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In the 15 years that the National Workers' Compensation and Disability Conference & Expo has been in existence, never has it been as popular as it was last November.

More than 2,400 attendees registered--double the 2005 attendance--and the number of booths sold in the expo hall jumped to 335 in 2006 from 266 in 2005, according to conference organizers.

A poll conducted on-site found 43 percent of managers believed offshoring was a benefit to comp claims management. But 42 percent believed there was nothing to be gained from sending claims offshore. (For more information, please read the story below.)

Just for the record, opponents of offshoring were the more vocal of the two camps. They clapped in approval when one executive made the case for keeping claims management on U.S. soil during the "Top TPAs" lunch roundtable.

Not only did claims managers reveal themselves divided over the issue, but leaders of TPAs, the very contractors hired to manage the processing of workers' comp and disability claims, also revealed themselves to be just as divided.

Take Richard J. McKenna, president of Gallagher Bassett Services Inc., for instance. He said he would consider sending noncore claims processing services offshore to ease the burden on administrators and claims adjusters.

That hardly went over well with his peer, David North, CEO of Sedgwick CMS. He swore that there was no need to send any kind of claims management services overseas as there was plenty of talent to be found stateside.

When both line managers and leaders of third-party administrators can't seem to agree among themselves as to whether to send claims services offshore, you can be certain that this issue will be rearing its head next year, and the year after, and the year after that.

A mighty divide it is. Perhaps that's why claims have gotten so complex. The industry simply can't agree on how to proceed.

This story is far from over. Stay tuned.

THE "OLD" IRONY

For comp and disability managers making a living in an industry where the average age is older than 40, and where the number of years of experience in the industry averages more than 15 years, was it any surprise that a recurring theme was how managers ought to act to protect their aging work force?

How ironic that tips gleaned from the dozens of sessions were applicable to many of the attendees themselves.

"A person who is age 50 needs two to three times the amount of light in their work space compared with someone half his age. Accidents can occur from a lack of light," said one of the session hosts, Cindy Roth, CEO of Ergonomic Technologies Inc. of Syosset, N.Y.

They sure do. Not that this audience, which is getting older and rarer as its members retire and fewer Generation X and Y managers step up to fill its shoes, needed any reminding.

Indeed, workers' comp and disability managers, along with their third-party administrators, are all too familiar with the shortage of skilled talent in the industry, a shortage that's getting more acute by the month.

At this rate, many of the attendees and disability managers may be finding themselves working long past the age of 65. Not because they have to, of course. Not even because they want to. But simply because their employers will be begging them to, as corporations find it nearly impossible to replace their existing workers' comp and benefit managers.

But, said Susan Henry of the Jacobson Group, in her session on recruiting new employees to an insurance organization titled "Surviving the Talent Crunch," there are ways to overcome this predicament. Workers' comp executives could save their companies from getting crunched by preparing an "elevator speech" for their organization, to help their employers market themselves and attract new talent.

A three-sentence, 30-second sound bite about your job and your company can be a valuable tool. The elevator speech can even help your company take on the competition, she said, and draw hordes of Millenium Generation talent. The elevator speech can leave listeners wanting more, prompting them to actually use that business card you gave them or consider handing in their resume to your organization, said Henry.

With a well-placed tidbit, dropped on a young account executive or two at an industry gathering or, literally, in a packed elevator whizzing up to the 40th floor, an aging workers' comp and disability manager might just have found his successor, allowing the manager to hop off the elevator for good.

In any event, anything's sexier than this elevator mumble: "Uh, I just do claims for a big insurance company."

TIPS TO KICK NARCO-TICKS

Employers must also learn to manage their injured employees' pain and their narcotics costs, attendees were told in a session on wellness and disability management.

Nearly 40 percent of paid workers' comp pharmacy costs come from narcotics and analgesics, said Nicholas Page, vice president of clinical services at workers' comp vendor PMSI, who hosted the session on breaking the workers' comp industry's dependence on narcotics. This costs money.

Just take the lollipop opioid painkiller Actiq. The drug quickly passes through the lining of a patient's mouth into the bloodstream, Page said. Patients feel relief in minutes.

The only problem for employers is the cost. Actiq, or fentanyl citrate, makes up nearly 10 percent of the paid narcotics costs, while only being involved in 1.15 percent of the prescriptions, according to Page's figures.

The key for employers and those who help them manage prescription costs is to make sure that injured workers don't reach the point where they need the quick, heavy fix of Actiq to manage their pain, said Page. This can be done by transitioning pained patients away from short-acting narcotics to long-acting narcotics, such as Duragesic, Methadone or the many generics out on the market since 2005, and prescribing the baseline dose of the drug that works.

CYRIL TUOHY is managing editor of Risk & Insurance®.

ANGELA CHILDERS and MATTHEW BRODSKY contributed to this story.

February 1, 2007

Copyright 2007© LRP Publications