With more Americans dying from opioid overdoses than car crashes, the Workers Compensation Research Institute (WCRI) is devoting a session at their upcoming 35th Annual Issues & Research Conference to discussing the latest research and efforts to address the opioid epidemic. The conference is taking place February 28 and March 1, 2019, at the Renaissance Phoenix Downtown Hotel in Phoenix, AZ.

“The dangers of prescription drug misuse resulting in death and addiction constitute a top public health problem in the United States,” said WCRI CEO John Ruser. “We believe this session, which combines research and what is happening on the ground, will be of great value to our audience.”

During this session, WCRI’s Vennela Thumula will present the Institute’s latest research on correlates of opioid prescribing to injured workers, which can help public officials and other stakeholders better predict which injured workers are more or less likely to receive opioids. Next, Letitia Davis with the Massachusetts Department of Public Health will discuss the results from a recent study they published on factors that may contribute to differences in the rate of opioid-related overdose deaths among workers in different industries and occupations. Then, Jacqueline Kurth and Jason Porter of the Industrial Commission of Arizona will discuss efforts taken by Arizona Gov. Doug Ducey and the Commission to address the opioid epidemic in their state.

The theme of this year’s conference is “Breaking Down Barriers to Improve Injured Workers’ Outcomes.” It will feature the latest research from WCRI, engaging sessions on the latest trends, and examples of industry stakeholders coming together to tackle some of the system’s most important challenges. The following are a few of the session titles:

• Challenges and Opportunities of Telemedicine
• From Washington State to Washington, D.C. – a Model for Returning Injured Workers to Work
• Group Health Deductibles and Workers’ Compensation
• Has There Been an Erosion of Workers’ Compensation Benefits?
• How Unions and Management Can Create Successful Return-to-Work/Stay-at-Work Programs
• Moving the Needle: Innovative Employer Ideas

The WCRI conference is a leading workers’ compensation forum for policymakers, employers, labor advocates, insurance executives, health care organizations, claims managers, researchers, and others. Conference participants will leave with new insights, valuable networking contacts, and a better understanding of key issues in today’s competitive environment. To learn more or to register, visit https://conference.wcrinet.org.

The Cambridge-based WCRI is recognized as a leader in providing high-quality, objective information about public policy issues involving workers’ compensation systems.

About WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, Massachusetts. Since 1983, WCRI has been a catalyst for significant improvements in workers’ compensation systems around the world with its objective, credible, and high-quality research. WCRI’s members include employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.

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Medcor, Inc., the nation’s leading health navigation firm, announces a new telemedicine service developed specifically for work-related injuries. Medcor Telemed™ will be available 24/7 in all 50 states, beginning January 14, 2019. This new service enhances Medcor’s existing injury triage service, already in use by more than 309,000 worksites, and will augment Medcor’s 240+ onsite and mobile clinics.

Medcor navigates patients to optimal care by using evidence-based medicine, proprietary clinical algorithms, and patented processes. Medcor serves employers across a wide range of industries, including many Fortune 100 and 500 companies, as well as government agencies, TPAs and insurance carriers.

Medcor’s President and CEO Philip Seeger said, “We designed our new service to address the challenges telemedicine faces in occupational health. This service will improve outcomes, reduce costs and provide a positive user experience for patients, their employers and for the treating doctors.” Mr. Seeger added, “Avoiding the conflicts of interest so common in medicine is a tough challenge to address, and it is a cornerstone of all Medcor’s health navigation services.”

Sophisticated algorithms programmed into Medcor’s system identify cases that are appropriate for telemedicine; high-acuity conditions that require in-person care and diagnostics are directed to the appropriate offsite facilities. Identifying the needed level of care saves time and expense. Vice President and General Manager Matt Engels oversees the new service. He said, “Medcor Telemed is an early intervention opportunity to guide low- and moderate-acuity injuries onto the right path to recovery and to jumpstart the claims management process. Our system connects patients to physicians seamlessly with wait times measured in minutes and without advance scheduling. Medcor Telemed is staffed by a team of hundreds of physicians to ensure coverage across all states day and night. Our physicians are trained and experienced in telemedicine and oriented to Medcor’s best practices in occupational health.”

