Earlier this year, workers’ compensation claims leaders once again participated in a nationwide survey about some of their most pressing operational challenges. Up 57 percent in survey participation from 2013, the confidential results – with insights from over 400 manager, director, and executive-level claims leaders – have now been published in the 2014 Workers’ Compensation Benchmarking Study Report. Top issues confronting claims organizations involve addressing the rapidly shrinking talent pool, grappling with emerging technology trends, and operationalizing performance measures…all while improving productivity and reducing costs. Strikingly similar to the 2013 Study findings, the 2014 Study reflects an industry facing critical hurdles, many of which are not getting better. Based on 70-plus data points, the 2014 results further quantify how claims organizations focus resources to address these substantial hurdles. Key findings reveal:
1) Challenges measuring best practices within top ranked core competencies
2) Declining investment in current and future talent development
3) Low adoption of disruptive technologies, such as predictive analytics
4) Continued obstacles with claims system integrations
5) Limited use of outcome measures and risk/reward strategies to propel top performance from internal staff, vendor partners and medical providers
6) Observed impact of the Affordable Care Act on claims
The study found broad consensus among respondents about what matters most in claims management. For instance, the top two most valued core competencies are disability management and medical management. However, formal training programs are modest relative to the complexity of these and other tasks. Less than half of respondents provide training to senior level claims staff and a smaller percentage, 42%, invest in training new hires. Among those who have formal training for new hires, 39% say that training ends within three months and another 28% say it ends four to six months post-hire. The majority of respondents say it takes up to four years for new employee investment in training to pay off. Specifically, 32% expect a reasonable ROI within two years and another 44% within three to four years.
The industry has struggled to bring technology tools to the adjuster in a streamlined, user-friendly way. Unfortunately, systems can be very difficult to integrate. A symptom of sub-optimal solutions can be called the “three screen scenario,” wherein adjusters might use three computer screens to access multiple systems throughout the day as they manage streams of phone calls and emails.
Less than a third of respondents say they measure provider performance. This low rate extends across all classes of respondents. When provider performance measures are used, return-to-work outcomes and claim costs are most common, while less than quarter of respondents measure average narcotic use.