Column: Workers' Comp

The Benefits of Change

By: | December 1, 2013 • 3 min read
Roberto Ceniceros is senior editor at Risk & Insurance® and chair of the National Workers' Compensation and Disability Conference® & Expo. He can be reached at [email protected] Read more of his columns and features.

Looking across the workers’ compensation landscape going into 2014, the forces driving inevitable change include Obamacare’s unknowns, insurer combined ratios, vendor consolidation, and Oklahoma’s experiment with an alternative benefit delivery structure.

To steal from the comedian Gallagher, change is inevitable — except from a vending machine.


Change is also afoot at Risk & Insurance®. I recently joined the R&I team to continue the magazine’s mission of helping workers’ comp professionals make sense of the numerous forces impacting the business world and your industry.

I have been fortunate to report on risk management for 19 years, with much of that time focused on workers’ comp topics. I say fortunate because I love workers’ comp and its richness of issues, stories, and people who shape it or get shaped by it.

Many of the issues and stories I see playing out in 2014 are already here today, including the Affordable Care Act’s impact.

Opinions have varied on how the health care law will touch workers’ comp, and on issues such as how a potentially healthier population will impact claims, whether medical provider shortages will emerge, and the way treatment costs might shift.

The law’s fumbling rollout isn’t making the murky waters any clearer. But it appears here to stay and whatever changes result won’t alter an employer’s mission of helping injured workers return to productive lives.

It also won’t eliminate the need for workers’ comp claims payers to focus on applying the right medical care and weeding out unnecessary expenses while reassuring injured employees and complying with complex laws.

Whether the economy gains strength in 2014 is another unknown. Fortunately, insurer combined ratios have improved several points from 2011’s troubling 117 percent, helped by rising rates and a stable, although low-growth, employment picture.

For now, observers say, combined ratio improvement means a tempering of ongoing insurance price increases. But future insurance prices will be impacted by the future economy.

Then, there is the continuing consolidation of workers’ comp service providers into the hands of private equity firms. That could narrow employers’ choices among service providers and perhaps boost the private equity owners’ ability to squeeze more revenue from employers.

Yet, the changes could also unleash opportunities, such as the potential for consolidated entities, with their economies of scale and larger financial positions, to push greater investment into new technology that improves claims management and reduces costs.


But, as a neutral observer, events in Oklahoma present my favorite potential force for change ahead. The state’s recent law allowing employers to create an alternative to the traditional workers’ comp mechanism for delivering care and benefits could serve as a model for other states.

But that will likely depend on whether employers in Oklahoma succeed in truly helping injured workers while reducing their costs.

Obviously, it remains to be seen what good or bad comes from the forces shifting the workers’ comp landscape.

No matter the changes, though, you can count on finding me here writing this column and working with the staff at Risk & Insurance® to report on the changes ahead — to help you keep abreast of the emerging claims trends, the economic factors shaping insurance markets, and the legal and medical management news impacting workers’ comp.

More from Risk & Insurance

More from Risk & Insurance

Risk Management

The Profession

Janet Sheiner, VP of risk management and real estate at AMN Healthcare Services Inc., sees innovation as an answer to fast-evolving and emerging risks.
By: | March 5, 2018 • 4 min read

R&I: What was your first job?

As a kid, bagging groceries. My first job out of school, part-time temp secretary.

R&I: How did you come to work in risk management?

Risk management picks you; you don’t necessarily pick it. I came into it from a regulatory compliance angle. There’s a natural evolution because a lot of your compliance activities also have the effect of managing your risk.

R&I: What is the risk management community doing right?


There’s much benefit to grounding strategic planning in an ERM framework. That’s a great innovation in the industry, to have more emphasis on ERM. I also think that risk management thought leaders are casting themselves more as enablers of business, not deterrents, a move in the right direction.

R&I: What could the risk management community be doing a better job of?

Justified or not, risk management functions are often viewed as the “Department of No.” We’ve worked hard to cultivate a reputation as the “Department of Maybe,” so partners across the organization see us as business enablers. That reputation has meant entertaining some pretty crazy ideas, but our willingness to try and find a way to “yes” tempered with good risk management has made all the difference.

Janet Sheiner, VP, Risk Management & Real Estate, AMN Healthcare Services Inc.

R&I: What was the best location and year for the RIMS conference and why?

San Diego, of course!  America’s Finest City has the infrastructure, Convention Center, hotels, airport and public transportation — plus you can’t beat our great weather! The restaurant scene is great, not to mention those beautiful coastal views.

R&I: What’s been the biggest change in the risk management and insurance industry since you’ve been in it?

The emergence of risk management as a distinct profession, with four-year degree programs and specific academic curriculum. Now I have people on my team who say their goal is to be a risk manager. I said before that risk management picks you, but we’re getting to a point where people pick it.

R&I: What emerging commercial risk most concerns you?


The commercial insurance market’s ability to innovate to meet customer demand. Businesses need to innovate to stay relevant, and the commercial market needs to innovate with us.  Carriers have to be willing to take on more risk and potentially take a loss to meet the unique and evolving risks companies are facing.

R&I: Of which insurance carrier do you have the highest opinion?

Beazley. They have been an outstanding partner to AMN. They are responsive, flexible and reasonable.  They have evolved with us. They have an appreciation for risk management practices we’ve organically woven into our business, and by extension, this makes them more comfortable with taking on new risks with us.

R&I: Are you optimistic or pessimistic about the U.S. health care industry and why?

I am very optimistic about the health care industry. We have an aging population with burgeoning health care needs, coupled with a decreasing supply of health care providers — that means we have to get smarter about how we manage health care. There’s a lot of opportunity for thought leaders to fill that gap.

R&I: Who is your mentor and why?

Professionally, AMN Healthcare General Counsel, Denise Jackson, has enabled me to do the best work I’ve ever done, and better than I thought I could do.  Personally, my husband Andrew, a second-grade teacher, who has a way of putting things into a human perspective.

R&I: What have you accomplished that you are proudest of?

In my early 20s, I set a goal for the “corner office.” I achieved that when I became vice president.  I received a ‘Values in Practice’ award for trust at AMN. The nomination came from team members I work with every day, and I was incredibly humbled and honored.

R&I: What is your favorite book or movie?

The noir genre, so anything by Raymond Chandler in books. For movies,  “Double Indemnity,” the 1944 Billy Wilder classic, with insurance at the heart of it!

R&I: What is your favorite drink?


Clean water. Check out for how to help people enjoy clean, safe water.

R&I: What’s the best restaurant at which you’ve eaten?

Liqun Roast Duck Restaurant in Beijing.

R&I: What is the most unusual/interesting place you have ever visited?

China. See favorite restaurant above. This restaurant had been open for 100 years in that location. It didn’t exactly have an “A” rating, and it was probably not a place most risk managers would go to.

R&I: What is the riskiest activity you ever engaged in?

Eating that duck at Liqun!

R&I: If the world has a modern hero, who is it and why?

Dr. Seuss who, in response to a 1954 report in Life magazine, worked to reduce illiteracy among school children by making children’s books more interesting. His work continues to educate and entertain children worldwide.

R&I: What do your friends and family think you do?

They’re not really sure!

Katie Dwyer is an associate editor at Risk & Insurance®. She can be reached at [email protected]