Claims Administration

TPA Consolidation: Is Bigger Always Better?

TPA consolidation in the market creates confusion for some employers. But size isn't the only criteria that determines fit.
By: and | July 20, 2016

Consider the workers’ compensation third party administration market, by the numbers, as of today:

  • The top 5 TPAs represent 64 percent of the total benefits paid by TPAs
  • The top 10 TPAs represent 77.5 percent of the total benefits paid by TPAs

Rumor has it that the consolidation among these top TPAs will continue this year making the “big guys” even bigger. But is bigger necessarily better?

What’s happening in our industry can be compared to what has happened in retail. Malls, department stores and online shopping continue to give smaller, specialized retailers a run for their money.

Larger retailers typically attract consumers looking for mainstream products suitable to their everyday needs. But there is still a place for the specialized boutique, for those shoppers who believe they can find something special at shops that are off the beaten track.

There is a perception that they can find that one special place where they will be one of a small group of customers who appreciate distinctive design and want personalized and customized service.

Seek Out the Best Fit

The same forces drive companies looking for TPA claims services. Even as the large TPAs continue to dominate the market, there are still companies seeking out a “boutique” provider — looking for something unique, and believing that they will get better service.

Much as the changes in the retail industry have resulted in larger stores and an opportunity for more shoppers to access them, the workers’ comp industry market consolidation has some benefits. We see these merged companies work to integrate people, processes, culture and technology.

Some buyers of TPA services welcome these inevitable changes, but others are exploring their options and seeking “boutique” service providers that may be more inclined to tailor a program to meet their individual needs.

Bigger may or may not be better. It all depends on what your company values most and how well a TPA meets those needs. Some criteria to consider:

  • Does your TPA have a culture similar to your company?
  • Can your TPA provide a well-designed, customized program?
  • Do you want your TPA to collaborate with you and advocate for you?
  • Is your TPA nimble enough to change along with your company?
  • Does your TPA have jurisdictional expertise where you need it?
  • Does your TPA provide you with tools and data analytics you can use for continual program improvement?

The choice is all yours. What will it be?

Maddy Bowling, a principal in Maddy Bowling Consulting, Inc., has 35 years of executive management experience within operating, corporate and consulting environments. Lynn Craig is principal of Lynn Craig Consulting, LLC, with more than 25 years of experience directing successful programs within the public, private, healthcare and financial services sectors. Maddy and Lynn can be reached at [email protected].

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