Patients and physicians benefit from Medcor care navigators who stay with the injured worker through the entire telemed process, from registration to resolution. The navigators handle technical and administrative aspects of the session. They document and clarify key workers’ compensation information, such as return-to-work status and restrictions for modified duty. At the end of each session, the navigator facilitates carrying out treatment orders from the physician. The system automatically processes reports for all the stakeholders.

Medcor’s new service operates with a combination of Medcor’s technology and licensed systems. It works on desktop computers, tablets and smart phone apps, which can be downloaded at the time of service. Medcor has already provided more than 2.5 million injury triage and other telehealth visits, which represent a solid foundation of experience for its new telemed service.

For more information, watch the short video at this link https://youtu.be/CTUT5QeoQIg/, contact media@medcor.com or call 815-759-5442.

After Traumatic Injury, Workers’ Comp Thrives with This Return-to-Work Strategy

A workplace accident can leave a worker with a spinal cord injury, an amputation, severe burns or a brain injury, turning their world upside-down. The physical toll is obvious if a worker is missing a limb or immobile. But the psychological hurdles often are hidden.

Recovery can be fraught with emotions, fear and anger among them. This complicated tangle — and the way a person handles it — can reduce the odds that a person will ever re-enter the workforce.

Facetime With Phil — All About NSAIDS — A Category Of Drugs That Can Be Used To Treat Pain

All NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) cause side effects to a certain degree. It is important for a prescriber to look at a patient holistically in determining what version of the drug is right for them. Join myMatrixx Chief Clinical Officer Phil Walls in his discussion all about NSAIDs, which takes a deeper dive into these type of drugs and how to determine what is the best choice for an injured worker.

Ringler Radio: Inside the Post-Settlement Process

The post-settlement process can be complex, especially when it comes to medical care for injured parties and their families. Finding a reliable team of people to make the process seamless is key. RinglerRadio host, Larry Cohen with Porter Leslie, President of Ametros, and Attorney Paolo Longo, Jr., a partner in the Orlando office of Bichler, Oliver, Longo & Fox, discuss how to simplify ongoing medical expenses and ease the hassle of the healthcare system.

Tower MSA Partners’ focuses its WCI-TV segments on settling claims

For the fourth consecutive year, Tower MSA Partners is sponsoring WCI-TV, the televised coverage of WCI 2018. “Our theme this year is ‘Knocking Down Barriers to the Settlement of Claims,’” said Dan Anders, Tower’s Chief Compliance Officer.

Unreasonably high pharmacy costs, inappropriate use of opioids and other drugs, vague references to possible future surgeries, and jurisdictional challenges pose some of the common obstacles to settling claims. In other cases, injured workers are afraid of exhausting their settlement dollars or losing the support of their adjuster or nurse case manager.

Dehydration and Heat Stroke

Dehydration and heat stroke are two very common heat-related diseases that can be life-threatening if left untreated. What is dehydration? Dehydration can be a serious heat-related disease. It is also a dangerous side effect of diarrhea, vomiting, and fever. Children and people over the age of 60 are particularly susceptible to dehydration. What causes dehydration? Under normal conditions, we all lose body water daily through sweat, tears, breathing, urine, and stool. In a healthy person, this water is replaced by drinking fluids and eating foods that contain water.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Chicago-based Medcor, Inc., the leading health navigation firm, has acquired San Francisco-based Talisman Systems Group, Inc., the leading provider of network management services for workers’ compensation and other industries. Talisman will operate as an independent subsidiary of Medcor, retaining its leadership and TalisPoint brand and will remain based in San Francisco.

Medcor navigates patients to optimal care through onsite clinics and virtual health services, using evidence-based medicine, proprietary clinical systems and patented processes. Medcor clients include employers from a wide range of industries and insurance carriers. The TalisPoint system validates, updates and manages network data and produces referral documents for insurance carriers, claims administrators, provider networks and employers.

