Value-based contracting models are already being used by the healthcare system. But in today’s workers comp arena, they are a hot-button topic. A Coventry white paper released earlier this year investigated the potential of this model over the current regime.
The Argument for Value-Based Contracting (VBC)
As opposed to the current workcomp model, in which utilization and care management teams rely on a fee-per-service approach via a discounted network of external vendors, value-based contracting takes a far different approach. Volume-based contracting and fee-for-service care is cast-aside for a payment structure based on performance/outcomes, not services rendered, eliminating the financial incentive to treat more.
Quality Value-Based Contracting Models…
- Unite the goals or payors and providers.
- Pay for better outcomes (superior quality, faster results) regardless of the number of services rendered to achieve them.
- Utilize predictive pricing for payors/providers, with agreed upon treatment costs by injury/illness. (All costs for an episode of care, such as knee replacement, are bundled as one fee. Patient-centered medical homes cover patient care coordination and outcomes under a per member, per month fee.)
- Have an ‘outcome focus,’ relying on a model calibrated to deliver the right combination of services to achieve the best outcome.
- In this ‘pay for performance’ model, preventative care is seen as a way to curb costs and treat injuries and illnesses before they become serious. (Think: creeping catastrophic claims.)
- Data analytics monitor a provider or hospital’s success.
Could the old claims mentality be replaced by value-based contracting? As the industry strives for savings and improved patient outcomes, time will tell. As the regime evolves, Minnesota Comp Advisor will be here for you through it all.
As workers’ comp claims continue to decline in frequency and jobs continue to become safer, you may want to consider looking to other avenues for savings. With employee leave, disability management, and wellness absences continuing to rise in prevalence, and legislation increasingly complex, absence management offers an array of opportunities in controlling costs and preventing headaches.
For these reasons, workers’ comp management providers are supplying their clients with a new benefit: Employee management tips and systems for better management of employee absences.
How Can Your WorkComp Management Program Help You Handle Absenteeism?
Workers’ comp claims management professionals can help businesses manage non-occupational absences by tapping into skills and resources necessary to manage illness and injury-related absences, as both essentially involve the same things:
• Claims processing.
• Reducing incident rates.
• Coordinating services.
• Navigating the complexities of return-to-work and associated absences.
• Costs associated with absenteeism.
• Compliance with pertinent laws.
Are You Skirting Absence Management Disaster?
With the strong correlation between health behaviors and claims costs, and the link between employee absence and lost revenue, it pays to have a plan for managing absences of all kinds - from both the injury management and health and wellness perspectives.
From FMLA and ADA to jury duty and blood donor leave, federal and state mandates continue to grow increasingly complex. Ever-changing rules elevate your risk of violation without expert outside assistance and employee management tips. Fortunately, claims management firms are in the perfect position to provide them.
Looking for a few outside-the-box employee management tips to control your rapidly-changing labor landscape? Minnesota Comp Advisor has the total health of your company covered. Discover more about our amazingly flexible skills and solutions today.
2017 is well underway. What’s in the works for worker's comp insurance this year?
Keep an Eye Out for These Changing Worker's Comp Insurance Issues
• The New Administration
Former President Obama was headed toward federal reforms including minimum state benefit standards. President Trump, however, is a vocal opponent of federal regulations, leaving this issue on hold.
• Healthcare Reform
Healthcare reform has the potential to affect benefit requirements, quality of care, the calculation of premiums, and claims filings — if and when anything passes. Stay tuned...
More recently, OSHA had shifted resources from education to enforcement.
With a successor yet to be named by the Trump Administration a new direction is expected, but like healthcare reform the path remains unclear.
The broadening of regulations and enforcement increased under the Obama Administration are expected to relax, with the federal government less likely to expand the boundaries of existing ADA/FMLA laws.
• Workcomp Rates & Premiums
More driven by changes in market competition than changes in exposures, the previous hyper-competitive marketplace is expected to slow as new entrants respond to long-tail losses hitting the books.
• Long-Tail Exposures
Long-tail exposures, premiums collected today for tomorrow’s losses, will require close scrutiny in the coming years. What could inflate your costs? Raised life expectancies, costlier new drugs and treatments, medical science advancement in prosthetics, and more.
In 2017, there’s expected to be continued emphasis on alternatives to opioids for acute and chronic pain, with expanding coverage.
Are you staying aware of the worker's comp insurance issues that could significantly impact your bottom line? Minnesota Comp Advisor has you covered. Contact us to learn about new ways you can save today.
Catastrophic injuries are complex, costly, life-altering events for injured workers and their families. In this next installment, we’ll continue looking into the path to improved catastrophic workman’s comp claim outcomes.
Other Considerations for Catastrophic Claims:
• Comorbidity Complications
Comorbidities such as diabetes, heart disease, high blood pressure, poor circulation, obesity, and age greatly complicate injuries and recovery. By identifying these factors and monitoring corresponding issues, a catastrophic claims team can better circumnavigate pitfalls.
