Boston, MA – Liberty Mutual Insurance has appointed Dr. Will Gaines, MD, MPH, as national medical director of its Commercial Insurance strategic business unit.
Dr. Gaines is responsible for managing the Property & Casualty industry’s largest team of regional medical directors, as well as the strategies and tools that help Liberty Mutual – and Helmsman Management Services, its wholly-owned third party administrator – better manage the cost of workers compensation claims by delivering superior medical outcomes for injured employees quickly and cost-effectively. Every day, Liberty Mutual’s regional medical directors engage with treating physicians, advise on individual claims, and improve the application of resources to help produce better medical outcomes and effective return to work.
In fact, Liberty Mutual closes workers compensation claims 23 percent faster and produces a 10-year average cost per workers compensation claim that is 9 percent lower that its competition, according to an internal analysis of 2013 data published by SNL Financial.
“Will is perfect for this critical role,” notes Glenn Shapiro, chief claims officer, Liberty Mutual Commercial Insurance. “Throughout his nearly 12 year career at Liberty Mutual – including serving as associate national medical director for the last two years – he played a key role in developing the medical strategies and tools we use today to bring the right resources to each claim at the right point in its lifecycle.”
Some of the strategies and tools Dr. Gaines helped develop include:
- Data analytics – Liberty Mutual was the first Property & Casualty insurer to bring to workers compensation claims management the sophisticated data analysis long standard in the group medical industry.
- Predictive models – Liberty Mutual’s data analytics capabilities have produced a range of predictive models that impact claim management. One model quickly identifies workers compensation claims likely to become more expensive than the average cost of similar claims. Claims managers are notified of these claims and the resources required to better manage them.
- Outcomes based networks – Liberty Mutual harnesses data analytics to build networks of medical providers more likely to provide evidence based-medicine so injured workers get the best care. The insurer continuously measures medical provider performance against a set of proprietary leading indicators shown to result in better medical outcomes.
- Prescription management – Controlling total workers compensation claim costs requires strategies that ensure appropriate medications for claimants and manage the use of powerful narcotic pain killers. These and other strategies helped Liberty Mutual cut the amount spent on opioid and other powerful narcotics by 13 percent in 2014.
“To bring value to policyholders and our claims and medical management areas, I’ll function as a player-coach,” notes Dr. Gaines, MD, MPH. “I’ll split my time between the big picture – looking at broad trends and for new opportunities to create tools that deliver better outcomes – and getting involved on individual claims, talking with providers and being a resource for our nurses and case managers. These two approaches are so complementary, with the lessons learned in one directly benefiting the other.”
Dr. Gaines, MD, MPH, national medical director, Liberty Mutual Insurance, is Board Certified in Preventative Medicine-Occupational Medicine and Board Certified in Internal Medicine. He has published and presented material in the field of occupational medicine and preventive medicine, and serves on several state and national committees involving workers compensation, occupational and environmental medicine.
Source: Liberty Mutual
Disclosure:
Helmsman is a WorkCompWire Ad Partner.
This is not a paid placement.