Through this acquisition, Medcor expands its innovative health navigation services. These begin with rapid, convenient access to health assessment at the onset of symptoms or injury, followed by guidance to appropriate care. Often, Medcor can provide the care directly or guide patients in self-care. When referrals into the healthcare system are necessary, Medcor’s systems help ensure patients receive the care they need and avoid overtreatment and unnecessary costs. Sophisticated algorithms help Medcor identify serious cases quickly. TalisPoint data helps connect patients with the right provider in the proper network to improve clinical and financial outcomes.

Medcor President and CEO Philip Seeger explained, “We are combining two best-in-class businesses whose services are very complementary to one another. This is a powerful way to bring more value to our clients; the fact that we already have mutual clients shows that our customers have independently come to the same conclusion. The high-quality network information that TalisPoint provides will help us more efficiently navigate patients to the right place, at the right time, to receive the right level of care.”

Talisman President and CEO Monique Barkett said, “TalisPoint allows for fast, accurate and up-to-date access of vendors and medical networks. This facilitates Medcor’s service delivery by providing person-specific information and pinpointing the exact facility and provider called for by Medcor’s care protocols. To stay at the forefront of our industry, we prioritize innovation to ensure our systems will continue to be best-in-class in the years to come. With Medcor, Talisman now has a proven information technology partner to help us develop the next generation of TalisPoint.”

The two companies share reputations for transparency, high customer service, and operating without conflicts of interest. For more information, watch the short video at this link https://youtu.be/AvAFzJJqjSI, contact media@medcor.com or call 815-759-5442.

Medcor operates 240 clinics at or near client worksites and provides virtual health services to over 309,000 worksites throughout the United States and Canada. Medcor serves clients across a wide range of industries, including private firms and government agencies. Medcor helps employers and patients navigate the complexities of healthcare to achieve better clinical and financial outcomes. Learn more at medcor.com.

Talisman’s core product, TalisPoint, offers web-based customized network management tools to assist users in selecting medical providers and other vendor types. Access to verified provider data is a key to effective communication between patients, providers and employers. Learn more at talispoint.com.

The Intersection of Medicine and Disability: A Doctor’s View

Whether we are a health care practitioner, an employer or a claims professional, disability is something we deal with on a daily basis. What are the nuances of a disability claim and how can the roles and responsibilities within these claims be better understood?

Dr. Iglesias breaks down what goes into a disability determination and how employers, claims administrators, and physicians can make better and more timely disability determinations that will benefit all the stakeholders in a disability claim.

Facetime With Phil — Introduction To Analgesics

What are the different drugs available and how does a prescriber make a choice? Join myMatrixx Chief Clinical Officer Phil Walls as he begins a discussion on Analgesics. In this vlog, Phil covers the basics on this topic and begins a deeper dive into the treatment of pain management.

Dan Anders: Building a Better Relationship with your MSA Vendor

Let’s face it. When you realize that settlement of a workers’ compensation claim will require a Medicare Set-Aside (MSA) you may let out an audible groan or even a choice profanity. An MSA will no doubt add cost and time to settlement of a claim. This is why it is so important to partner with a Medicare Secondary Payer (MSP) compliance vendor that can effectively work with you to limit those costs and reduce the time involved with the MSA to the greatest extent possible while still ensuring you are compliant with Medicare requirements.

Opioid Litigation Update

Two-thirds of the deaths from drug overdoses in the U.S. involve opioids. This has been declared a crisis in America. On this Ringler Radio podcast, host Larry Cohen and co-host, Heather Anderson discuss how the Beasley Allen law firm’s attorney Rhon Jones is joining forces with the Attorney General of Alabama in litigation to put a halt to this devastating crisis that touches so many lives today.

Workers’ Compensation Cost Reduction Starts with Better Medical Care

Seek the best possible care for employees with workers’ compensation injuries, because better care will result in fewer treatments and ultimately lower costs. So said Margaret Spence, president and CEO of C. Douglas & Associates in West Palm Beach, Fla., during a June 20 concurrent session at the SHRM 2017 Annual Conference & Exposition in New Orleans. Spence recalled one employer in the panhandle of Oklahoma whose workers were told they had to use doctors in the rural area. When Spence got involved with the handling of the firms’ workers’ compensation claims, the company concluded that the doctors in that area were less qualified and every employee was sent to Oklahoma City for treatment.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Artemis Emslie Joins Ametros’ Board of Directors

Artemis Emslie has become an independent member of the board of directors of Ametros. As a highly regarded thought leader in the industry, she will provide strategic insight and guidance for the company to ensure products and services align with the company’s overall vision.

