March 22, 2017

Thomas D. Johnson: Antifragile: How WC Organizations Can Benefit from ‘Disorder’

Tom Johnson

Volatility, disorder, uncertainty, and randomness are conditions we dislike and try to avoid. However, in his 2012 blockbuster book, Antifragile: Things That Gain from Disorder, author Nassim Nicholas Taleb paints a different picture. If something is fragile, it breaks easily. Think of a crystal goblet or Fabergé egg — neither would do well if dropped onto a concrete floor…[Continue Reading]

Mariellen Blue: California Legislation May Elevate UR Processes for All

Mariellen Blue

California Senate Bill 1160 (SB 1160) is slated to bring major reforms to the California workers’ compensation system. Its provisions aim to eliminate both delays in the utilization review (UR) process and inappropriate denials of care for injured workers. In addition, it will help prevent billions of dollars in workers’ compensation billing fraud. Depending on how effective…[Continue Reading]

Joe Guerriero: Patient Advocacy: A Key Driver of Value-Based Care

Joe Guerriero

The value-based care conversation has finally made its way to the Worker’s Compensation landscape, and stakeholders are Investigating new models aimed at improving outcomes and lowering costs. Now, as this change is occurring, industry leaders increasingly point to the need for expanding strategies to hone in one key tactic: patient advocacy. The “more is better” mentality of past…[Continue Reading]

Carlos Luna: It’s About Time – Value-Based Care Comes to Workers’ Compensation

Carlos Luna

With the total annual cost of lost productivity attributable to health-related conditions exceeding $225 billion in the United States, employers are looking for ways to get the best medical results at the best prices for injured workers. In fact, more than 40 percent of employers are considering implementing value-based plan designs or high-performing networks in the coming…[Continue Reading]

Dan Anders: New Tricks for New Claims

Dan Anders

As discussed in last week’s article, old dogs can be taught new tricks. A proactive settlement initiative can not only get legacy claims off the books, but it can also dramatically reduce costs and improve patient care. In one case, a man who suffered a minor back injury at work more than 25 years ago was weaned off fentanyl, hydrocodone, and several other drugs. The claim’s pharmacy…[Continue Reading]

Dan Anders: How Old Dogs Can Learn New Tricks

Dan Anders

The saying goes you can’t teach old dogs new tricks. But when it comes to clinically driven settlement initiatives involving complex “old dog” workers’ compensation claims, old dogs can be taught new tricks. What’s more, the lessons learned from old dog claims can become a foundation for “new tricks” that can be applied in the management of all claims, building a best practices…[Continue Reading]

Jose Tribuzio: 6 Business Intelligence Capabilities for Workers’ Compensation

Jose Tribuzio

Significant data is collected in the workers’ compensation (WC) claims industry. Being able to analyze and act on this data can have far-reaching implications for improving program performance. With modern business intelligence (BI) tools organizations can gain the insights needed to optimize cost savings, create safer work environments and…[Continue Reading]

Jose Tribuzio: 7 Digital Imperatives for Workers’ Comp Claims

Jose Tribuzio

The digital age is upon us, and the signs are all around. Turn on the TV, and commercials eagerly promote smart, digital consumers who lock cars, turn down home thermostats and glance into refrigerators remotely from their smartphones. These digitally savvy consumers are ubiquitously connected to the Internet, email and social media. They own several digital devices…[Continue Reading]

Nina Smith: Three Ways Workers’ Comp Insurers Will Harness Technology to Deliver Better Outcomes in 2017

Nina Smith

Technology is transforming the way we live, work and play—and the workers’ compensation industry is no exception. As an industry, we are beginning to understand how to harness technology and look at big data sets in very specific ways that allow us to solve complex problems. Here are three ways that I anticipate workers’ compensation insurers will leverage technology…[Continue Reading]

Mitch Freeman: PBM Challenges in Navigating Drug Therapy Issues – Integration Provides Insight

Mitch Freeman

When an employee is injured on the job, it is the beginning of a journey, and it’s not a vacation. Numerous decisions will be made that impact the destination of that journey. Opioid therapy for the treatment of pain is one of the most critical decisions made on the path to recovery. When chosen wisely, they can help an injured worker recover as completely as possible as soon as possible without…[Continue Reading]

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