At the 2018 WCRI Annual Issues & Research Conference, Terrence Welsh MD, Chief Medical Officer for the Ohio Bureau of Workers’ Compensation discussed their efforts to decrease inappropriate opioid prescribing in Ohio. Ohio has a monopolistic state fund, meaning if you are not self-insured you are insured by the state. Pharmacy management is done in-house. They average about 100,000 new claims a year. The injured worker has choice of medical provider in Ohio workers’ compensation. In 2011, when Ohio BWC started reviewing this issue they had 8,000 injured workers dependent on opioids. Over 47,000 workers were receiving opioid medications, which
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At the WCRI Annual Issues & Research Conference, Randall Lea MD from Alice Peck Day Hospital discussed value-based care. They have been working on a study of value-based care and the workers’ compensation industry. Value-based care has been gaining traction on the group health side but not in workers’ compensation. Study participants included medical providers, payers and regulators. They found none of the study targets were overly enthusiastic about the concept of value-based care in workers’ compensation. Survey respondents expressed doubt the model would catch on because of regulatory constraints and a lack of understanding by market participants. A major
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At the 2018 WCRI Annual Issues & Research Conference, Dr. Erica Groshen, former Commissioner of the US Bureau of Labor Statistics discussed labor market conditions. The United States has added 9.8 million jobs since the prior peak in January 2008. While there have been some monthly fluctuations, the overall trend has been steadily upward. Over the past year, most of the growth has been in professional and business services, education and health services, and leisure and hospitality. There has also been strong growth in the construction industry. The unemployment rate is down to 4.1%. This is the lowest rate since
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At the 2018 CLM/Business Insurance Retail, Restaurant and Hospitality Conference, a panel discussed the impact that technology is having on these industries. The panel included: Marsha Bonner – Chief Risk and Benefits Officer; RLJ Lodging Trust Venkat Kandru – EVP, IT; The Howard Hughes Corporation Kim Sanders – Senior Director of Risk Management; Brinker International Raymond Zale – Partner in Charge; norASIA Consultancy and Advocacy Retail Industry The retail industry is undergoing a sweeping transformation as more and more shoppers are staying out of brick and mortar stores and shopping online. Over 3,400 retail locations closed in 2017 marking the
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At the 2018 CLM/Business Insurance Retail, Restaurant and Hospitality Conference a panel discusssed the importance of the customer experience in the claims process and how this can impact perceptions of your brand. The panel included: Tracy Carr – Senior Account Manager; Gallagher Bassett Services, Inc. Daniel Flores – Global Claims Coordinator; Whole Foods Market Lori Freedman – Claims and Risk Consultant; Wortham Insurance and Risk Managment The focus of Whole Foods is quality standards for everything that they sell. They review the ingredients on all products that they sell to make sure they meet their standards in terms of what
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At the 2018 CLM/Business Insurance Retail, Restaurant and Hospitality conference a panel discussed the workplace challenges associated with marijuana. The panel included: Kerry Keeney Curtin – Senior Claims Analyst; Allied World Insurance Company Tony Lutfi – CEO; Maritime Management Company Barry Moscowitz – Attorney; Thompson, Coe, Cousins & Irons LLP Shane Singh – Attorney; Lewis, Brisbois, Bisgaard and Smith LLP As everyone knows, one of the big challenges around marijuana is the lack of consistency between federal and state laws in these areas. It is still considered illegal on the federal level but it is allowed in over 30 states
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At the 2018 CLM/Business Insurance Retail, Restaurant and Hospitality conference a panel discussed emerging risks which will be impacting the industries now and into the future. The panel was: Lance Ewing – EVP Global Risk Management and Client Services, Cotton Holdings Inc. Ty Sheaks – Attorney, McCathern PLCC Cameron Shirley – Senior Director Risk Management, P.F. Chang’s One of the biggest risk management concerns around emerging risks is whether there is insurance coverage available for that risks. An emerging risk is typically not fully understood which makes evaluating the risk from an insurance coverage standpoint extremely difficult. Some of the
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Comorbid conditions are complicating injured worker recovery. This session at the 2017 National Workers’ Compensation & Disability Conference outlined the scope of comorbidity challenges facing employers and strategies to combat them. Speakers included: Eric Patten, Senior Director of Clinical, One Call Care Management Richard Graham, Director Workers’ Compensation, SEPTA Obesity, diabetes, high blood pressure, heart disease, mental health issues, arthritis, tobacco use and substance abuse are all very common comorbid conditions. The workforce as a whole is aging and, as an employee ages, he or she is more likely to have at least one comorbidity. According to NCCI, evidence of
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Establishing Client Service Instructions (CSI), written in cooperation with your workers’ compensation claim partners, that reflect the core values of your organization provide a formal communication tool that sets expectations to all invested parties. This 2017 National Workers’ Compensation and Disability Conference session, presented by Ronda Ostrander – Director, Associate, and Occupational Health and Wellness Manager at Ascension Health and Sam McMurry – Executive Director of Texas Self Insurance Association, walked through how to create, manage, and measure CSIs. The purpose of the CSI is to establish expectations and commitments of the employer, adjuster, carrier, and any other involved party
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This session at the 2017 National Workers’ Compensation & Disability Conference offered a behind-the-scenes look at how to build a relationship with third-party administrators (TPA) that drives claims results. Speakers included: Caroline Burhenne, Regional Client Service Manager, PMA Companies Caryl Russo, Senior Vice President Corporate Care, RWJBarnabas Health To create an effective partnership, both employer and TPA must focus on the following four main areas: 1. Leadership Set a vision for what you want to achieve and how the partnership looks. To do this, you must create an atmosphere where both employer and TPA is empowered, has influence up and
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