“We are very excited to have Artemis on the board,” said Marques Torbert, the CEO of Ametros. “Her experience as a senior leader of a fast-growing and successful company in our space gives her a unique perspective to add to our board.”

5 Easy Steps to Foster Loyalty and Positive Culture

Developing a positive culture and inspiring loyalty requires a delicate and sometimes complicated balance between intentional interventions and behavioral modifications. In a day and time when the word loyalty has somewhat lost its meaning, maintaining a high retention rate and creating a positive work environment is critical and complicated.

Creation of a positive working culture, and the ever-elusive loyalty, requires leaders that are sincere, heartfelt and real. The best leaders are able to effectively communicate with the generational spectrum and inspire loyalty through their approachability, their communication style and their interaction at a guttural level.

Don’t Get Taken Advantage of by Medicare Advantage

If the title of this article has drawn you in, then you likely are somehow touched by Medicare Secondary Payer (MSP) compliance, whether as an attorney representing a claimant or carrier or claims professional working with no-fault, workers’ compensation or liability claim. The question going through your mind is what has Medicare come up with now to make my job more difficult?

Indeed, MSP compliance has significantly expanded over the last 17 years. Since the advent of the Medicare Set-Aside review process in 2001, the Centers for Medicare and Medicaid Services (CMS) has added policies and contractors to its enforcement mechanisms under the Medicare Secondary Payer Act. MSAs led to an extensive growth in CMS’s Medicare conditional payment recovery efforts, including the 2010 launch of Section 111 Mandatory Insurer Reporting for liability, no-fault and workers’ compensation insurance.

Facetime with Phil – Generic Substitution

Generic substitution is one of the most effective strategies you can implement to maximize drug savings. It is the job of myMatrixx to monitor and develop strategies to ensure you are not exposed to the unnecessary cost of a brand name prescription. Join myMatrixx Chief Clinical Officer Phil Walls in his final vlog of a five-part series regarding drug prices vs. drug costs. In this vlog, Phil talks about the various marketing strategies that brand name companies are using to maintain market share.

Fresno jury says Chipotle owes former manager $7.97 million for wrongful termination

For years, Jeanette Ortiz was a loyal, hardworking general manager for Chipotle Mexican Grill on Shaw Avenue across from the Fresno State campus. But in January 2015, Ortiz was fired, accused of stealing $626 in cash from the restaurant’s safe, said a lawyer for Chipotle Mexican Grill Inc. There was even video evidence to prove Ortiz’s theft, the lawyer said.

But when Ortiz denied stealing the money and asked to see the video evidence, her bosses at Chipotle declined. Instead, the company destroyed the video evidence, said Fresno attorneys Warren Paboojian and Jason Bell, who represent Ortiz in a wrongful termination case she brought against the fast-food giant.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Mentoring Millennials Is Key

by Neil Lentine, President of Broadspire USA.

As a Baby Boomer, it has been an interesting process learning to interact with millennials who are just getting started in their careers.

I’ve had to keep in mind that the millennials have been shaped by social networks, where everyone is perceived to be on equal footing and immediate feedback is constantly sought. Growing up in the dawn of the digital age, their view of the world is, in many ways different than my own, so learning where they’re coming from is important to help guide them in a direction where they can be successful.

Rapid Advances In Technology Outpacing Risk Management: Marsh/Rims

Emerging technologies continue to rapidly change the way businesses operate and interact with customers, yet risk management processes are not keeping pace with the associated risks, according to a new report published today by Marsh, a global leader in insurance broking and innovative risk management solutions, and RIMS, the risk management society™.

