NAVIGATING THE “NEW NORMAL” IN WORKERS COMP: RETHINKING WORK AND AUTOMATION

Administrators, public entity, state fund, employer), many variations of operating models exist. Some payers license software to manage state reporting, utilization review, bill review, electronic payments and more, whereas others have elected to outsource these functions to service organizations. Other payers have decided to insource some of the tasks while outsourcing others — typically referred to as a hybrid model. Many of these entities are taking a second look at past decisions to determine what may make sense going forward.

Now more than ever, it is important for workers’ compensation leaders to evaluate their program models, not purely from a cost effectiveness strategy, but also as a proactive labor strategy. If 50% of insurance professionals are due to retire in the next 15 years, it is time to think differently to eliminate risk. Payers who have historically handled the range of services (mentioned above) in-house are considering outsourcing non-core functions to organizations that specialize in those tasks. Others may want to bring or keep functions in house, but need to identify software capabilities with extensive automation built in.

Automation Pays Off

The benefits of automation are undeniable: higher productivity, accuracy, and cost reductions. When it comes to workers’ comp, there are many opportunities to make processes simpler and faster, including straight-through medical bill processing, electronic billing, and electronic payments to name a few. In the case of eBilling, the benefits are not only for the provider, but for the payer as well. If a bill can be received electronically, it eliminates the document intake, processing, data capture, and storage. So, the more you automate, the more efficiencies you can create for staff and reduce expenses.

The financial benefits of electronic payments are even more compelling. Take, for example, medical payments to providers. A paper check costs approximately $8 to $9 on average with a high of $30 per payment. If you establish an electronic payment process, those costs can be reduced substantially. Paper checks are not only expensive, but they are fraught with timeliness and accuracy issues. The efficiency gains from removing the paper, associated with medical payments alone can help organizations focus on core functions and redirect their attention to recruitment, training, and retention of claims adjusters vs. administrative staff while improving quality. While these are only a few of the examples of ways automation can benefit insurance payers, it serves to highlight some of the opportunities where technology can help with the labor market crunch.

Whether employers plan to pull employees back to the office or continue to support remote work models, simplifying processes and focusing resources on high-value tasks will greatly benefit workers’ comp programs. In addition to streamlining operations, it also is a good strategy to attract and retain employees, not to mention addressing new work environments and the issues they face. The beginning of the year is the perfect time to evaluate the best approach going forward, because it may be much different than what made sense in the past.

Rebecca Morgan is the Vice President of Product Management for Mitchell’s Workers’ Compensation Solutions

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