Practical Solutions for a Changing Claims Environment
Many theories are emerging on the future of workers’ compensation in a rapidly changing world, but the National Workers’ Compensation and Disability Conference® & Expo built our upcoming 2015 session program mostly by focusing on existing solutions for claims payers’ current challenges.
Yet now that building the program for the 24th annual conference scheduled for November 11-13 at Mandalay Bay in Las Vegas is complete, I can also report that the lineup of 32 breakout sessions will include some forward-looking discussions.
Attendees will mostly find practical breakout-session presentations on topics like The Home Depot’s strategy for deploying nurse case managers, Southwest Airlines’ quality-assurance efforts for selecting vendor partners, and how employer Reyes Holdings applied an integrated disability and absence management approach.
Our selection group helped pick speakers often by favoring presentation proposals containing pragmatic solutions to the problems they and their industry colleagues face or see as emerging issues needing greater clarity.
The selection group included Denise Algire, director, managed care & disability corporate risk, Safeway Inc.; Bill Wainscott, manager workers’ compensation & occupational health, International Paper; Dan Reynolds, editor-in-chief, Risk & Insurance; and myself.
Like the rest of society, though, workers’ comp is seeing many technology-driven changes and more lie ahead, of course. That is driving thought-provoking, insurance industry discussions on topics such as how the future face of employment and increased use of robotics will impact underwriters.
Those are important considerations. But there remains a need to help workers’ comp professionals understand current applications for technology the industry is still coming to grips with, like the application of predictive analytics.
That is why the National Workers’ Compensation and Disability Conference® & Expo will provide sessions like one to be led by ESIS, explaining the industry’s data analytics and predictive modeling capabilities. The presentation will be backed by Georgia Pacific explaining of how it has actually applied the tools to improve claims results.
We did not, however, ignore discussions on emerging changes.
Sedgwick Claims Management Services Inc. and Harbor Health Systems, for example, will discuss evolving medical management topics such “accountable care, value-based pricing and patient engagement.” But with an eye to the practical, the session will also include a senior workers’ comp manager from Boeing sharing how the company’s current practices align with the expected shifts in healthcare delivery.
Our breakout sessions also look to enlighten on controversial topics impacting the workers’ comp industry. Attendees will have the opportunity to hear two opposing views on the movement pushing for more states to allow employers to opt out of their traditional workers’ comp systems as is currently allowed in Texas and Oklahoma.
The full conference agenda will be available online June 21.
But here is a sneak peak at what the agenda will include:
- Walmart and PRIUM sharing the retailer’s efforts to manage pharmaceutical misuse
- Pacific Gas and Electric’s adoption of a 24/7 telephonic injury management program
- LifeTEAM Health and a Kaiser Permanente medical director describing the results from helping injured employees overcome psychosocial risks with a biopsychosocial strategy
- A discussion on workplace violence, causation, mental trauma and prevention
- Explanations of strategies and available tools for administering the Americans with Disabilities Act and leave laws such as the Family Medical Leave Act.
- A Hyatt Hotels senior occupational health manager on practices for injury prevention, early intervention, and claim-severity mitigation.
It’s an agenda built with an aim to meet the needs of a cross section of workers comp and disability management professionals, including medical providers, attorneys, claims managers and risk management department leaders.
Organizers Comb Through Proposals, Build Program
The 24th annual National Workers’ Compensation and Disability Conference® & Expo takes place Nov. 11-13 at the Mandalay Bay Resort and Casino in Las Vegas. The conference is produced by LRP Publications, which also publishes Risk & Insurance® magazine.
Occupational as well as nonoccupational injuries and disabilities will be the focus of some sessions at this year’s conference. During the annual program planning meeting, the conference’s top advisors decided to increase the discussions of disability, while still providing plenty of workers’ comp-related sessions.
“We will be strengthening the disability track to broaden the definition of ‘disability’ beyond workers’ comp, to other claims,” said Roberto Ceniceros, conference chair and senior editor at Risk & Insurance® Magazine. “We want to expand the audience that can benefit” from the conference.
Disability Management remains one of five tracks housing the sessions (see box). While it will receive increased attention, Ceniceros said that won’t detract from the emphasis on workers’ comp.