The 15th Annual Excellence in Risk Management report delves into risk professionals’ knowledge of and role in managing technology innovation such as artificial intelligence (AI), blockchain, and the Internet of Things (IoT). According to the findings, 59% of respondents said their organizations are currently using or exploring the use of IoT systems; 47% are using or exploring the use of AI; and 24% are using or exploring the use of blockchain. Despite the growth, only 14% said they strongly believe they have a clear process in place for addressing disruptive technology risks. Nearly half could not say there was a clear process at all.

Force Behind Industry’s First Cost of Risk Survey Berry Griffin, Jr. Inducted into The Risk Management Hall Of Fame

RIMS, the risk management society™, and American International Group, Inc. (AIG) today announced Berry Griffin, Jr. as the 2018 inductee into the Risk Management Hall of Fame (RMHF).  The RMHF serves as a means to maintain the history of the field of risk management and recognizes risk practitioners who have made significant contributions to advancing the discipline. Mr. Griffin was officially inducted at RIMS 2018 Annual Conference & Exhibition in San Antonio.

RIMS 2018 Awards & Honors

RIMS, the risk management society™, today announced the winners of its series of industry awards presented during RIMS 2018 Annual Conference & Exhibition Awards Luncheon in San Antonio.

RIMS’ most prestigious honor, the Harry and Dorothy Goodell Award, was presented to Ward Ching, Managing Director, Western Region at Aon Global Risk Consulting. Named in honor of RIMS’ first president, the award pays tribute to an individual who has furthered the goals of the Society and the risk management discipline through outstanding service and achievement.

University of Wisconsin-Madison Wins 2018 Spencer-RIMS Risk Management Challenge

At the Spencer Educational Foundation reception, case-study provider Andrew Bent, risk manager at Sage Group plc announced University of Wisconsin-Madison (UWM) student team as the winners of the 2018 Spencer-RIMS Risk Management Challenge. The team, comprised of four risk management students, competed against 26 other universities and delivered the award-winning risk management presentation in front industry leaders at RIMS 2018 Annual Conference & Exhibition in San Antonio.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

RIMS Conference 2018: Go Big

RIMS 2018 Annual Conference & Exhibition is the premier event for the risk management community. If you have risk management responsibilities, GO BIG and join us in San Antonio this April. In the spirit of going BIG, we’re offering four new diversity and inclusion opportunities to ensure that everyone feels included and understood at RIMS 2018.  Learn more & register.

Alex Sheen to Deliver RIMS 2018 Opening Keynote

Alex Sheen is the founder of because I said I would, a social movement and nonprofit dedicated to bettering humanity through promises made and kept. Sparked by the loss of his father, Alex and his organization send “promise cards” to anyone anywhere in the world at no cost. Alex is someone who truly honors commitment. He once walked over 240 miles across the entire state of Ohio in 10 days to fulfill a promise. Since his father’s passing on September 4, 2012, because I said I would has sent over 4.47 million promise cards to over 150 countries. His charitable projects and awareness campaigns have been featured on ABC World News, CBS Nightly News, Fox News, The Today Show, Good Morning America and many other programs.

Booth 1426: Medcor Trailblazing Healthcare: Meet Champion Saddle Bronc Rider Jacobs Crawly

Medcor embodies the same entrepreneurial spirit held by the pioneers of the west. Visit Medcor and find out how we can chart a new path to better health outcomes for your workforce. Visit us at booth #1426 at RIMS 2018, April 16th through the 18th and meet champion saddle bronc rider Jacobs Crawley.

Booth 1417: Crawford / Broadspire / WeGoLook: Wanted – Open Claims with No End in Site

Learn about software, analytics, and strategic plans of action to quickly identify identify and neutralize issues that delay claim closure.

RIMS Community Service – Soldier Angels

Soldiers’ Angels provides aid and comfort to the men and women of the United States Army, Marines, Navy, Air Force, Coast Guard, their families and a growing veteran population. Founded in 2003 by the mother of two American soldiers, Soldiers’ Angels has grown from a grassroots effort to a national 501(c)(3) nonprofit organization. One of the largest nonprofits dedicated to supporting our military, Soldiers’ Angels has provided over $100 million in aid to service members and their families through care packages, food assistance and support items to patients in VA hospitals. The nonprofit coordinates over 150,000 volunteer hours each year.

