In a nutshell, at most companies, the first reason is (1) there are some people doing some things in some locations some of the time but it’s an uncoordinated approach so from a political standpoint, it can be a risky career move (at least it seems so when you start, until your costs begin to drop.) The 2010 RIMS Benchmark Survey identifies the percentage of companies that say they have an uncoordinated approach to workers compensation management. You'll be suprised.
And, the second reason is (2) they get “pushback” from management, unions, doctors, and attorneys. Management usually provides the most pushback when “can’t do” people come forward from many silos. These are things I've said for 25 years, and they are as applicable and important today as they were 25 years ago when I started tackling workers compensation management. To overcome this, you have to be very persistent, encouraging a “can do” approach.
The third (3) and biggest obstacle companies face is STARTING. They want everything perfect before they start, they don’t know how to get going, they don’t have the resources to get going, or they face pushback they don’t know how to overcome.
The best advice is “You don’t eat elephant in one bite. Eat elephant one bite at a time.” You take small steps first.
As a result of not having a consistent, standardized, approach, there are People Gaps and Procedural Gaps, tons of gaps. This is the fourth (4) reason the first step is the most difficult.
And, the fifth (5) reason is …. companies frequently MISIDENTIFY the problems. The insurance company, the TPA, or the medical cost containment vendors usually are blamed when the problems are most often attributed to internal gaps.
Here's an example, a large theme park was so upset with their carrier they were planning to move their business (change insurance companies). The perception was the carrier was using “too much Nurse Case Management."
An audit team of seven professionals, including a medical doctor, looked at every open file. The office head and supervisor at the insurance company seemed oblivious as to why the theme park was dissatisfied with their service.
The supervisor said she had never spoken to them, however. Her reason? “They’ve never called me….” (emphasis added)…
But the theme park regional manager said: “Nurse Case Management is overused and the carrier is unresponsive to our needs.” When she was asked what the claims supervisor said when they discussed this, and she said SHE HAD NEVER SPOKEN TO HER because the claims supervisor should call her. WHAT?????!!!!! You must be kidding! Nope, she really said that.
The problem had been misidentified; it was not over use of Nurse Case Management but lack of communication.(workersxzcompxzkit) So, if you are having a hard time getting started, you aren't alone. In fact, you are in the majority. Don't be paralyzed with fear or wait for "all lights to be on green." Take the first step now. Knowing the 5 reasons starting is difficult will help you start your own journey in workers comp cost containment.
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