“Our new program cochair Bill Wainscott [manager of workers’ compensation and occupational health at International Paper] is super strong in workers’ comp,” he said. “So we’re strengthening our traditional focus on worker’s comp.”
The increased focus on disability resulted from evaluations submitted by previous conference attendees. “The input we receive from attendees is invaluable in helping us build the next year’s conference program,” Ceniceros explained. “It gives us direction and guides us through the whole process.”
Building the Program
Members of the conference advisory board are currently combing through the hundreds of speaking proposals submitted. Program cochairs Wainscott and Denise Gillen-Algire, director of managed care and disability corporate risk for Safeway Inc., have begun the arduous task of carefully reading and analyzing the proposals to whittle them down to those that will be included.
“We received many great proposals on a wide variety of topics — current trends and issues of concern to workers’ comp and disability practitioners,” Ceniceros said. “We especially look for those that emphasize education; information that attendees can take back to their workplaces and put into action.”
This year, conference organizers are getting help from Dan Reynolds, editor-in-chief of Risk & Insurance. “Dan is part of the team helping to select the proposals along with Bill and Denise,” Ceniceros said. “I’ll weigh in with my thoughts after the others. That’s the process.”
Once the list has been narrowed down by the chairs and Reynolds, the additional members of the advisory board will offer their opinions. This year’s advisors include:
Kathryn Caverly, senior director of product planning at LexisNexis; Dr. Marianne Cloeren, medical director of Managed Care Advisors Inc. and chair of the American College of Occupational and Environmental Medicine’s Council on Occupational and Environmental Medicine Practice and a member of the ACOEM board of directors; Jill Dulich, senior director at Marriott Claims Services; Kenneth Eichler, director of regulatory and outcome initiatives at Work Loss Data Institute; Max Koonce, senior director of risk management at Walmart; John T. Leonard, president and CEO of MEMIC; Maureen McCarthy, senior vice president and manager of workers’ compensation claims and managed care at Liberty Mutual; Joseph Paduda, principal of Health Strategy Associates, and author and blogger for ManagedCareMatters; Rebecca Shafer, president of Amaxx Risk Solutions Inc.; Mark Sidney, vice president of claims for Midwest Employers Casualty Company (a W.R. Berkley Company); Patrick J. Walsh, vice president and chief claims officer of corporate claims at Accident Fund Holdings Inc.; Mark Walls, vice president of Communications and Strategic Analysis at Safety National and founder of the Work Comp Analysis Group on LinkedIn.
“The advisory board members are all very accomplished workers’ comp and disability professionals,” Ceniceros said. “They represent all different facets of the industry such as employers, insurers, vendors, and others.”
Once again, conference leaders are honing in on the needs of employers in building the program. Attendees will see many new speakers and cutting-edge issues, mixed in with several returning sessions.
“The ‘60 Tips in 60 Minutes’ session continues to be very popular,” Ceniceros said. “While we have not yet identified the panelists for it, we know they will represent a mix of professions and personalities. People tell us they really enjoy the fast pace, entertainment of the session — and, of course, the great information provided.”
Risk Scenarios Live! will return for a third year. The multimedia-driven session offers an interactive discussion of a typical workers’ comp claim as it develops, giving attendees the chance to weigh in with their thoughts and recommendations at certain points and hear from an expert panel.
Also returning will be the bloggers. The top social media posters in workers’ comp and disability will be back to opine on the top issues of the day based largely on input from readers throughout the year.
Visit the conference website for more information.
RIMS Recap: Tech Trends that Could Change Everything
Last month, Gordon Clemons, CEO and Chairman of CorVel Corporation, presented at the RIMS Conference in New Orleans, La. about emerging technology and how it is impacting risk management and workers’ compensation. The discussion served as a springboard for new insights on how technology will change the industry, and reaffirmed the need for integrated systems and human interaction for the best results.
The presentation noted the future is here – and technology is constantly evolving in hopes of outpacing tomorrow’s needs. As these technology platforms become more inherent in daily life, the gap in translating their utilization to workers’ compensation will begin to close.
Technology in Healthcare
While many consumer-based technology advancements exist in other industries, perhaps most notably in the retail space helping vendors to reduce various delays in the sales experience, people may forget that healthcare, too, is a consumer industry. And as such, healthcare also experiences workflow lags, which can be collapsed.