RIMS Thought Leader Theater

The RIMS Thought Leader Theater (TLT) offers attendees additional education through a series of succinct, interactive discussions on a variety of topics. Visit RIMS HQ in the Marketplace to hear these high-speed 20-minute presentations not offered at any other time during the conference.

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers’ compensation cost containment systems and helps employers reduce their workers’ comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is a co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2018 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

A recent study by the Workers’ Compensation Research Institute (WRCI) regarding the Illinois workers’ compensation system is worth paying attention to for all interested stakeholders across the United States.  The findings of the study highlight the need for claims management teams to not only be proactive in their approach to claims, but engaged with state policymakers regarding the direction of their system.  By taking these steps, programs can reduce costs in their programs and ensure injured workers receive the medical care and treatment they deserve.

WRCI Study Overview

The CompScore™ report reviewed areas concerning medical payments, prices and service utilization of the Illinois workers’ compensation program compared to 17 other states.[1]  It also analyzed how medical payments changed over time through 2016.

According to the study findings, the following conclusions were reached related to the Illinois workers’ compensation program:

• Payments per claim were higher than the median of all other study states from 2013 through 2015;

• During this same time frame, medical payments per claim grew an average of 3.1%;

• While Illinois had a lower price paid on claims for non-hospital medical services (patient evaluation and office visits), costs were higher for other medical services. This included the price paid on surgical and other professional medical services; and

• Medical costs continue to be a significant driver in workers’ compensation claims. Areas that were identified as leading to this were medical utilization factors, which included more visits per claim and services performed by health care professionals per visit.

Reducing Work Comp Costs Via Proactive Claims Management

There are many lessons proactive members of the claims management team can learn from the WCRI report regarding workers’ compensation claims in Illinois.  This should serve as a reminder for those seeking to make a difference that good claims management skills require one to be proactive on all files.

• Medical treatment parameters. Proactive claims management teams need to aggressively use these rules to minimize costs.  This includes asking an independent medical examiner to review and provide a professional expert opinion on the care received.  It is also important to receive comment on what care, if any, exceeded the medical treatment parameters;

• Medical fee schedules. Claims management teams should regularly conduct internal audits to determine if medical care is being reimbursed via the applicable medical fee schedules.  Failure to do so can result in paying more than required, which reduces the effectiveness of a program and the bottom line;

• Using litigation as a settlement tool. Workers’ compensation claims sometimes languish, which results in excessive and unnecessary costs to a program.  Claim handlers and others on the team need to be proactive and look for opportunities to place matters into litigation to force settlement discussions.  All affirmative defense must be made in good faith.  It is also important to remember that simply calling the injured worker or their attorney regarding settlement may be all it takes to resolve an ongoing claim.

Reducing Work Comp Costs Via Public Policy Engagement

The findings of the WCRI report demonstrate the importance of engagement by interested stakeholders with lawmakers and state program regulators.  Not being involved in the public square can result in increased workers’ compensation costs.  Workers’ compensation fee schedules and treatment parameters serve as the basis for reimbursement and treatment available to cure and relieve the effects of a work injury.  The impact on the cost of medical claims becomes noticeable in jurisdictions with reimbursement is noticeable in Illinois based on the following study findings:

• Higher than average medical payments; and

• Higher than average provides paid for professional medical services.

Conclusions

The recent WCRI report highlights ongoing areas of concern in Illinois and across the country when it comes to growing workers’ compensation costs.  Proactive stakeholders seeking to reduce workers’ compensation costs need to be engaged in their file load and within the public square to run effective programs.

[1] States reviewed included: AR, CA, FL, GA, IN, IA, KY, LA, MA, MI, MN, NJ, NC, PA, TX, VA, and WI.