• Ask the Worker
The worker knows best which treatments/equipment are working/lacking. Today’s technology allows for this information to be directly compared with physician notes, case management reports, and claims data to provide a broader picture and better outcome.
• Include the Family
The catastrophic claims team should also meet with the family to discuss care progress and pitfalls, as well as clarify care and recovery expectations.
• Understand Home Care May be Unavoidable
Most suffering catastrophic injuries will never return to work. Worse, some may not gain full independence. In these situations, options of 24-hour home care, nursing care, and family care must be carefully considered based on dynamics and injuries, to ensure quality of life.
• Consider Environment/Modifications
Environment can significantly impact post-discharge plans. Payers may have to cover the additional costs of home modification/relocation necessary to meet care needs.
• Don’t Overlook the Importance of Ongoing Monitoring
Regardless of the point in the path of the injured worker’s journey, regular file reviews are essential to identifying red flags. This safeguards compliance, and ensures the continuation of proper, quality care.
Helping workers avoid catastrophic workman’s comp claims is job #1. If the unimaginable occurs, know that Minnesota Comp Advisor is here to help. Learn how today.
It's a well-understood fact, getting employees back to work is a great way to manage workcomp insurance expenses. But are you pushing too hard?
Changing the Tide
Of the 70-80% of companies engaged in return-to-work programs, many are pushing these programs more aggressively in recent years due to their benefits: BLS data shows declines in virtually all major occupational injury and illness rates. OSHA shows these programs, combined with improved safety measures and more rigorous care, have put the brakes on runaway costs. Since the mid-1980s, more and more workers are returning to work before fully healing, engaging in restricted work regimens with temporary assignments, shortened hours, and job modifications. But how soon is too soon?
Pushing the Limits
With the ever-growing push to get people back on the job, controversy has arisen with emotional pitfalls-a-plenty. ‘Aggressive’ and ‘early’ return-to-work programs alongside ‘light-duty’ assignments are causing workplace brouhahas, to be replaced with more PC, less emotionally-charged verbiage and procedures.
Ensuring a Smooth Return
- Proactively devise - and refer to - written policies for return-to-work procedures, understanding that they take time. Educate all managers, supervisors, and employees on the return-to-work policy and expectations.
- Sell supervisors/management, who can make or break programs, and must understand the return on investment versus lost time and financial drains effecting job security.
- Be careful not to seemingly ‘harass’ workers in your efforts to control costs.
- Choose meaningful (not coddling or embarrassing) transitional assignments – and don’t devise them last-minute.
- Ensure all parties, from the employee to their physician and supervisor, are on-board.
Looking for new ways to manage workcomp insurance expenses? Take a load off with the help of Minnesota Comp Advisor today.
Technology makes text and email messaging a quick and convenient method of communication. However, it can have a harmful effect on workplace morale when used in the wrong situation.
Nothing beats a good old-fashioned conversation in these specific work scenarios:
• When change is imminent.
Change is often scary, and may be difficult for your employees to process and embrace. In the work environment especially, where employees often envision the worst possible scenario of how a change might affect them. Referred to as “awfulizing,” if misinterpreted or left in question, your change could result in employees fearing for their jobs, lowering morale and increasing the likelihood of them seeking work elsewhere. To head off issues at-the-pass, meeting one-on-one and indulging in Q&A is highly advisable.
• When constructive criticism is warranted.
In the case of offering constructive criticism, typed correspondence is easily misinterpreted, from CAPS LOCK conundrums to overlooked intent. Delivering input in-person also provides the added bonus of allowing you to witness your employees' reaction, which can help you better tailor the message to help them be more receptive to feedback. Reinforcing the message in text or print, however, such as in response to a situation where your suggestions have been overlooked, is fine.
• When terminating an employee.
As a general rule, terminating an employee is best done in person, especially if the termination is unexpected. It’s empathetic, and offers the terminated employee the chance to hash out the logistical details of the process.
When stakes and emotions run high, protect your workplace morale with the right communication techniques. Gather the tools and information you need for success with the help of Minnesota Comp Advisor today.
Lose your best employee? Don’t fret, there’s a rainbow at the end of the storm. Begin your journey back to normal with winning employee management tips, where with a positive attitude and essential staff feedback, you’ll soon return to the sunnier side of business.
Pop open an umbrella
When you lose a star employee, your staff may become deluged with worries: Increased workloads, overtime, even the survival of the business. Be honest with your staff without drowning in fear. Explain things will be tough for a while, but express your optimistic attitude about resurfacing from the setback as a team.
Spread a little sunshine
Offer existing employees the opportunity to step into their potential, possibly filling the shoes of the employee that left you bereft. Your next star employee could be right under your nose.