While patients and claims may not lend themselves as freely to mobile applications and technology that subscribes to the “Internet of Things” philosophy, the rapid rate of development foretells the not-too-far-off arrival of the “a-ha,” “wow factor”-type application that consumers are seeking in the healthcare industry.
Once we get there, we can only expect that the Pangea of resources will yield better outcomes. The potential impact to medical management includes more affordable/accessible healthcare, patient convenience, personal assistance, automatic inputs to claims systems and less administration from both patients and injured workers.
“Healthcare is stubborn about change. There are more data points in healthcare and there is a greater need for high quality and accuracy,” Clemons said.
Tech Trends for the Next Digital Decade
As an industry advocate in all things innovation, CorVel has been keeping tabs on emerging tech trends. As they begin to influence in other industries, it sparks the question – will they eventually change workers’ compensation?
Here are some of the trends on CorVel’s radar:
Smart phones and tablets were the first mobile devices to really start to gain traction across people’s personal lives. Since then, wearables (like Fitbits and smart watches) have been part of the next digital generation to be taken up by consumers.
As these personal devices quickly advance, wearables could offer payors and employers added insight into the wellness of claimants through the extent of their retrievable data.
Beacons are devices that use low-energy Bluetooth connections to communicate messages or triggers directly to a smart device (such as a phone or tablet). Retailers have started using this technology, sending offers to near-by consumers’ phones. Now the concepts of smart mirrors and smart walls offer a one-stop-shop with recommendations related to the preferences of the shopper – making a hyper-efficient business model. It is possible that we could see these devices adapted to being a catalyst for healthcare’s business model by reducing the delays of administrative work.
Formally known as unmanned aerial vehicles (UAV), drones can be remote-controlled or flown autonomously through pre-defined flight plans within their internal systems. Some carriers are testing the use of drones to potentially be used to evaluate property damage and responding to natural disasters.
As most injuries reported in workers’ compensation are musculoskeletal injuries, the industry lends itself well to the benefits of telecommunications and telemedicine. With the rise of electronic capabilities, telemedicine becomes another option to help guide an injured worker through their entire episode of care, reducing time delays.
In order to get to that point in time, implementing these trends (and those that are yet to be launched) will only be as successful as the population willing to accept them. Buy-in will require a commitment to the long-standing pillars of the industry. According to Clemons, “While technology can truly move the needle in workers’ compensation, it will take more than bells and whistles to maximize its impact.”
“People’s feelings are valid. The skepticism surrounding new technology is not misplaced, but neither is the enthusiasm,” Clemons said.
New Trends, Same Priorities
Beyond the buzzwords and hype surrounding the latest apps and devices, for new technology to succeed within the workers’ compensation realm, it boils down to the two primary concepts that drive the industry to begin with – effective infrastructure and a people-first philosophy.
The power of applicable resources and the actionable data that results from them is in the foundation of the systems themselves; that primarily being through the influence of integration. It is not a new concept; however, as technology advances and the reach of analytic capabilities broadens, it is important to find a provider that can harness this data and channel it into effective workflows to increase efficiencies and promote better outcomes.
CorVel’s proprietary claims management system has been developed and supported by an in-house, full-time information systems division to be intuitive and user-friendly. Complex, proprietary algorithms link codified data across the system, facilitating collaboration between services, workflows, customers, and technology and eliminating the risk that a crucial piece of information will be missed. The result is an active “ecosystem” providing customers with actionable data to provide the most accurate, comprehensive picture at any time, while also collapsing inherent delays.
For the injured worker, the critical human touch connection in the workers’ compensation process can never be minimized. By cutting lag time throughout the various inefficiencies underlying the industry’s workflows, CorVel can connect injured workers with quality care sooner. As systems advance, claims and managed care associates do not have to spend as much time on administrative work and will instead be able to devote more time to the injured workers, reviving the human touch aspect that is just as impactful within the industry.
Regardless of the technology that lies ahead, CorVel looks to the future with investments in innovation, while not losing sight of their role and responsibility to clients and patients. Dedicated to constant improvement for the services they provide injured workers and industry payors, CorVel is committed to improving industry services one app, click, drone (or whatever is yet to come) at a time – perhaps something to discuss in San Diego at next year’s RIMS conference.
For more information, visit corvel.com.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with CorVel Corporation. The editorial staff of Risk & Insurance had no role in its preparation.