Access the above reference study and learn more about WCRI: https://www.wcrinet.org/reports/compscope-medical-benchmarks-for-illinois-18th-edition 

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

©2017 Amaxx LLC. All rights reserved under International Copyright Law.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

It’s the week of our industry’s biggest conference of the year.  There will be a lot of great content, but I’m looking forward to these 5 sessions:

The Nordstrom Way: Boosting Injured-Worker Engagement

• Speaker: Janine Kral, VP Risk Management, Nordstrom
• Room: South Pacific C Session Number: K1
• Time: Wednesday, December 06, 2017: 8:30 AM – 10:00 AM

At Nordstrom, injured-worker advocacy isn’t just a recent strategy. Learn how the retailer — widely recognized for its customer service culture — has applied its customer-focused approach when engaging injured workers and advocating for their care. Janine Kral will describe how the company’s practices have evolved over time to ensure that injured employees are able to stay on the job and deliver the service level crucial to the company’s bottom line.

Steal These Ideas! Teddy Award-Winning Employers Showcase Their Successful Strategies

• Speaker: Frank Altiere, President, PMA Management Corp
• Speaker: Roberto Ceniceros, Senior Editor, Risk & Insurance Magazine
• Room: Islander B-C Session Number: M2
• Time: Thursday, December 07, 2017: 8:30 AM – 9:45 AM

Gain direct insight into how risk managers and safety professionals created some of the most successful programs in the nation in this roundtable discussion featuring winners of the 2017 Risk & Insurance Teddy Award. Learn their key strategies and tangible practices that drive documented and sustainable results at their companies. You’ll leave inspired with real take-home ideas to elevate your program to the next level!

The Intersection of Medicine and Disability — A Doctor’s View

• Speaker: Marcos Iglesias, CMO, Broadspire
• Room: South Pacific F Session Number: DM3
• Time: Thursday, December 07, 2017: 10:45 AM – 11:45 AM

With qualification for benefit programs like non-occupational disability insurance, social security and workers’ compensation often dependent on a doctor’s determination, claims payers can play a crucial role in helping them make sound assessments. A popular NWCDC speaker, Dr. Marcos Iglesias will help you understand disability-assessment methods and decipher what makes someone disabled, whether it’s a diagnosis or an impairment — and who gets to decide. You’ll discover the value of accurate communications with medical providers and how they can help the injured regain an active life.

Old Dogs, New Settlement Tricks

• Speaker: Beth Savelli, Former Risk Manager, Swissport USA Inc.
• Speaker: Daniel Anders, Chief Compliance Officer, Tower MSA Partners
• Room: Islander F-H Session Number: CM1
• Time: Wednesday, December 06, 2017: 11:00 AM – 12:15 PM

A successful settlement initiative requires analyzing cost drivers across legacy claims to eliminate barriers to resolution, establish whether to settle immediately, or match cases with optimal interventions, such as physician peer review, clinical oversight or legal action. Learn how Swissport, an employer in a high-risk industry, initiated an aggressive settlement process, and discover how you can adopt those lessons to create new claims management practices.

60 Tips in 60 Minutes — Sage Advice for Overcoming Complex Claim Challenges

• Speaker: Barry Bloom, Managing Principal, The bdb Group
• Speaker: Caryl Russo, SVP Corporate Care, RWJBarnabas Health
• Speaker: Kathleen Bray, Corporate Counsel, SFM Mutual Insurance Co
• Speaker: Stuart Colburn, Shareholder, Downs Stanford P C
• Speaker: Bill Wainscott, Manager Occupational Health & International Paper Company
• Speaker: Dawn Watkins, Director of Integrated Disability, Los Angeles Unified School District
• Speaker: Marcos Iglesias, CMO, Broadspire

• Room: Islander F-H Session Number: G1
• Time: Friday, December 08, 2017: 8:30 AM – 9:45 AM

There is greater likelihood now than ever for worker injuries to develop into complex claims. Flawed claims decisions, inadequate medical attention and other missteps can exacerbate resolution challenges. Fortunately, there are opportunities to prevent complex cases and mitigation measures when they reach that scale. In one of the conference’s most popular sessions, a panel of experts from different workers’ comp disciplines will reveal the lessons they learned — providing their sage advice in a lively, fast-paced presentation that will jump start your Friday morning.

See you there!

Author Michael Stack, CEO Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%.  He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.