Here’s Proof That Advocacy Programs Are Producing Optimal Results

Companies seeking to reduce litigation in their workers' comp cases are finding worker advocacy is one way to gain the trust of injured workers.
By: | December 6, 2018 • 3 min read

Lesley Zielinski doesn’t need to be sold on the concept of worker advocacy in creating better workers’ compensation outcomes. The senior director, workers’ compensation and risk intelligence for Kelly Services, has seen firsthand what a new approach to managing claims can do for worker health and the bottom line.

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Zielinski presented on the topic, “How Advocacy Programs Produce Optimal Outcomes,” at the NWCDC in Las Vegas on Wednesday, Dec. 5, and she had some pretty interesting things to say alongside Linda Maw, the director of workers’ comp for TrueBlue, and Veronica Cressman, a senior vice president, medical programs with ESIS.

Kelly Services, a staffing services provider, was seeing high litigation rates on its workers’ comp claims in some parts of California. So in 2016, Kelly started taking a less confrontational approach to managing workers’ compensation claims.

That meant “not delaying claims unless there was a really strong reason why and looking at a claim that was being suggested for denial and considering whether it was a strong move to deny versus accept and closely manage the claim,” Zielinski said.

Lesley Zielinski, senior director
workers’ compensation and risk intelligence, Kelly Services

Zielinksi and her team also developed a custom telephonic nurse case management program that could be used in some of the company’s most problematic locations.

In addition to the company’s California trouble spots, the program also rolled in some claims from Illinois, Missouri and Florida.

The nurse case managers were charged with letting injured workers know Kelly Services had requested the nurse case management service for them and that they were there to help with any insurance or medical questions the worker might have. ESIS is now utilizing its own model, based in part on the work pioneered by Zielinski and Maw.

“After we touched base with a couple of clients, those two in particular — where we realized they had stepped forward and started doing their own pilots — we asked for them to start sharing that information, because they were working with our nurses and they were working with our claims reps, but we had not yet formalized it from our side,” said Cressman of ESIS.

A less confrontational workers’ comp approach meant “not delaying claims unless there was a really strong reason why and looking at a claim … suggested for denial and considering whether it was a strong move to deny versus accept and closely manage the claim.” — Lesley Zielinski, senior director, workers’ compensation and risk intelligence, Kelly Services

“Yes, we were aware of it, but they started it and then tapped into that and we looked at how we could make sure that the messaging and the goals across the board were shared with all disciplines within the ESIS organization,” she added.

Veronica Cressman, SVP, medical programs, ESIS

“We have embedded that into our best practices, and then in addition to that, some of our clients have gone one step further and made sure that there is someone from the clients’ representatives actually doing outreach and making sure that the employees’ concerns are being heard, that they are valued, that they have a job to go back to,” she said.

The result? In the California trouble spots, the first wave of the Kelly Services program, litigation rates were cut from 23.6 percent of cases to 13.7 percent of cases. Rates were also cut in Missouri and Illinois. Florida, with its problematic Castellanos decision at the state Supreme Court level, is still a tougher row to hoe.

Cressman said ESIS is in the process of collecting data to see how effective the advocacy approach has been for its other clients that are utilizing the method. &

Dan Reynolds is editor-in-chief of Risk & Insurance. He can be reached at [email protected].com.

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]