At a time when health insurance reform rules the headlines, there also are perils and changes coming in the workers' compensation market.
By surveying claims managers, examiners and nurse case managers, the research revealed three key concerns and needs in order to perform more effectively in 2010:
1. Controlling Medical Costs and Outcomes: Across the board, participants 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.
2. Accountability to a High Level of Performance: At all levels, workers’ compensation professionals are under tremendous pressure to demonstrate a high-level of performance. 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, organizations need services and tools to help them offload and manage specialized functions, so they can better focus on the tasks that directly impact client service, costs and outcomes.
3. Education to Keep Pace with an Ever-changing Industry: Workers’ compensation is a complex industry. Claims and nurse professionals must become familiar with a number of 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. Many organizations must supplement in-house training with other cost-effective opportunities to expand expertise, while meeting continuing education requirements.
“By conducting market research, we’re able to hear firsthand about the challenges many workers’ compensation professionals face,” said Bill Colacurcio, director of marketing at One Call Medical. “With these findings, we strive to continually provide our clients and injured workers with the greatest value from our diagnostic specialty network—in terms of quality, accuracy, timeliness and cost savings.”
