An Integrated Approach to Workers’ Compensation Vendor Management

A high-performance workers’ compensation program requires managing outside vendors and effectively coordinating their service offerings with the employer’s internal resources to improve the injured worker’s experience and case outcomes. In this session at the 2017 National Workers’ Compensation & Disability Conference, a panel of claims experts provided a targeted approach to get the most out of partnerships with with insurers, TPAs, managed care organizations, nurse case managers and other service providers.

Speakers included:

• Carrie Struzynski, Senior Manager, Risk Management and Insurance at Randstad North America, Inc.
• Jodie Massingill, Senior Manager, Casualty Claims at Sysco Corporation
• Mollie Kallen, President & CEO at MKCM/National Case Management

“Vendor integration” is defined as identifying all medical and ancillary workers’ compensation providers as potential “partners” to fit into an existing workers’ compensation program, model and philosophy to achieve best outcomes through enhanced collaboration, communication, preferred pricing and best practices. This can be achieved in the following important steps.

1. Measuring Outcomes

It is crucial to hold vendor accountable for results so that you can reach your organizational goals. Start by holding in-person quarterly or semi-annual stewardship meetings. You can review results, but also use this opportunity to ask your vendors for new ideas to tackle your challenges.

You can also conduct a file review every 3-4 months (combination of virtual/in-person) and audit each TPA adjuster’s claims handling prior to each file review/consequences. Are they hitting key metrics that your organization is concerned about? For instance, how quickly are files being closed?

2. Motivating/Incentivizing Your Team

Establishing vendor accountability produces results. Recognize superior performance so that vendors know when they are doing a great job. Closing contests among adjusters are also effective. Encourage healthy competition.

3. Maintaining Transparency

Communication with your team is critical, but it is important that all of your vendors communicate and collaborate with each other as well. Every vendor brings their own best practices to the puzzle and it is very effective when you can encourage them to work together. Partnership meetings and interdisciplinary roundtable discussions can be effective for trouble shooting. This can help move your program forward. Ultimately, it makes everyone feel like they are part of your organization and they become invested in the results.