2016 Power Broker

Power Broker Rising Stars

The class of 2016 impresses with its size and quality.
By: and | March 1, 2016 • 3 min read

Judging the talent employed by commercial insurance brokers leads us to one conclusion; optimism is the order of the day.

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As we discovered this year, not only are the ranks of high-achieving younger brokers as strong as ever, they are increasing in number.

We’ve renamed our Power Broker® “Under 40” category to “Rising Stars” to better celebrate this wave of talent and to focus on an important point. Yes, this is a younger group of professionals, all of them under 40, but it’s more on point to think of them as the future leaders of this profession.

As Power Broker® winners and finalists, this set of Rising Stars demonstrated a superior level of creativity in finding solutions for their clients, unflagging customer service and a devotion to learning more about their industry.

Just four years ago, the number of brokers honored by this designation hovered around 40. Last, year, there were 54 Power Broker® winners and finalists recognized in the Under 40 category.

Over the next few pages, you will see the names and affiliations of 77 brokers we recognize as Rising Stars. Since the launch of this category in 2009, more than 250 brokers under 40 received the designation.

The average age of the Rising Stars designees is 36. They represent a powerful wave of talent that is bolstering a profession, which like many other professions will be challenged to replace talent as the baby boomers retire.

For this group of Rising Stars, a career in commercial insurance brokerage is a compelling challenge that results in rich rewards.

“I really enjoy telling ‘the story’ on behalf of my client to the insurance carrier, to pique their interest in an account,” — Ashley De Paola, assistant vice president, Alliant

We first came to know Lockton’s Christopher Keith when he broke into the Power Broker® ranks as a winner in the Workers’ Compensation category in February 2013.

In those days, Keith worked for the Philadelphia-based Graham Co. Keith, 39, said it’s the “entrepreneurial” nature of the business that he finds so rewarding.

“I like the fact that I am managing my own profit and loss statement,” said Keith, who this year achieved Power Broker® status in the Aviation category.

Ashley De Paola, assistant vice president, Alliant

Ashley De Paola, assistant vice president, Alliant

At Lockton’s annual President’s Dinner, he was recognized as the “prototype” Lockton producer.

“I’m very proud of that,” he said.

Alliant’s Ashley De Paola, 33, a 2016 Power Broker® in the Real Estate category, said it’s the quick-paced, evolving atmosphere of commercial insurance brokerage that excites her.

“I really enjoy telling ‘the story’ on behalf of my client to the insurance carrier, to pique their interest in an account,” De Paola said.

Earlier in her career, a client expressed his concern over her age and experience. Her review of his insurance program changed his mind.

“It was very rewarding when he later asked me to work on his business,” she said.

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Beecher Carlson’s Joe Roberta, a 2016 Power Broker® winner in the Private Equity category, has several reasons he likes working in this industry. Top of the list is that this is a very “social industry.”

“I truly enjoy working with people that I’ve been fortunate enough to build long-term relationships with,” he said.

Justin Wiley, 32, Power Broker® winner in the Public Sector category, works for Arthur J. Gallagher & Co., which prides itself on its mentoring efforts.

The company sent Wiley to Orlando, Fla., to work with veteran Rich Terlecki, himself a multiple Power Broker® winner.

“My goal was to learn and gather from him as much intellectual capital as possible,” Wiley said.

Clearly, Terlecki taught him well.

