Webinar – True Partners: Accessing Actionable Data in WC through More Transparent, Collaborative Vendor Relationships
Everyone agrees that gaining access to meaningful, actionable data in a timely manner is one of the keys to balancing return on investment and achieving great workers’ compensation claims outcomes. But getting to that goal is easier said than done.
Time and again, we hear stories about the frustrations claims executives experience in getting the data that they want, when they want it: Whether that be from carriers, pharmacy benefit managers, or medical service providers.
In this November, 2014 webinar, Patty Hostine, a 2014 Risk All Star and Responsibility Leader® and the US Director of Disability Management with Flex N Gate, will discuss her approach to creating effective relationships with vendors that stress the importance of timely data transparency.
Patty will be joined by Jerry Poole, the president and CEO of Acrometis, a claims processing software provider that uses technology to break down the barriers to the safe, effective transmission of actionable claims data.
Hostine and Poole will discuss:
- What types of data are critical to risk managers in reducing their cost of risk and how to overcome the challenges in obtaining the data, especially when it resides with partners.
- Using data from multiple sources to create a meaningful risk picture.
- The responsibilities of all involved in the gathering and sharing of critical data, including the employer. This includes effective communication with payers on what data is important to your program and creating expectations on when and how you want that data delivered.
- Defining and branding your program and its goals so that a productive environment is created for all participants while a high level of partner accountability is achieved.
- Understanding the benefits to everyone, including vendors, when they cooperate and provide data that risk managers are looking for.
- How to work with data to make lasting changes to your cost of risk, including what key data risk managers should be using but probably aren’t.
Space is limited, so register today!
Webinar – Data at Work: Putting the 2014 WC Benchmark Study Results Into Practice
Survey responses from more than 660 claims leaders trace progress and outline challenges in four key areas of workers’ compensation claims management. Rather than provide a rearview snapshot of industry conditions from years past, the study, directed and published by Rising Medical Solutions, is a present-day view of current industry issues and opportunities. Building on the study’s 2013 data, the 2014 results profile a claims management profession that is highly dependent on technology and talent, yet is struggling with how best to bring technology to bear successfully in key areas such as adjuster efficiency, driving performance, measuring medical outcomes and closing claims. A panel of the study’s architects will provide expert guidance on the complex challenges that face the industry today, including:
- Creating processes for measuring provider and vendor performance and identifying the tools successful organizations use to improve these areas of scrutiny.
- Tackling industry consolidation and its impact on the ability of claims organizations to integrate systems while still meeting the core goal of healing injured workers and returning them to a productive existence.
- Quantifying the Affordable Care Act’s early impact on claims organizations and recommending strategies for mitigating its effect.
- Detailing how investment constraints in the areas of training, technology and risk/reward models are affecting adjuster performance and key metrics like claims closure ratio and case loads.
Webinar attendees will receive a complimentary copy of the 2014 Benchmarking Study, which will be released in the coming weeks. Space is limited, so register today! Webinar Date: Thursday, October 30th, 2014, 1:00pm ET
Six Best Practices For Effective WC Management
It’s no secret that the professionals responsible for managing workers compensation programs need to be constantly vigilant.
Rising health care costs, complex state regulation, opioid-based prescription drug use and other scary trends tend to keep workers comp managers awake at night.
“Risk managers can never be comfortable because it’s the nature of the beast,” said Debbie Michel, president of Helmsman Management Services LLC, a third-party claims administrator (and a subsidiary of Liberty Mutual Insurance). “To manage comp requires a laser-like, constant focus on following best practices across the continuum.”
Michel pointed to two notable industry trends — rises in loss severity and overall medical spending — that will combine to drive comp costs higher. For example, loss severity is predicted to increase in 2014-2015, mainly due to those rising medical costs.
Debbie discusses the top workers’ comp challenge facing buyers and brokers.
The nation’s annual medical spending, for its part, is expected to grow 6.1 percent in 2014 and 6.2 percent on average from 2015 through 2022, according to the Federal Government’s Centers for Medicare and Medicaid Services. This increase is expected to be driven partially by increased medical services demand among the nation’s aging population – many of whom are baby boomers who have remained in the workplace longer.
Other emerging trends also can have a potential negative impact on comp costs. For example, the recent classification of obesity as a disease (and the corresponding rise of obesity in the U.S.) may increase both workers comp claim frequency and severity.
“The true goal here is to think about injured employees. Everyone needs to focus on helping them get well, back to work and functioning at their best. At the same time, following a best practices approach can reduce overall comp costs, and help risk managers get a much better night’s sleep.”
