At the 2015 IAIABC Annual Convention, Mona Carter and Jeff Eddinger from NCCI discussed the current state of the industry and issues it faces in the future. NCCI has decribed the state of the industry as calm with turbulence ahead.  Among the issues they feel will cause turbulance in the future are: Exclusive remedy Courts around the nation are continuing to allow pursuit of tort claims arising from workers’ compensation claims. This includes constitutional challenges to whether workers’ compensation is still a grand bargain for injured workers. Medical and recreational use of marijuana As this spreads around the nation it
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These short presentations at the IAIABC 101st Annual Convention focused on the positive and highlighted success stories in the workers’ compensation industry. What Went Right: Regulatory and Legislative Highlights of 2014 and 2015 Speaker: Brian Allen – Helios DEA informants reap millions in workers comp benefits. FDA was asked to evaluate the rescheduling of marijuana. Florida appellate court rules the workers’ comp system is constitutional. A good year for the workers’ compensation industry from a profitability standpoint. Limitations on physician dispensing. California removes the word “alien” from their Labor Code. Ongoing decline in utilization of opioids in workers’ compensation. States
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Workers’ compensation is described as a “grand bargain” between labor and management. The 101st IAIABC Convention kicked off with a panel discussion about how workers’ compensation has evolved and must continue to evolve. The panel consisted of: Dave DePaolo – WorkCompCentral (moderator) Sandy Blunt – Vice President of Insurance Services, Medata (moderator) Frank Fennerty, Jr. – Labor Member, Washington Board of Industrial Appeals David Menchetti – Partner, Cullen, Haskins, Nicholson & Menchetti, P.C. Brandon Miller – President, Minnesota Workers’ Compensation Insurers’ Association Joan Vincenz – Corporate Director-Safety, United Airlines Among the highlights: States are competing for jobs by cutting taxes
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At the 2015 Workers’ Compensation Educational Conference in Orlando, a panel discussed the shift from networks focused on discounts and penetration to that of quality of care and outcomes received by injured workers.  The panel consisted of: Greg Moore – President, Harbor Health Kimberly George – Senior Vice President, Sedgwick Dr Jacob Lazarovic – Chief Medical Officer, Broadspire Mark Walls – Vice President Communications & Strategic Analysis, Safety National Key components to an outcomes-based scoring model are: Claim duration Return to work Recidivism (reopening rate) Following established treatment and return-to-work guidelines (ODG) Litigation rate Medical and indemnity paid Claims team
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At the 2015 Workers’Compensation Educational Conference in Orlando, a panel discussed telemedicine and its potential application in the workers’ compensation space. The panel consisted of: Bill Lewis, M.D., Chief Medical Officer, Concentra Medical Centers Steve Shaya, M.D., Chief Medical Officer, Health Net Connect Sri Mummaneni, M.D., Chief Health Officer, Opus Telehealth Telemedicine is being utilized more and more in healthcare models throughout the United States: 59% of large employers are expected to offer telemedicine in 2015 Many national health plans offer telemedicine to employers The VA and Department of Defense have adopted telemedicine. 43 Medicaid programs currently reimburse some forms of telemedicine services In spite of
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This session at the 2015 WCI Conference discussed forward thinking approaches to early intervention and how to effectively address claims with long-term exposure to narcotics. The speakers included Teresa Bartlett, M.D., Senior Vice President, Medical Quality, Sedgwick, Michael Gavin, President, Pruim, and Tron Emptage, Chief Clinical Officer, Helios. Dr. Bartlett started this session by presenting the group with some startling statistics. 80% of opioids dispensed in the world are in the U.S. 99% of all hydrocodone dispensed in the world is dispensed in the U.S. Education is key regarding narcotics. The injured worker needs to be cognizant of all side effects
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At the 2015  Workers’  Compensation Educational Conference in Orlando, David North, President and CEO of Sedgwick and Richard Victor, Executive Director of WCRI, spoke about how the Affordable Care Act (ACA) is currently impacting workers’ compensation and how it will continue to impact the industry in the future. The Affordable Care Act is having a tremendous impact on healthcare in the United States. This year, four of the top five group healthcare providers have been involved in M&A activity. Anything that has such a significant impact on healthcare is going to also have an impact in workers’ compensation. The phases
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At the 2015 WCI Conference this session addressed how companies use predictive analytics and what they measure to understand if it is successful. The speakers included Scott Rodgers, Executive Vice President Casualty Operations, Sedgwick, George Furlong, Senior Vice President Managed Care Outcomes, Sedgwick, Dr. Marcos Iglesias, M.D., Vice President, Medical Director, The Hartford, and Mark Sidney, Vice President of Claims, Midwest Employers Casualty Company. When we think about Big Data, we think about gathering all the information we can that is available to use for predictive modeling. One of the panelist stated that data in general has three components: volume,
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This session at the WCI 2015 Conference took a look into new strategies for catastrophic injuries from the leading experts in the catastrophic case management. The speakers included Darrel Brown, Executive Vice President, Chief Claims Officer, Sedgwick, Scott Goll, Senior Vice President of Operations, Paradigm Outcomes, and Karen Derrico, Vice President Workers’ Compensation and Critical Care Division, Best Doctors. 1% of all claims are catastrophic claims and they make up 20% of costs. Catastrophic claim frequency is not high but when you see catastrophic claims you know something big happened. Unfortunately no one wins in this type of claims. Characteristics
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At the 2015 WCI Conference this session discussed how to build an engagement model that is sustainable, scalable and measurable. The speaker for this session was Kathy Kukor, Senior Consultant, Risk International Services, Inc. Kathy Kuhor started her session by explaining how to connect the process with the people to improve return-to-work outcomes. The impact of an injury is felt by the company, work team, community, family and employee. The ripple effect of an injury is all encompassing. Do we really want to leave outcome to chance? When creating a return-to-work program at your organization, create a vision and mission
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