The 2016 Power Broker® Rising Stars

Morgan Anderson, 38 Arthur J. Gallagher Irvine, Calif. Real Estate

Morgan Anderson, 38
Arthur J. Gallagher
Irvine, Calif.
Real Estate

Peter Ballas, 33 Aon Morristown, N.J. At-large

Peter Ballas, 33
Aon
Morristown, N.J.
At-large

Brooke Barnett, 37 Marsh Los Angeles Entertainment

Brooke Barnett, 37
Marsh
Los Angeles
Entertainment

Herman Brito Jr., 26 Marsh New York Marine

Herman Brito Jr., 26
Marsh
New York
Marine

John Byers, 34 Aon Franklin, Tenn. Employee Benefits

John Byers, 34
Aon
Franklin, Tenn.
Employee Benefits

Sandy Carter, 32 Beecher Carlson Atlanta Automotive

Sandy Carter, 32
Beecher Carlson
Atlanta
Automotive

Brandon Cole, 31 Arthur J. Gallagher Irvine, Calif. Nonprofit

Brandon Cole, 31
Arthur J. Gallagher
Irvine, Calif.
Nonprofit

Edward Conlon, 37 Aon New York Financial Institutions

Edward Conlon, 37
Aon
New York
Financial Institutions

Chris Connelly, 32 Arthur J. Gallagher Orlando, Fla. Public Sector

Chris Connelly, 32
Arthur J. Gallagher
Orlando, Fla.
Public Sector

Anne Corona, 38 Aon San Francisco Technology

Anne Corona, 38
Aon
San Francisco
Technology

Cara Cortes, 35 Aon Pittsburgh At-large

Cara Cortes, 35
Aon
Pittsburgh
At-large

Uri Dallal, 37 Aon New York Financial Institutions

Uri Dallal, 37
Aon
New York
Financial Institutions

Ashley De Paola, 33 Alliant New York Real Estate

Ashley De Paola, 33
Alliant
New York
Real Estate

Brian Dougal, 38 Aon San Francisco Real Estate

Brian Dougal, 38
Aon
San Francisco
Real Estate

Justin Dove, 29 Arthur J. Gallagher San Francisco Real Estate

Justin Dove, 29
Arthur J. Gallagher
San Francisco
Real Estate

Patrick Drake, 27 Aon Southfield, Mich. Utilities, Alternative

Patrick Drake, 27
Aon
Southfield, Mich.
Utilities, Alternative

Dan Edelstein, 37 Willis Towers Watson New York Manufacturing

Dan Edelstein, 37
Willis Towers Watson
New York
Manufacturing

Tim Farward, 36 Marsh Philadelphia Utilities, traditional

Tim Farward, 36
Marsh
Philadelphia
Utilities, traditional

Larissa Gallagher, 28 Aon Southfield, Mich. Manufacturing

Larissa Gallagher, 28
Aon
Southfield, Mich.
Manufacturing

Dominic Gallina, 39 Aon New York Real Estate

Dominic Gallina, 39
Aon
New York
Real Estate

Kevin Garvey, 37 Aon Cleveland Automotive

Kevin Garvey, 37
Aon
Cleveland
Automotive

Matthew Giambagno, 26 Marsh, New York Energy/Downstream

Matthew Giambagno, 26
Marsh, New York
Energy/Downstream

Blake Giannisis, 36 Aon New York Real Estate

Blake Giannisis, 36
Aon
New York
Real Estate

George Gionis, 33 Aon Philadelphia At-large

George Gionis, 33
Aon
Philadelphia
At-large

Debbie Goldstine, 39 Lockton Chicago Manufacturing

Debbie Goldstine, 39
Lockton
Chicago
Manufacturing

Sarah Goodman, 36 Marsh New York Pharma/Life Sciences

Sarah Goodman, 36
Marsh
New York
Pharma/Life Sciences

Jessica Govic, 30 Arthur J. Gallagher Itasca, Ill. Public Sector

Jessica Govic, 30
Arthur J. Gallagher
Itasca, Ill.
Public Sector

Robert Hale, 39 Aon London Utilities, traditional

Robert Hale, 39
Aon
London
Utilities, traditional

Joshua Halpern, 34 Aon New York Private Equity

Joshua Halpern, 34
Aon
New York
Private Equity

Matthew Heinz, 39 Aon New York Private Equity

Matthew Heinz, 39
Aon
New York
Private Equity

Charlie Herr, 25 Arthur J. Gallagher Kansas City, Mo. Education

Charlie Herr, 25
Arthur J. Gallagher
Kansas City, Mo.
Education

Blythe Hogan, 31 Aon New York Fine Arts

Blythe Hogan, 31
Aon
New York
Fine Arts

James Jackson, 35 Willis Towers Watson New York Financial Institutions

