edge companies will demand of you.

But that is just one of the conference’s many learning opportunities. Along with taking advantage of those, I hope you contribute to conversations focused on improving workers’ comp.

Above all, I hope you have a great time while learning and networking!

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Column: Workers' Comp

What’s Old May Be New Again

By: | November 2, 2015 • 2 min read
Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

Perhaps it’s time to eliminate workers’ compensation medical care and treat injured workers in the more-efficient and lower-expense group-health system.


That’s a potential strategy I’m hearing discussed more often, reminding me of the attempts 20 years ago to do just that.

The “24-hour care” system, which melded workers’ comp medical care into group health, emerged from the idea that group-health plans would treat employees 24/7, no matter where or when an injury or illness occurred.

But why would the strategy succeed this time?

Proponents respond that the Affordable Care Act’s push to hold medical providers accountable by basing their compensation on the treatment outcomes they produce, rather than on a fee-for-service model, will make health care offered under workers’ comp appear even less efficient.

A workers’ comp health care fee-for-service model that encourages more treatments won’t be sustainable, they add.

Employers would be better off treating all injuries in the group health system without regard for causation. — Dr. Bernyce Peplowski, consultant former health care executive

It won’t make sense for employers to pay their group-health doctors under a system holding them accountable while simultaneously compensating doctors to treat injured workers under a system clinging to fee-for-service, said Dr. Bernyce Peplowski.

Peplowski worked for Kaiser Permanente when it operated a 24- hour-care pilot program in Southern California from 1994 to 1997. She has since served in several roles, including as senior VP, national medical strategy and innovation for U.S. HealthWorks Medical Group and as the medical director for California’s State Compensation Insurance Fund.

Under the current workers’ comp system, employers regularly pay for injuries with questionable causation factors. When it’s unclear whether an aging worker’s knee problems resulted from a strenuous job or from their genetic makeup, employers often pay for treatment through the less efficient workers’ comp system, Peplowski said.

So employers would be better off treating all injuries in the group health system without regard for causation, added Peplowski, who is now a consultant and proponent of combining workers’ comp medical care and group health care.

Under Kaiser’s 1990’s pilot, the health plan charged the County of San Diego $330 per employee per month for group health care plus $16 per employee per month for the expense of treating any workers’ comp injuries.

Successful results allowed Kaiser to return $200,000 to the county.

But other 1990s-era 24-hour-care pilots managed differently failed to produce positive results. At the same time, the rapidly increasing workers’ comp insurance pricing that fueled the interest in 24-hour care reversed.

That killed interest in continuing the innovation. Employers were content with cheaper insurance.


But things are different today, proponents of merging workers’ comp care with group health argue.

Today, drivers of ever increasing health expenses are not going away and will continue to place greater strain on employers, the proponents maintain.

There is also evidence that employers are growing increasingly restless with paying more to treat the same type of injury under workers’ comp than they do under their group health plan.

While many entrenched parties would resist a shift to a new workers’ comp treatment model, perhaps it is time for new pilot programs.

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2015 NWCDC Preview

Guidance for the Perplexed

This year’s workers’ compensation conference helps make sense of a shifting regulatory environment and an increasing array of vendors and solutions. 
By: | October 15, 2015 • 7 min read
Mandalay Bay Resort and Casino

The task of helping injured workers recover and managing their workers’ compensation and disability claims is growing increasingly complex.


Rising medical costs amid a shifting health care-delivery system present one set of challenges. The poor overall health of the nation’s workforce and regulations such as the amended Americans with Disabilities Act are additional forces complicating matters.

That is why delivering proven strategies for tackling the issues facing employers and other claims payers has become such a priority.

Scheduled for Nov. 11-13 at Mandalay Bay in Las Vegas, the 24th Annual National Workers’ Compensation and Disability Conference® & Expo will provide opportunities to meet with industry leaders and hear directly from peers providing practical solutions for medical, legal and claims-management issues, among other topics.

While Las Vegas offers up swank restaurants and clubs for evening relaxation, conference breakout sessions promise serious information and tactics for improving injured worker health, enhancing workers’ comp program performance and boosting an employer’s bottom line.

For example, Patti Colwell, Southwest Airlines’ workers’ comp program manager, will discuss a quality-assurance strategy for selecting service providers and determining whether they are delivering on their service promises.

The presentation is part of the conference’s Program Management track, developed to help employers and others eliminate injuries, improve operational performance, support injured worker health and speed return-to-work outcomes.

The track will include a session on applying data analytics and predictive modeling that can improve the focus of claims management and risk assessment — but only if applied properly.

It makes sense to learn about properly applying predictive modeling tools from colleagues who have gained practical knowledge by actually using the tools. So, Tim Starks, director of casualty at Georgia-Pacific, joins Frank Murray, SVP of claims at ESIS, to share lessons the employer gleaned from applying predictive analytic solutions.

Medical Management

Medical management is another shifting factor in claims management, on top of its increasing cost. The conference’s Medical Management track will provide up-to-date information on the topic.

A panel of the foremost medical directors in workers’ comp will speak about optimally applying medical intervention’s power, and the harm done when that doesn’t happen.

Adam L. Seidner of Travelers Insurance, along with Marcos Iglesias of The Hartford, will discuss how the Affordable Care Act will make smart medical-intervention strategies even more crucial. They’ll be joined by Mel Belsky, medical director of the workers’ comp program at Albertsons Safeway Inc.

Denise Zoe Algire, director of managed care and disability corporate risk management at Albertsons Safeway, will moderate the panel.

