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Upcoming Webinar

Webinar – True Partners: Accessing Actionable Data in WC through More Transparent, Collaborative Vendor Relationships

Learn how good, collaborative vendor relationships can help you access meaningful data and improve claims outcomes.
By: | October 23, 2014 • 1 min read

Presenters

Webinar_Acrometis

Overview

Webinar Sponsor

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 Date: Thursday, November 13th, 2014, 1:00pm ET Webinar_YesAttendWebinar_NoAttend

Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at dreynolds@lrp.com.
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Risk Insider: Martin Frappolli

What’s Your Education Risk Management Policy?

By: | October 23, 2014 • 2 min read
Martin J. Frappolli, CPCU, FIDM, AIC, is Senior Director of Knowledge Resources at The Institutes, which provides professional development to the industry, including the CPCU designation. He can be reached at frappolli@TheInstitutes.org.

One common theme among our industry’s educational conferences is a focus on the future, from discussing what insurance and risk management professionals should know about increasingly complex automotive technologies to what the industry is doing to address long-term demographic trends.

I always look forward to these sessions, as I do any opportunity to learn from colleagues and industry experts, because it seems as if our profession is changing more, and faster, than ever.

This pace of technological change and the exponential increase of data are leading to unforeseen challenges and opportunities. It’s amazing, but has the potential to be scary for the unprepared.

Consider the companies that didn’t fully understand the risks of firms like Uber and Lyft and turned away their business; some regulators still struggle with the sharing economy concept.

Think of the agencies whose clients were vulnerable because they didn’t research the details of cyber risk until after there was a data breach.

Imagine how many organizations out there are exposed to possible failures and inefficiencies because leadership isn’t aware of fundamental enterprise risk management (ERM) practices.

So what could be done, then, to prepare for the as-yet-unnamed challenges of the future? Quite simply, plan to stay educated.

There should be a conscious, proactive effort to assess what types of information a company needs to be successful, and to put a structure in place to make sure employees are getting that information.

For keeping team members up-to-date on the latest market developments, organizations need a formal strategy that goes beyond traditional in-house training or tuition reimbursement.

Just like they need an ERM plan to assess the insurable and non-insurable risks they face, they need education risk management to address the risks posed by having uninformed professionals. Let’s call it an Ed-RM plan.

From a high level, education risk management would ensure that new employees are brought up to speed quickly and thoroughly during the onboarding process and would also lay out a plan for the ongoing maintenance of their expertise.

It doesn’t mean that organizations have to mandate that employees pursue advanced degrees or designations, although encouraging them to do so would certainly be an effective way to make sure there are capable leaders waiting in the wings.

What it does mean is that there should be a conscious, proactive effort to assess what types of information a company needs to be successful, and to put a structure in place to make sure employees are getting that information.

Of course, all the current ways we learn new ideas and technical skills would fit into this plan.

Attending conferences, networking with colleagues, pursuing continuing education, and even reading industry publications like this one are valuable tactics for continuous learning.

But an Ed-RM plan would establish a strategy. If we aren’t constantly discovering new skills and improving our training in an industry changing as quickly ours, then we are falling behind.

The smartest and most successful businesses are those that recognize lack of learning as a risk and learn to manage it.

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Sponsored: Helmsman Management Services

Six Best Practices For Effective WC Management

An ever-changing healthcare landscape keeps workers comp managers on their toes.
By: | October 15, 2014 • 5 min read

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.

SponsoredContent_LM“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:

Pre-Loss

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?

Post-Loss

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.

Email Debbie Michel

Visit Helmsman’s website

@HelmsmanTPA Twitter

Additional Insights 

Debbie discusses how Helmsman drives outcomes for risk managers.

Debbie explains how to manage medical outcomes.

Debbie discusses considerations when selecting a TPA.

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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 Helmsman Management Services. The editorial staff of Risk & Insurance had no role in its preparation.


Helmsman Management Services (HMS) helps better control the total cost of risk by delivering superior outcomes for workers compensation, general liability and commercial auto claims. The third party claims administrator – a wholly owned subsidiary of Liberty Mutual Insurance – delivers better outcomes by blending the strength and innovation of a major carrier with the flexibility of an independent TPA.
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