James Jackson, 35
Willis Towers Watson
New York
Financial Institutions

Sarah Johnson Court, 35 Aon, Miami Fine Arts

Sarah Johnson Court, 35
Aon, Miami
Fine Arts

Christopher Keith, 39 Lockton Blue Bell, Pa. Aviation & Aerospace

Christopher Keith, 39
Lockton
Blue Bell, Pa.
Aviation & Aerospace

Charlie King, 36 Alliant Houston Energy/Upstream

Charlie King, 36
Alliant
Houston
Energy/Upstream

Jonathan Kosin, 37 Aon Southfield, Mich. Construction

Jonathan Kosin, 37
Aon
Southfield, Mich.
Construction

Tyler LaMantia, 29 Arthur J. Gallagher Itasca, Ill. Education

Tyler LaMantia, 29
Arthur J. Gallagher
Itasca, Ill.
Education

Jeanna Madlener, 37 Wells Fargo Portland, Ore. At-large

Jeanna Madlener, 37
Wells Fargo
Portland, Ore.
At-large

 Kimberly Mann, 27 Marsh Philadelphia Environmental


Kimberly Mann, 27
Marsh
Philadelphia
Environmental

Kristina Marcigliano, 27 DeWitt Stern New York Fine Arts

Kristina Marcigliano, 27
DeWitt Stern
New York
Fine Arts

 Matt Medeiros, 34 Arthur J. Gallagher Media, Pa. Retail


Matt Medeiros, 34
Arthur J. Gallagher
Media, Pa.
Retail

Mary Mulhern, 33 Marsh Chicago Health Care

Mary Mulhern, 33
Marsh
Chicago
Health Care

Dennis Nevinski, 31 Aon Chicago Aviation & Aerospace

Dennis Nevinski, 31
Aon
Chicago
Aviation & Aerospace

Lee Newmark, 28 Arthur J. Gallagher Itasca, Ill. Health Care

Lee Newmark, 28
Arthur J. Gallagher
Itasca, Ill.
Health Care

Jake Onken, 26 Aon Houston Health Care

Jake Onken, 26
Aon
Houston
Health Care

Joanna Paredes, 28 Rekerdres & Sons Dallas Marine

Joanna Paredes, 28
Rekerdres & Sons
Dallas
Marine

Stephen Pasdiora, 27 Cottingham & Butler Rosemont, Ill. Employee Benefits

Stephen Pasdiora, 27
Cottingham & Butler
Rosemont, Ill.
Employee Benefits

Stefanie Pearl, 35 Marsh New York Financial Institutions

Stefanie Pearl, 35
Marsh
New York
Financial Institutions

Jason Peery, 37 Aon Newport Beach, Calif. Real Estate

Jason Peery, 37
Aon
Newport Beach, Calif.
Real Estate

Adrian Pellen, 32 Aon Chicago Construction

Adrian Pellen, 32
Aon
Chicago
Construction

Chris Rafferty, 36 Aon Chicago Manufacturing

Chris Rafferty, 36
Aon
Chicago
Manufacturing

Daniel R’bibo, 36 Arthur J. Gallagher Glendale, Calif. Entertainment

Daniel R’bibo, 36
Arthur J. Gallagher
Glendale, Calif.
Entertainment

Brent Rieth, 30 Aon San Francisco Technology

Brent Rieth, 30
Aon
San Francisco
Technology

 Joe Roberta, 35 Beecher Carlson New York Private Equity


Joe Roberta, 35
Beecher Carlson
New York
Private Equity

Robert Rosenzweig, 30 Risk Strategies New York Technology

Robert Rosenzweig, 30
Risk Strategies
New York
Technology

 Patrick Roth, 35 Aon Denver Pharma/Life Sciences


Patrick Roth, 35
Aon
Denver
Pharma/Life Sciences

 Laura Rubin, 33 Beecher Carlson Boston Utilities, Alternative


Laura Rubin, 33
Beecher Carlson
Boston
Utilities, Alternative

 Ian Schwartz,31 Aon Los Angeles Real Estate


Ian Schwartz,31
Aon
Los Angeles
Real Estate

Christopher Shorter, 36 Aon Houston Energy/Downstream

Christopher Shorter, 36
Aon
Houston
Energy/Downstream

Brian Simons, 34 Aon New York Financial Institutions

Brian Simons, 34
Aon
New York
Financial Institutions

Andrew Smith, 28 Marsh New York Marine

Andrew Smith, 28
Marsh
New York
Marine

Timothy Sullivan, 38 Willis Towers Watson Boston Financial Institutions

Timothy Sullivan, 38
Willis Towers Watson
Boston
Financial Institutions

Kurt Thoennessen, 37 Ericson Ins. Advisors Washington Depot, Conn. Private Client

Kurt Thoennessen, 37
Ericson Ins. Advisors
Washington Depot, Conn.
Private Client