The Medical Management track will also include Lisa Kelly, senior workers’ compensation manager at Boeing, who will share results obtained from the employer’s outcomes-based provider network and Boeing’s efforts to select quality care doctors.

Kimberly George, SVP, senior healthcare advisor at Sedgwick, and Greg Moore, president and CEO at Harbor Health Systems, will join Kelly to explain Boeing’s preparations for the coming changes in the delivery of health care to injured workers, including emerging care models like accountable care organizations and value-based pricing.

Disability Management

Breakout sessions for this year’s conference were also crafted with a sharper focus on disability management.

Dave Taylor, director of integrated disability management at Reyes Holdings, will explain how his company applied integrated absence management to solve disability and productivity challenges.


Renee Mattaliano, VP and practice lead of workforce management at HUB International, will join Taylor to detail how Reyes, a beer and food distributor, marshalled the necessary investment, data, vendors, corporate health resources and internal talent required to succeed at integrated absence management.

The breakout session is part of the conference’s Disability Management track highlighting strategies for mitigating drivers of employee illness and absence, whether occupational or non-occupational.

Addressing the challenges of administering disability, workers’ comp and leave laws will be discussed during “Best Practices in Leave Management and ADA Administration,” a session led by Terri L. Rhodes, CEO for the Disability Management Employer Coalition, and Karen English, a partner at Spring Consulting Group LLC.

Claims Management

The conference’s Claims Management track promises practical information on today’s tools for mitigating claims issues.

Stephanie Perilli, senior director of medical & health management at The Home Depot, will share her experience on leveraging data to determine when injured workers benefit from nurse case manager care.

Mary O’Donoghue, VP of medical services at Helmsman Management Services, a unit of Liberty Mutual, will team up with Perilli to discuss the art of evaluating the value of data.

Legal and Regulatory

The conference’s Legal/Regulatory track will offer the opportunity to hear opposing views on current legislative efforts to allow employers to opt out of workers’ comp systems across more states.

Trey Gillespie, senior workers’ comp director at the Property Casualty Insurers Association of America, will argue the value of existing workers’ compensation and disability programs, while Bill Minick, president at PartnerSource, will explain proponents’ goals during a breakout moderated by Dan Reynolds, editor-in-chief at Risk & Insurance®.

The Legal/Regulatory track will also feature a session titled “Extreme Violence in the Workplace: Causation, Mental Trauma and Prevention.” Albert B. Randall Jr., a trial attorney at Franklin & Prokopik, and Lori A. Severson, senior loss control consultant at Lockton Cos., will examine violence prevention and incident response.

Below is a synopsis of some of the other sessions at this year’s event. The entire agenda can be found online.

Arthur M. Southam M.D., executive VP, Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals

Arthur M. Southam M.D., executive VP, Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals

Opening Keynote: Achieving Excellence in Medical Treatment

What to expect: Providing injured workers quality health care is increasingly crucial for improved claims outcomes. But how to obtain true quality care remains a challenge. Dr. Arthur Southam will share lessons learned from group health and explain how Kaiser has successfully driven measured improvements in care quality among its 9.6 million members.

Who: Arthur M. Southam M.D., executive VP, health plan operations for Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals.

Session: Walmart’s Campaign to Manage Prescription Drug Misuse

What to Expect: After Walmart identified and mitigated legacy claims impacted by high-dose morphine prescriptions, it developed a data-driven strategy to prevent prescribing of harmful pharmaceuticals among new claims. Hear how those lessons can be applied by working with your pharmacy benefit manager.


Who: Mark Pew, SVP, PRIUM; Janice Van Allen, director of workers’ compensation, Walmart Stores Inc.

Session: Managing Risks and Claims in the Age of Legalized Marijuana

What to Expect: Clinical and legal experts will discuss shifts in workplace policies, claims management standards and service-provider guidelines that claims payers must learn about to prepare for changing marijuana-use laws.

Who: Markie Davis, director, risk management, State of Colorado; Kevin Glennon, VP, clinical education & quality assurance programs, One Call Care Management; Gregory J. McKenna, VP & counsel, Gallagher Bassett Services; moderator: Denise Algire, director, managed care and disability corporate risk management, Albertsons Safeway.

Session: PG&E Puts Telephonic Injury Assistance in Employee Hands

What to Expect: Shorter injury durations and fewer workers’ comp claims became long-term disabilities when Pacific Gas and Electric Co. changed its culture and implemented a 24/7 telephonic injury management program providing injured employees contact with occupational health nurses and physicians.

Who: Bryon Bass, director, integrated disability management, Pacific Gas & Electric Co.; Dr. Peter P. Greaney, CEO and medical director, WorkCare Inc.

Session: Proven Workers’ Comp Claims Management Strategies That Get Results

What to Expect: Approaches for analyzing claim portfolios and improving claim reviews along with lessons for effectively collaborating with insurers and third-party administrators are on tap as a senior risk analyst shares program-management practices that produced results for her employer and can help companies of any size.


Who: Stephanie Tutt, corporate senior risk analyst, Computer Sciences Corp.

Session: Employee Focused Program — What Does It Mean and Will It Work?

What to Expect: Engaging employees for the best claims outcomes requires making them the focus of your program even before an injury occurs. This session will offer practical tips for keeping the injured employee at the forefront of your program’s efforts.

Who: Drake Rogers, attorney, Young Clement Rivers; Bill Wainscott, manager, workers’ comp and occupational health, International Paper.

Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.
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