Workers ‘compensation study compiles claims best practices

Identifying goals key to effective claims practices, study finds

Workers Comp

By Allie Sanchez

As part of its continuing efforts to bridge delivery gaps in the industry, the annual Workers’ Compensation Benchmarking study compiled claims best practices that have resulted in better outcomes for their proponents, according to a report by WorkCompWire.
 
This is the first time Rising Medical Solutions, the organization that undertook the study, identified such practices. The study has been ongoing for four years.
 
According to the report, as enumerated by WorkCompWire, some of the key characteristics of effective claims practices include:
  • A link between key performance indicators and desired claim outcomes
  • The use of technology enabled decision support tools, such as analytics, automation and predictive modelling
  • Use of employee-centric and advocacy based service models
  • Use of pharmacy metrics
  • Stipulation of expected provider quality and outcomes in contracts
 
“We’ve heard from the claims community about difficulties identifying which best practices actually move the needle because industry data is often limited or unavailable,” observed Rachel Fikes, vice president and study program director at Rising Medical Solutions in the wire report.
 
“Providing quantitative, primary data to substantiate various methods in claims management was the next logical step in the study’s evolution,” she added.
 
The study surveyed almost 500 claims leaders who reported on their methods to achieve effective and efficient outcomes.


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