 John Tomlinson, 37 Lockton Encino, Calif. Entertainment


John Tomlinson, 37
Lockton
Encino, Calif.
Entertainment

 Kaitlin Upchurch, 30 Wortham Houston At-large


Kaitlin Upchurch, 30
Wortham
Houston
At-large

 Liz Van Dervort, 30 Gillis, Ellis & Baker New Orleans Nonprofit


Liz Van Dervort, 30
Gillis, Ellis & Baker
New Orleans
Nonprofit

 Rene Van Winden, 36 Aon Houston Energy/Downstream


Rene Van Winden, 36
Aon
Houston
Energy/Downstream

Ben Von Obstfelder, 30 Aon Wauconda, Ill. Retail

Ben Von Obstfelder, 30
Aon
Wauconda, Ill.
Retail

Michael Walsh, 35 Marsh Boston Real Estate

Michael Walsh, 35
Marsh
Boston
Real Estate

Emily Weiss, 29 DeWitt Stern New York Fine Arts

Emily Weiss, 29
DeWitt Stern
New York
Fine Arts

Jeremiah White, 38 Aon Frederick, Md. Transportation

Jeremiah White, 38
Aon
Frederick, Md.
Transportation

 Joshua White, 28 Gulfshore Insurance Naples, Fla. Private Client


Joshua White, 28
Gulfshore Insurance
Naples, Fla.
Private Client

Casey Wigglesworth, 37 Aon Washington, DC Fine Arts

Casey Wigglesworth, 37
Aon
Washington, DC
Fine Arts

 Justin Wiley, 33 Arthur J. Gallagher Orlando, Fla. Public Sector


Justin Wiley, 33
Arthur J. Gallagher
Orlando, Fla.
Public Sector

Wendy Wu, 38 Aon Shanghai Automotive

Wendy Wu, 38
Aon
Shanghai
Automotive

Susan Young, 30 Marsh Seattle Retail

Susan Young, 30
Marsh
Seattle
Retail

Dan Reynolds is editor-in-chief of Risk & Insurance®. He can be reached at [email protected] Tom Starner, a freelance journalist, can be reached at [email protected]
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2016 Power Broker

At Large

Clout in the Market

Cara Cortes Vice President Aon, Pittsburgh

Cara Cortes
Vice President
Aon, Pittsburgh

Few things are more important to boards of directors and corporate officers than directors and officers coverage – and that is where Aon’s Cara Cortes excels.

One private equity portfolio company needed D&O coverage at the end of the month. They couldn’t get an extension and an application had yet to be filled out.

Two days before coverage expired, the company asked Chip Gutshall, CEO of Work Comp Strategic Solutions, another of the portfolio companies, for help. He immediately called Cortes, who raced to the rescue.

“She got a 60-day extension for the application,” Gutshall said. “That was awesome. She carries a lot of clout within the market to pull something like that off.”

Cortes has also been extremely helpful in D&O and employment practices liability claims, he said.

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“I wouldn’t trade her for anyone,” he said.

A risk manager in the Midwest said that Cortes “does a great job at matching up our exposure, our risk, with the best potential partners.

“We were able to significantly improve the coverage in several respects and to reduce the cost beyond what the [soft] market was.”

Cortes’ assistance with cyber coverage for St. Clair Hospital was what stood out the most for Linda Lattner, corporate compliance officer at the hospital.

Longstanding Expertise

Craig Howser Executive Vice President Alliant, Chicago

Craig Howser
Executive Vice President
Alliant, Chicago

There’s a limited market for professional lawyer liability, and Craig Howser is an expert at searching out the best specialized coverage for his clients.

“He’s at the top of my list as a business partner for our firm,” said Judy Vetkoetter, executive director of Gardere Wynne Sewell.

“He is really on top of our business and the kinds of challenges the legal industry faces. He is very connected and resourceful as far as market options go. I sing his praises.”

Instead of market-driven premium increases at renewal, Howser has been able to point out to underwriters the uniqueness of Gardere’s effective risk management to put together a solution that lowered the firm’s self-insured retention.

He is also a strategic thinker, introducing Gardere to new underwriters even when there wasn’t an immediate need. That approach paid off a few years ago when a previous lead underwriter decided to change its approach to insuring large law firms.

Howser assisted the Gibbons PC law firm when it left a captive program it had been with for 25 years and entered the commercial marketplace.

