Workers’ compensation is a positive change-agent in the claims arena and beyond. Despite this, the workers’ compensation system is under attack. While there are certainly problems with the system, there is more good news than bad news in the system, which is a demonstrably successful benefit delivery vehicle. The system has also proven to be a successful change-agent, promoting much needed reform, particularly in the areas of medicine, safety, and rehabilitation. At the WCI’s 2017 Workers’ Compensation Educational Conference a panel of experts discuss what’s right with workers compensation. The panel included:
Darrell Brown, Chief Claim Officer, Sedgwick
Brian Allen, Vice President of Governmental Affairs, Optum
Andy Condrey, Claims Operations Manager, The Gray Insurance Co.
Pat Hiles, VP National Insurance Claims, Liberty Mutual
So what’s right and what’s challenging?
Good -Advocacy based model. The bottom line numbers are good. This is understanding the importance of the injured employee and what their perspective is on this given situation. There is great opportunity to gain that knowledge and help facilitate the process to make the process run smoothly from the actual injury to them returning to work.
Challenge- Growth in medical costs. Projected to be $.70 of every dollar by 2025. With the aging workforce this along with opioid epidemic are challenges in the system. The states learn from each other.
Good – Workers comp was on the leading edge of this opioid epidemic. The costs of claims increase immensely when an opioid is issued in a work comp claim for an injured worker. Currently the industry is reducing the use of opioids for injured workers but there is still an issue surrounding opioids. Focus on prevention first then recovery. That is a real positive for workers compensation. Even though this is a positive, the negative associated with this is how do we fully educate our nurse managers and make headway on the front end of the claim.
Good – Focusing on selecting the correct doctor for the injured worker not the doctor based on costs. Everyone benefits from the right care for the injured worker starting in the beginning. There are medical costs savings and lost worked days costs savings.
Good – Medical care and innovation – Telemedicine and 24 hour nurse line care are two innovations that are beneficial to the employer and the employee.
Good- Studying our system and the data collected. Workers’ compensation is good on collecting data when the injury happens and during the process of returning the injured worker back to work.
So there are many positive things with workers’ compensation such as advocacy based model and medical care and innovation now but there are always areas of growth and improvement such as growth in medical costs. The workers’ compensation industry is working in the right direction to get the positive change going upward.