My 2014 New Year's Revolutions for Workers' Comp

Welcome to the revolution....

By Robert Wilson

Resolutions are for pansies. Every New Year people seem to make their annual resolutions designed to improve their personal health and well being. Most of us are lucky to get just a few days out of them before their battered and broken remnants are hauled away in the first week of the New Year's trash.

Since these weak and ineffective New Year's resolutions are designed to improve oneself, and I need no such improvement (my wife's personal observations and assessments notwithstanding), I have decided this year not to make any. No, this year I am subscribing to the theory of "go big or go home", and have instead declared my "New Year's Revolutions" for the entire industry. These are the ideas and issues we need to tackle this year.

Of course, actually accomplishing these will take all of us, working in concert as a well oiled machine. It will be a team effort, and every man and woman needs to do their part. Everyone but me, that is. I had to think of these things after all. My job is done.

• Fix Our Opioid Abuse Problem - Admittedly this is a big one to start off with, but frankly I am sick of talking about prescription drug abuse in this country. Believe me; we would be much better off just fixing the issue versus wringing our hands and endlessly researching the problem. Doctors, stop prescribing drugs for conditions they were never designed to handle. Claims people, find doctors who can actually help manage pain, as opposed to slathering multiple drugs on top of it and hoping it will go away.
  
  Earlier this year, I attended a conference session that included a Director of Risk for a very large, extremely well known self insured company. That director was discussing their efforts to monitor and control the use of prescription drugs for their injured workers. In what I consider to be the 2013 "Quote of the Year", she said "[Company Name] is not interested in letting doctors kill its employees". I wanted to write about that more extensively, but we were not given approval to go on the record with the company name - primarily because we live in a namby pamby wussy world where we are afraid of offending doctors who kill our employees.
• Regarding Doctors, Pay for Performance - Outcomes rule, low fees drool. Paying a bit more for those doctors who consistently get results will save money over the long haul. One carrier this past year conducted a study that showed over 80% of their medical costs were being driven by 7% of the doctors in their network. That is what can happen when you select doctors on the basis of their cost rather than the strength of their ability. Let’s face it; some doctors view the patient as a profit center, and inadequate or unnecessary care is an essential ingredient to making a financial statement healthy, if nothing (and no one) else. Factoring in that some of those doctors may be specialists who inherited truly catastrophic cases, it sounds to me like there is still room to trim that network by 5 or 6%.
• Empower Claims Professionals - The front line of customer service at the most critical point of the business relationship, claims handling is in need of an overhaul this year. Improve training, reduce caseloads, provide them with proper tools (in the interest of full disclosure, we sell those tools), and watch outcomes improve while your claims costs drop. A Claims VP of a multi-state western carrier told me this year they had embarked on such a plan, reducing their adjuster caseload to 75. Their litigation costs in California alone dropped 60%. That is phenomenal, considering litigation costs in California never ever drop. They simply increase with every legislative improvement.
• Change the Industry Name - Workers' Compensation should be called Workers' Recovery. Words mean things, and these words put the emphasis squarely where it needs to be, and enables all players to clearly understand the end game.

There you have it. Four simple New Years Revolutions. That’s not so bad, considering the benefits that all involved could gain.

My work here is done. Yours is just beginning. Now get cracking, we only have a year.

Original Source

Law Office of O'Toole & Sbarbaro, P.C.

Phone: 303-595-4777

226 West 12th Avenue Denver, Colorado 80204

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