“We have saved millions and millions of dollars in premiums over the past few years,” said Patrick Dunican, chairman and managing director.

In addition, the firm’s coverage was broadened by a manuscripted policy form that included possible future exposures such as cyber liability or data breaches.

On the Cutting Edge

Randy Nornes Executive Vice President Aon, Chicago

Randy Nornes
Executive Vice President
Aon, Chicago

The risks and exposures of companies in the new sharing economy receive significant media attention and face uncertain regulatory demands.

Although many insurers steer clear of such high-profile risks, Randy Nornes was able to do “extraordinary work” in helping one such company gain the coverage it needed, according to a risk executive at a sharing economy company.

“He was really, really good. He is No. 1,” said the executive. “I can’t give you a lot of detail but he was able to help us develop things in the market from scratch from financial structure to policy writing.

“He connected us with the right resources to create something that the market was not very open to getting involved with,” he said.

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“His most important asset was to help insurers get comfortable with the risk,” the executive said.

And Nornes is constantly available. “He is like an ER, working 24/7. It is outstanding customer service.”

Nornes is also a crucial asset in helping clients and insurers better understand the risks associated with the Internet of Things. IoT risks are broader than the privacy, reputational and liability exposures typically included in cyber coverage, as IoT also includes physical risks.

One of the Team

Michael Falvey Executive Vice President Willis Towers Watson, Norfolk, Va.

Michael Falvey
Executive Vice President
Willis Towers Watson, Norfolk, Va.

Weis Markets Inc. lost its risk manager this year, but rather than replacing the position, it relied more heavily on the expertise and knowledge of Michael Falvey.

“He really goes above and beyond the normal insurance broker,” said Chris De Tray, director, safety and risk management, Weis Markets.

In addition to placing insurance and shepherding renewals, Falvey is “the best business partner out there,” helping Weis proactively deal with risk management concerns, including vendor risk transfer and safety reviews.

“He absolutely is an extension of our department and understands what our model is. He does a very, very good job of making sure we are not at risk,” De Tray said.

For the Virginia Port Authority, Falvey helped Chris Harrell, vice president, contracts and risk management, rebuild the insurance program “from the bottom up. When I say the program, I mean 3,000 employees, six marine terminals and every policy you can think of from executive liability coverage to auto to human resources to ships on terminal.

“When we rebuilt it, it consolidated a lot of things,” he said. “It was a big value add.”

Marti Dickman, vice president, risk management, ADS Waste Holdings Inc., said “the quality and level of performance we get from Michael is exceptional.”

Active in acquisitions, ADS has been challenged with the structure and poor claims history of some legacy programs.

Responsive and Knowledgeable

Jeanna Madlener Vice President, Senior Sales Executive Wells Fargo Insurance, Portland, Ore.

Jeanna Madlener
Vice President, Senior Sales Executive
Wells Fargo Insurance, Portland, Ore.

Whether it’s addressing workers’ comp issues or the diverse needs of nonprofit organizations, Jeanna Madlener is creative, responsive and knowledgeable.

“Jeanna is tremendous,” said Vincent Salvi, risk and compliance manager at Northwest Evaluation Association (NWEA), which provides educational services to associations worldwide.

The insurance requirements from some schools can be “quite unusual,” he said, but Madlener resourcefully helps NWEA work through those challenges.

Two challenges affecting The Dussin Group, whose restaurant portfolio includes the Old Spaghetti Factory, were workers’ compensation and letters of credit, said Dean Griffith, president.

“Our outstanding letters of credit were frustrating to us,” he said, noting that Madlener “worked very hard to get those down.”

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She was also instrumental in collaborating with the company’s medical provider to take responsibility for an expensive workers’ comp claim with reserves in excess of $250,000. The loss was decreased to just over $25,000, reducing the impact to Dussin Group’s premium expenses by more than 15 percent over the next three years.

Scrutinizing safety issues is also crucial, Griffith said. The company doesn’t want “rainbows and sunshine” from her store audits, he said. “A safe work environment is not just great on the cost side, but also for our people.”

Navigating Cyber Policies

Kaitlin Upchurch Managing Director Wortham, Houston

Kaitlin Upchurch
Managing Director
Wortham, Houston

Placing cyber policies is a complex undertaking, but for retail and health care organizations, that task is significantly more demanding. Kaitlin Upchurch nails it.

