MADISON, CONN. — Workers’ compensation payers spend tens of thousands – even millions of dollars — upgrading and replacing their claims systems, so Health Strategy Associates (HSA) set out to capture payers’ opinions, perceptions and attitudes about them in its “First Annual Survey of Workers’ Compensation Claims Systems.”
- There is a major disconnect between front-line professionals and senior executives about whether their claims systems were electronically linked to bill review and medical management applications. Execs thought they were; front-line pros say they are not.
- High costs of integration with other applications and high maintenance costs are significant concerns.
Current systems have been in place about five and one-half years and will likely be replaced or significantly modified within two to three years.
- No vendor is universally recognized as an industry leader, and many were completely unknown to a substantial percentage of respondents.
“The key driver for upcoming system replacements or modifications is the need for ‘full’ integration of claims, utilization review and risk,” said Sandy Blunt, the HSA associate who conducted the survey. “Buyers are tired of smoke-and-mirror integrations. They want the real thing in a single system and a single database.”
Joseph Paduda, principal of HSA, was intrigued by the finding that no vendor enjoyed widespread brand recognition. “When asked to identify the leading systems vendor, the number-one answer was ‘do not know,’” he noted. “Clearly, there is an opportunity for vendors to brand themselves and promote integration solutions.”
The survey polled two distinct groups at workers’ compensation payers: the senior executives in charge of acquiring and maintaining claims systems and the front-line professionals responsible for day-to-day claims handling. Participating in the on-line survey were 144 respondents employed by workers’ compensation insurers, third-party administrators, state funds, and self-administered employers.
Highlights from the survey are available for free download from Health Strategy Associates Surveys. For information on purchasing detailed survey reports, please email firstname.lastname@example.org. Author of the popular Managed Care Matters weblog, Paduda is the principal of Health Strategy Associates, a national consulting firm serving insurers, employers and health care providers.
Source: King Knight Communications