By Steven E. Penman, Executive VP, COO, Sedgwick
Introduction
Technology is having a profound influence on the way organizations are managing their workers’ compensation programs. Such advancements are helping employers better communicate with injured employees, ensure compliance with increasing governmental regulations, and target resources in a way that achieves more positive outcomes.
Improve Communications
Workers’ compensation is a high touch system that requires ongoing communication with injured workers. Often, injured employees seek legal counsel when information is not forthcoming. Complete and timely communications can help alleviate uncertainly and foster a smoother claims process and better outcomes.
Today’s information age society seeks real-time news and updates on a 24/7 basis. The workers’ compensation system is not immune to these demands and technology advancements are enabling employers to be more responsive. Drawing upon the success achieved in the disability and leave arena, employers are turning to push technology as another means of communicating with injured workers.
Push technology offers alternative means of communication beyond the more traditional use of phone and mail. Those injured workers who choose to use push technology can elect to receive claims updates via text or email. For example, injured workers can be notified if or when:
- An indemnity payment is made
- An examiner has been unsuccessful in reaching the injured worker via other means of communication
- A claim is reassigned from one examiner to another
Additionally, there are technology solutions that allow injured workers to access a website where they can check the status of their claim any time of day or night. Increasingly, this information is also accessible from a mobile app directly from the injured worker’s smartphone. As expected, the younger generation is readily embracing this technology, and many of all ages are gravitating toward the convenience of these types of solutions.
This technology also benefits the claims community as it helps promote increased awareness of activity throughout the lifecycle of a claim. It has proven to be a convenient way to reassure injured workers of the status of a claim and help them readily interact with their claims adjuster, if needed. These additional avenues of communication further facilitate the exchange of information between an injured worker and the adjuster handling the claim.
Ensure Compliance
Technology is also helping employers comply with today’s increasing regulatory demands. Employers face strict compliance requirements and heavy fines for not maintaining a safe work environment or meeting administrative requirements.
For example, during President Obama’s first term in office, OSHA initiated a national emphasis program on recordkeeping to assess the accuracy of injury and illness data recorded by employers. This recordkeeping initiative involved inspecting occupational injury and illness records prepared by businesses and appropriately enforcing regulatory requirements when employers were found to be under recording injuries and illnesses.
There are technology solutions today that automate much of the recordkeeping and reporting processes. These systems make it easy to identify cases that need immediate attention.
Additionally, employers can print OSHA 301 forms, OSHA 300 logs and 300A summary reports for immediate use. Some systems even offer direct links to reference materials such as the OSHA recordkeeping guidelines.
Technology also makes it easy to compile and maintain notes on each of these files. By relying on technology and alleviating much of the manual processes and paperwork, employers can focus their attention and resources on other aspects of their programs
Direct Resources
Technology is providing employers with access to more real time data and information than ever before. The result is improved decision-making capabilities and the ability to take action early in the process. As more information is compiled and collected, the credibility and certainty associated with such information increases and its predictive capabilities improve.
As an example, technology systems allow employers to benchmark their workers’ compensation program performance against others within the same industry. The resulting data will show how their metrics compare against similar performance measures of others with like exposures.
Employers can also benchmark their performance against themselves. Information can be produced that allows an individual company to compare the performance of various divisions or locations. Metrics might include cost per claim, the number of claims reported, cost per unit of payroll, claim durations, or division compliance with placing injured workers in transitional duty jobs. Ultimately, employers will want to know which divisions or locations are producing the most favorable outcomes and why.
The ability to compile and assess data in a defined manner has also enabled employers to benchmark the performance of medical providers. The objective is to identify medical providers who consistently deliver higher quality outcomes than the norm. Benchmarking in this manner and the engagement of high quality medical providers in the treatment process have proven to be a successful technique in controlling seemingly unbridled medical costs and reducing indemnity exposure.
Additionally, employers can identify if particular parties are showing up on cases more frequently and increasing the cost of cases or indicating a potential for fraud. This alerts the employer and allows a plan of action to be drawn up to address these situations before they infect other divisions or locations.
Given today’s powerful systems and the vast amount of data collected, employers can draw on technology and experts who identify and understand trends in the data. Such understanding allows action to be taken early on before problems and costs escalate.
Conclusion
Workers’ compensation is a data intensive system and it remains a challenge for virtually all employers. Increasing regulations, rising medical costs, and the uncertainty posed by healthcare reform continue to make this a formidable issue on all fronts.
The good news is technology is developing rapidly and employers are benefiting from these advancements. Technology advancements have been shown to allow employers to improve communications with injured workers, help ensure compliance with increasing regulations, and better direct resources to achieve more favorable outcomes. While the world continues at a faster, quicker pace, employers would benefit by taking time out to explore technology alternatives and see how they can capitalize upon such advancements for the betterment of their workers’ compensation programs.
About Steve Penman
Steve Penman is the chief operating officer for Sedgwick. As COO, he is responsible for directing and coordinating the management of all Sedgwick operations engaged in the direct delivery of claims services on behalf of clients. These include the firm’s workers’ compensation, disability and employee absence, managed care, liability, and specialty business groups.
Steve joined Sedgwick in 1978 and has served in several management and leadership roles. As director of information technology, he oversaw the original design and development of the JURIS® system, Sedgwick’s industry-leading proprietary technology platform that remains the heart and soul of its business. Under Steve’s leadership, cutting-edge systems and technology became an integral part of Sedgwick’s offerings, product development, and customized service delivery.
He has also served as Sedgwick’s director of casualty operations, with responsibility for the company’s core workers’ compensation and liability claims management operations, as well as director of specialty operations, overseeing specialty claims operations, customer service centers, ancillary services, and clinical and cost containment operations.
Steve is a former member of the U.S. Marine Corps.
About Sedgwick
Sedgwick Claims Management Services, Inc. is the leading North American provider of innovative claims and productivity management solutions. Sedgwick and its affiliated companies deliver cost-effective claims, productivity, managed care, risk consulting, and other services to clients through the expertise of more than 10,000 colleagues in 195 offices located in the U.S. and Canada. The company specializes in workers’ compensation; disability, FMLA, and other employee absences; managed care; general, automobile, and professional liability; warranty and credit card claims services; fraud and investigation; structured settlements; and Medicare compliance solutions. Sedgwick and its affiliates design and implement customized programs based on proven practices and advanced technology that exceed client expectations. For eight years in a row, Sedgwick has been awarded the distinguished Employer of Choice® certification, the only third-party administrator (TPA) to receive this designation. In 2011 and 2012, the company was named the Best Overall Large Account TPA by buyers of risk services through an independent survey conducted by Business Insurance. For more, see www.sedgwick.com.