“She is just very, very good,” said Margot Roth-L’Heureux, global director of risk management, Whole Foods Market Inc. “She did a tremendous job.

“As anyone in the insurance world knows, cyber is not easy for anybody in retail,” she said. “You have to count on your broker to structure your program correctly and manage your expectations.

“Cyber has a lot of visibility with your officers and board right now. She brought good candidates to the table and different configurations for not only the best way to use money in our budget but to get us the best coverage,” Roth-L’Heureux said.

James Banfield, director of risk management/associate general counsel at Baylor College of Medicine, echoed those sentiments.

After years of self-insuring, Baylor wanted to explore going to market for cyber coverage. Upchurch took the lead, offering information and helping Baylor complete the “fairly extraordinary” applications.

When Baylor was dismayed about the prospect of completing each insurer’s separate application, Upchurch was able to convince the insurers to use a common document, with Baylor providing additional information if needed.

BlackBar

Finalists:

George Gionis, Account Executive, Aon

George Gionis, Account Executive, Aon

Thomas Sewell, Senior Vice President, Insurance Brokering Executive, Wells Fargo Insurance

Thomas Sewell, Senior Vice President, Insurance Brokering Executive, Wells Fargo Insurance

Patrick Walsh, Regional Executive Vice President, Arthur J. Gallagher

Patrick Walsh, Regional Executive Vice President, Arthur J. Gallagher

Peter Ballas CISR, Senior Broker, Aon

Peter Ballas
CISR, Senior Broker, Aon

Timothy Egan Senior Vice President, NY Global Property, Willis Towers Watson

Timothy Egan
Senior Vice President, Global Property, Willis Towers Watson, NY

 

 

 

 

 

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Sponsored: Liberty Mutual Insurance

To Better Control Total Workers Comp Costs, Manage Physical Medicine

The time is ripe to consider physical medicine to better manage the total cost of risk.
By: | April 4, 2016 • 6 min read

Soaring drug prices get all the attention in the workers comp space. Meanwhile, another threat has flown under the radar.

More than 50 percent of lost time workers compensation claims involve physical medicine — an umbrella term encompassing physical therapy, occupational therapy, work conditioning, work hardening and functional capacity evaluation.

Spending on physical medicine accounts for 20 to 30 percent of total workers compensation medical costs, a percentage set only to increase in the coming years. Despite the rapid growth of this expense, very few employers are engaged in discussions around how best to manage it.

“Now is the time to take a look at physical medicine and think about how it impacts total cost of risk,” said Frank Radack, Vice President & Manager, Liberty Mutual Insurance, Commercial Insurance – Claims Managed Care. “Employers should investigate comprehensive solutions to keep costs manageable and to deliver quality, evidence-based care to injured employees.”

Liberty Mutual’s Frank Radack defines physical medicine and why it is so important in managing total workers compensation costs.

Cost Drivers

Upswings in both pure cost and utilization of physical medicine are driving the spending surge. State fee schedule changes are largely responsible for increases in cost. California, for example, has increased the cost of physical medicine services by 38 percent over the past two years, and will increase it a total of 64 percent by the end of 2017. North Carolina changed its approach to its fee schedule effective June 1, 2015, resulting in an almost 45 percent increase in the cost of the average physical therapy visit.

Increased utilization compounds rising prices. Low severity claims like soft tissue injuries typically involve physical therapy, especially when co-morbid conditions threaten to slow down recovery.

“When co-morbids are present, like obesity, more conditioning is necessary for recovery from injury,” Radack said. “With people staying in the workforce longer, we see these claims more often because these types of injuries and co-morbid conditions become more common as people age.”

De-emphasis on surgery also bolsters physical therapy prescribing as patients seek less invasive treatments that might enable a faster return to work, even in a light or transitional duty role. Sometimes, patients with a minor injury might seek out physical therapy on their own as a precaution after an injury or under the mistaken belief it will hasten recovery, even if evidence-based guidelines don’t call for it in every treatment plan.

LM_SponsoredContent“Now is the time to take a look at physical medicine and think about how it impacts total cost of risk. Employers should investigate comprehensive solutions to keep costs manageable and to deliver quality, evidence-based care to injured employees.”
–Frank Radack, Vice President & Manager, Liberty Mutual Insurance, Commercial Insurance – Claims Managed Care

“Without proper claims management procedures, some physicians might be inclined to prescribe physical therapy as a palliative measure, even when it doesn’t provide much benefit to the patient,” Radack said.

