The term "integration" and more specifically, "integrated disability management" has been bandied about for more than a decade in ways that are inconsistent and have caused much confusion about the underlying opportunity represented by this concept. More than a decade ago, "integrated disability management" became the catchphrase for an emerging concept: leveraging synergies in the convergence of cost reduction and medical management opportunities. It was (and still is) separated by silos with pretty high walls between them -- typically within the two realms of human resources and risk management. After all, weren't many of the same physicians and other medical providers treating both occupational injuries and non-occupational maladies? Oftentimes that answer was "yes." Over time, the treatment of these exposure sources became more distinct as between occupational and non-occupational causes which naturally led to increasing difficulty in leveraging those early ideas with synergistic potential.
Roll forward to our present time and we see continuing interest in strategies to address the "integration" question. Only now, the question of what this really means is increasingly nagging at risk and human resource managers alike. Is there a simple, single answer? Unfortunately not. In fact, having spent the last 12 years plowing significant ground in the enterprise risk management (ERM) world, I'm seeing an increasingly obvious parallel. Just as ERM has for many been a struggle to gain meaningful traction in an equally challenging business environment of limited and strained resources, "integration" has seen similar challenges for reasons that include: limited impacts; long development periods to show results; the often competing priorities of different functions and their leaders; opposing corporate priorities; never-ending regulatory shifts; the political challenges of anything related to healthcare and its component parts etc.
Nevertheless, where functionaries have found the ability to collaborate around common interests and goals, many have put points on the board. Still, a single consistent definition of "integration" remains an illusive term with a diversity of meanings. While it may have started as that synergistic opportunity as between occupational and non-occupational managed care tactics, to others it's evolved to a set of opportunities to leverage more of the processes and sub-processes that serve both areas of exposure. Yet to others "integration" more narrowly means the integration of managed-care related interventions within one provider asserting to be able to do it all: ideally creating a seamless set of transactions and interactions that optimize the use of data; speed intervention time to minimize unwanted outcomes; minimize barriers to information sharing potentially affected by competitive interests of third parties; creating greater efficiencies for claims professionals by reducing workload and manual taskings; and even lowering legal expenses through a reduction in disenchanted claimants.
Clearly there is still much opportunity to plow this territory and achieve great results. If we settle on a definition of integration that leverages the opportunities that cross both workers' comp and non-occupational exposure areas, we can begin to narrow our focus on what matters most in the pursuit of this opportunity, namely the potential for collaboration among and between risk and human resource and/or benefit leaders. In fact, it is where these efforts often succeed or fail, typically a result of cross functional rivalries and limited understanding of the possibilities. This is aggravated by the fact that one function typically sits in the HR box on the organizational chart where the other usually sits in the finance or legal box. Regardless, organizational placement is a bad reason not to pursue the benefits to stakeholders, the most important of whom are your employees. Yes it's our employees who get caught in the breach resulting from these failures to work together. They're the ones who, from the start, are confused about which channel to operate in, which source of benefits is most appropriately applied and -- most significantly -- what rules to follow that will ideally get them healed most efficiently and back to productive work most quickly. The cumulative cost of this dysfunction is substantial, both to the employer as the primary funder of these "benefits" and the employee who pays an increasingly growing share of the costs of related medical transactions.
With these opportunities available to all, I think the time to move past functionally narrow agendas has arrived. Like in ERM, the question is whether or not the functionaries will rise to the challenge to do it right for the right reasons.
CHRIS MANDEL is senior vice president,
strategic solutions for Sedgwick. He is a long-term risk management leader and a former president of the Risk and Insurance Management Society Inc. He can be reached at email@example.com.
April 2, 2013
Copyright 2013© LRP Publications