Go into the eye of the storm
Conduct a thorough exit interview to help determine if there's any pattern to employee loss. Keep emotions out and be open to an unfiltered viewpoint. If the split is amicable, consider offering higher pay to rule this out as the sole motivator.
Consult your local weather men
This is also a great time to get with employees, seeking honest feedback in hopes of preventing the situation from happening again, and showing existing employees that you care for and respect their needs.
Don’t seek shelter in a shanty
Don’t rush to replace a great employee with a warm body. Be proactive, not reactive, taking your time to seek out a quality replacement.
Drowning in staffing issues? Minnesota Comp Advisor has the employee management tips you need to ensure success. Contact us today.
Filling out your first OSHA 300 log? It’s easy to get overwhelmed. When you’re logging workman's comp insurance related illnesses and injuries, the trick is to break it down to the basics…
What are you trying to report on your OSHA 300 log form?
• Cases with medical treatment beyond first-aid
Place a checkmark in column J, for “other recordable cases.” Note injury or illness in column M. These cases include any treatment except first-aid, diagnostics, observation and counseling. See section 1904.7(b)(5) of the regulatory text for details on what constitutes “first-aid.”
• Cases with days away from work
Place a checkmark in column H, entering the number of calendar days away in column K (whether or not they were scheduled to work, including weekends/holidays; maximum 180 days). In column M, note injury/illness.
• Cases with restricted work activity or a job transfer
Place a checkmark in column I, specifying the number of calendar days in column L. Count them the same as when recording days away from work (above). Note injury/illness in column M.
• Cases with days away from work AND restricted work activity
Place a checkmark in column H, leave column I blank, and enter days away in both columns K and L.
• Cases involving fatalities
Enter a checkmark in column G, specifying injury/illness in column M. Remember to report these within 8 hours of learning of their occurrence to the OSHA 800-number or local office.
Looking for other recording criteria?
Check out “Slide 13” of OSHA’s tutorial for step-by-step instructions involving other less common criteria.
Lost in a sea of workman's comp insurance paperwork confusion? Minnesota Comp Advisor can help. Contact us today.
Want to know how to lower your workman's comp rates? Here are some facts about adjusters that you might want to learn first:
1. Shaky Job Security
As harsh as it might sound, the fact that you have no safety program is actually good news for an adjuster. It means that since your safety program is not available, nor enforced, workman's comp claims are assigned to the adjuster's main office, which result in a steady work stream for the adjuster.
2. Minimal Supervision
The entire adjuster's office is an overworked mass of underpaid workers, meaning your adjuster is most probably not receiving the kind of strict supervision by his boss that leads to more efficient work,
An adjuster's job is extremely stressful. Imagine multiple deadlines piling up together, the non-stop ringing of the phone, and stacks of mail and email messages. Add some unhappy clients who are convinced that the adjuster is trying to fleece them or being deliberately unhelpful, and it becomes clear why adjusters often burnout.
4. Many Adjusters Leave
Who wants to work at a job where the pay is low and the work and stress levels are high? Naturally, not a lot of people. New adjusters are constantly arriving due to the promise of a good job, and then leaving quickly in search of a better job.
5. Mistakes are Taboo
Any mistakes the adjuster makes are taboo, in the sense that they will never talk about them or even admit to making them. The loyalty of the adjuster is towards his boss, not you.
For more information regarding how to lower your workman's comp rates, go to http://www.minnesotacompadvisor.com
Having a tough time motivating employees to manage their own safety and health? Take it to the next level - lower your workman's comp rates, engaging employees by ramping up your communication skills and taking your delivery and influence to the next level.
• Tell a story.
Powerhouses like Disney understand the power of storytelling for motivating employees, sourcing stories from employee experiences to connect emotionally in a way the workforce will remember.
• Be visual.
Make a video of workplace processes, then use it for review, garnering solutions from those who can offer essential, unbiased viewpoints such as your insurance company, and professional affiliates. Video is also a great tool for resolving training, in-the-field or communication issues.
• Get creative.
Photos, diagrams, pictographs and graphics are highly effective in promoting workplace safety. As great reminders, ensure they are clear and concise, eye-catching, professionally done, and properly placed for ultimate efficacy. Rotate safety gear and postings regularly to keep employees alert and compliant.
• Go beyond words.
Noise can increase the risk of occupational injury, making visual cues essential. Consider adopting a system of hand signals, vibrating pagers, or flashing lights to better deal with workplace risk areas.
• Be the change.
Employee commitment to safety often mirrors that of management. Ensure every level of management is involved, from line supervisors to V.P.s.
• DO repeat yourself.
Culture a sense of responsibility by stressing its importance through the use of consistent, clear messaging shared via various multiple mediums: print to digital, posters to texts, meetings to video messaging.
Ready to lower your workman's comp rates? Minnesota Comp Advisor has the tools you need to keep costs under control. Contact us today.
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