Medical costs, accountability among key challenges identified for '10
Controlling medical costs, improving accountability, and strengthening professional education are among the key challenges facing the workers' compensation claims industry in 2010, according to a survey.
One Call Medical, a provider of diagnostic testing for the workers' comp industry, recently unveiled the results of a series of surveys conducted with claims managers, examiners, and nurse case managers. Respondents identified three areas that must be addressed in order to perform more effectively:
- Control of medical costs and outcomes. Researchers said that across the board respondents had experienced a decrease in claims frequency but a significant rise in the medical cost component of their claims. Increasing at twice the rate of general inflation, medical expenses are the biggest cost-containment challenge, the study concluded.
- Accountability. Workers' comp professionals are under tremendous pressure to demonstrate a high level of performance. According to the respondents, clients are requiring audits and ongoing reports that quantify and meet key performance measures, as they relate to claims handling, utilization of provider networks, and achieving early return-to-work outcomes. As a result, researchers said organizations need services and tools to help them off-load and manage specialized functions, so they can better focus on the tasks that directly impact client service, costs and outcomes.
- Professional education. Claims and nurse professionals must become familiar with sophisticated topics, including medical procedures and regulatory changes. Due to the depth of knowledge required, there's a huge demand for education. In today's difficult economy, training budgets have been reduced. Researchers said many organizations must supplement in-house training with other cost-effective opportunities to expand expertise while meeting continuing education requirements.
Read more at the WORKERSCOMP ForumTM homepage.
March 18, 2010
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