Building Solutions

Brokers and buyers may not be able to do much about fee schedule changes, but they can partner with an insurer that better manages utilization through a multi-faceted claims system, qualified network vendors, data analytics, and peer interventions.

The keys to better managing the soaring cost of physical medicine.

“There is an opportunity to move physical medicine spending into network solutions and partnerships,” Radack said. A strong, collaborative network is key to maintaining direction over treatment decisions.

Liberty Mutual uses a proprietary data analytics program to study its providers’ prescribing and referral patterns and their outcomes. It then builds a network of point-of-entry general practitioners with a proven track record of optimal outcomes.

“The treating physician is a gatekeeper to other services, so it’s important to start there in terms of establishing a plan and making sure evidence based guidelines are followed,” Radack said.

Radack and his team use similar data analysis and partnerships to deploy networks pertaining only to physical medicine, so it can identify physical therapists who understand the occupational space and are focused on effective Return-to-Work (RTW). A provider who doesn’t understand RTW, or even know that the employer of an injured worker has a modified RTW program, may over-utilize PT. Getting employees with soft tissue injuries back into the work place is critical for delivering the best possible medical outcome and a timely recovery.

These therapists know the value of adjusting a treatment plan based on a patient’s progress, which often cuts unnecessary appointments and therapies.

“Our data analytics program is built internally by people who are aligned with the claims organization,” Radack said. “These insights drive our ability to shape networks and direct injured workers to providers with proven outcomes.”

Peer-to-peer interventions also play a big role in adjusting provider behavior and ensuring adherence to evidence-based guidelines. Liberty Mutual’s in house regional medical directors can bring their expertise to bear on challenging claims and discuss how to redirect treatment to meet these guidelines. Liberty Mutual also partners with experts to build networks of physical medicine and physical therapy providers who deliver quality outcomes cost-effectively and to asses a patient’s progress, working with providers to identify and resolve treatment issues.

Sharing information and measuring performance in these settings helps to change the environment around physical medical care. For example, interventions that steer physical therapists back to  established, evidence-based medical treatment guidelines often reduce the use of passive therapy treatments, like hot and cold packs, which are not as effective and can slow down recovery.

“Active therapies that get people moving often help them get them back to work faster and at a lower cost,” Radack said. Utilization review also helps to identify unnecessary treatments and signals the insurer to communicate evidenced-based expectations with the therapist or prescribing physician.

Solutions in Action

Physical therapy offers great value in spite of rising prices — but only if it’s managed carefully.

An example of the benefits of managing physical medicine.

Take for example the case of a worker with a shoulder injury. In an unmanaged situation, a physical therapist may prescribe 12 appointments, and the injured worker will go through all 12 sessions with no pre-approval of the treatment plan and no interim checkup.

In a managed situation, the physical therapist may only prescribe eight sessions, because she understands the benefits of a faster return to work and sees that guidelines don’t dictate a full 12 sessions for this injury. Halfway through the eight sessions, she checks in on the patient’s progress and determines that only two more sessions are necessary given the recovery and the medical guidelines; and so adjusts the treatment plan to a total of six sessions.

In this scenario, managed care saves the cost of six sessions over the unmanaged situation, and the employee gets back to work faster with a healthy shoulder.

Ultimately, workers comp buyers can achieve cost savings by making treatment decisions that optimize patient outcomes, rather than cut pure cost. To achieve that, every player — point-of-entry physicians, physical therapists, medical directors, claims managers and patients — need to shoot for the common goal of shortening recovery time by following evidence-based medical guidelines.

“When medical experts and network vendors work in concert with each other, along with data analytics and research to back them up, we can drive down utilization while improving outcomes,” Radack said. “All of these working parts together are the solution to managing physical medicine costs.”

To learn more about Liberty Mutual’s Workers Compensation solutions, visit https://www.libertymutualgroup.com/business-insurance/business-insurance-coverages/workers-compensation

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This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Liberty Mutual Insurance. The editorial staff of Risk & Insurance had no role in its preparation.




 

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Liberty Mutual Insurance offers a wide range of insurance products and services, including general liability, property, commercial automobile, excess casualty, workers compensation and group benefits.
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