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How Mergers and Consolidations Can Strengthen the Claims Ecosystem

July 1, 2022 - WorkCompWire

The workers’ compensation industry is undergoing dramatic change as mergers and acquisitions continue to rise. Naturally, this may heighten concerns for payers who fear shrinking competition will lead to fewer options.

However, when companies and solutions are integrated properly, it can create an entirely new value proposition and experience for customers. When done right, organizations align with the view of the end user and leverage the strengths of each company to enrich the whole scope of their experience. This includes broadening the breadth of products and services for customers to choose from, leveraging advancements from each organization to significantly improve and streamline products, and finding opportunities for integration and connection that create better outcomes and cost savings for customers. In the end, customers should expect to reap multiple benefits from this new union.

Better Together
EnlyteIn 2021, the Mitchell, Genex and Coventry family of businesses united under one brand – Enlyte. The goal was to align and integrate each company’s offerings to significantly benefit customers. Together, the Enlyte family of businesses has over a century of unparalleled experience in the property and casualty insurance space. With Mitchell’s dynamic range of technology, Genex’s renowned clinical experience and Coventry’s expansive networks, Enlyte now offers a powerful, cohesive portfolio of products and services.

While the three companies have worked together for years, the unification of brands has solidified connectivity throughout the organization. It is this collaboration, between clinical services, networks and technology, which enables Enlyte to produce better outcomes, improved savings, and enhanced value for our workers’ compensation customers.

As Dave Torrence, EVP & GM, Mitchell Pharmacy Solutions, explains, “bringing the three leading entities together under Enlyte has allowed us to boast the industry’s most unique collection of data. We have pulled this information together to offer a much more holistic view of what is going on across multiple business segments. Ultimately, that is what makes us special and brings value to our clients.”

A More Seamless Experience for All
One of the most important advantages a well-orchestrated merger can deliver to customers is seamless integration of services. When top industry companies combine their best attributes, it lowers the possibility for error and miscommunication. Customers have one channel through which they can efficiently access all solutions.

For Kate Farley-Agee, VP, Product Management of Coventry solutions, this more efficient process is especially important to ensuring injured employees are directed to the best providers.

“This would not be the case if you only had clinical or network services,” she said.
“Collaboration streamlines the claim and ends up being less costly because we are directing care to providers that we know have a lot of experience with workers’ comp, which tends to improve the outcome.”

Claim Processing as an Ecosystem
Better synchronization of the claims-to-claims process from first report of injury to recovery and return to work is key to delivering quality service from an expansive collection of workers’ comp solutions. This results in a safer and more efficient recovery for injured employees, while improving cost-containment savings for customers.

“It also improves data assets across products and services that provide customers with insights into their program performance. In this way, customers know how their program is performing against their peers and how they’re performing against their own past performance,” explained Rebecca Morgan, vice president of Product Management, Mitchell Solutions.

“Just as a biological ecosystem reacts to changes around it, so does a claims ecosystem,” Morgan said. “Carefully understanding how upstream processes affect the work we do and how the work we do impacts downstream processes is critical to ensuring the best outcomes.

“Field case management (FCM) is a great example,” Morgan continued. “We may start to see data coming from bill review as we observe the treatment patterns that might indicate a claimant could benefit from FCM. Unless I really understand the value and benefit of FCM, I might not notice treatment patterns or know what I should do about it. It really helps to keep the big picture in mind even as we narrow in on details and day-to-day decisioning.”

Unfortunately, not all merger and acquisition processes go off as planned. For customers, it’s important to partner with entities from trusted organizations who have the expertise across segments to see the benefits of these unions for clients – and Enlyte does this like no other in the industry.

Partner Post:
This is a sponsored post from WorkCompWire marketing partner Enlyte.

Filed Under: Featured Articles

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