– Debbie Michel, President, Helmsman Management Services LLC (a subsidiary of Liberty Mutual)
“These are just some factors affecting the workers compensation loss dollar,” she added. “Risk managers, working with their TPAs and carriers, must focus on constant improvement. The good news is there are proven best practices to make it happen.”
Michel outlined some of those best practices risk managers can take to ensure they get the most value from their workers comp spending and help their employees receive the best possible medical outcomes:
1. Workplace Partnering
Risk managers should look to partner with workplace wellness/health programs. While typically managed by different departments, there is an obvious need for risk management and health and wellness programs to be aligned in understanding workforce demographics, health patterns and other claim red flags. These are the factors that often drive claims or impede recovery.
“A workforce might have a higher percentage of smokers or diabetics than the norm, something you can learn from health and wellness programs. Comp managers can collaborate with health and wellness programs to help mitigate the potential impact,” Michel said, adding that there needs to be a direct line between the workers compensation goals and overall employee health and wellness goals.
Debbie discusses the second biggest challenge facing buyers and brokers.
2. Financing Alternatives
Risk managers must constantly re-evaluate how they finance workers compensation insurance programs. For example, there could be an opportunity to reduce costs by moving to higher retention or deductible levels, or creating a captive. Taking on a larger financial, more direct stake in a workers comp program can drive positive changes in safety and related areas.
“We saw this trend grow in 2012-2013 during comp rate increases,” Michel said. “When you have something to lose, you naturally are more focused on safety and other pre-loss issues.”
3. TPA Training, Tenure and Resources
Businesses need to look for a tailored relationship with their TPA or carrier, where they work together to identify and build positive, strategic workers compensation programs. Also, they must exercise due diligence when choosing a TPA by taking a hard look at its training, experience and tools, which ultimately drive program performance.
For instance, Michel said, does the TPA hold regular monthly or quarterly meetings with clients and brokers to gauge progress or address issues? Or, does the TPA help create specific initiatives in a quest to take the workers compensation program to a higher level?
4. Analytics to Drive Positive Outcomes, Lower Loss Costs
Michel explained that best practices for an effective comp claims management process involve taking advantage of today’s powerful analytics tools, especially sophisticated predictive modeling. When woven into an overall claims management strategy, analytics can pinpoint where to focus resources on a high-cost claim, or they can capture the best data to be used for future safety and accident prevention efforts.
“Big data and advanced analytics drive a better understanding of the claims process to bring down the total cost of risk,” Michel added.
5. Provider Network Reach, Collaboration
Risk managers must pay close attention to provider networks and specifically work with outcome-based networks – in those states that allow employers to direct the care of injured workers. Such providers understand workers compensation and how to achieve optimal outcomes.
Risk managers should also understand if and how the TPA interacts with treating physicians. For example, Helmsman offers a peer-to-peer process with its 10 regional medical directors (one in each claims office). While the medical directors work closely with claims case professionals, they also interact directly, “peer-to-peer,” with treatment providers to create effective care paths or considerations.
“We have seen a lot of value here for our clients,” Michel said. “It’s a true differentiator.”
6. Strategic Outlook
Most of all, Michel said, it’s important for risk managers, brokers and TPAs to think strategically – from pre-loss and prevention to a claims process that delivers the best possible outcome for injured workers.
Debbie explains the value of working with Helmsman Management Services.
Helmsman, which provides claims management, managed care and risk control solutions for businesses with 50 employees or more, offers clients what it calls the Account Management Stewardship Program. The program coordinates the “right” resources within an organization and brings together all critical players – risk manager, safety and claims professionals, broker, account manager, etc. The program also frequently utilizes subject matter experts (pharma, networks, nurses, etc.) to help increase knowledge levels for risk and safety managers.
“The true goal here is to think about injured employees,” Michel said. “Everyone needs to focus on helping them get well, back to work and functioning at their best.
“At the same time, following a best practices approach can reduce overall comp costs, and help risk managers get a much better night’s sleep,” she said.
To learn more about how a third-party administrator like Helmsman Management Services LLC (a subsidiary of Liberty Mutual) can help manage your workers compensation costs, contact your broker.
Debbie discusses how Helmsman drives outcomes for risk managers.
Debbie explains how to manage medical outcomes.
Debbie discusses considerations when selecting a TPA.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Helmsman Management Services. The editorial staff of Risk & Insurance had no role in its preparation.