White Paper

2025 Workers’ Compensation Benchmarking Study: Next-Gen Claims Differentiators

The latest annual report reveals four execution patterns that separate high performing claims organizations from their peers.

White Paper Summary

The 13th annual Workers’ Compensation Benchmarking Study reveals that higher performing claims organizations are not necessarily distinguished by different priorities, but by how effectively they execute them. While many organizations are investing in similar workforce, technology, and operational initiatives, the study findings show significant differences in how those investments are translated into measurable results.

Based on a nationwide survey of claims leaders, the 2025 Report explores a question facing many payers: Why do organizations pursuing similar priorities achieve such varied outcomes? Using the study’s signature comparison of Higher Performers (organizations with claim closure ratios of 101% or greater) and Lower Performers (100% or below), the latest findings point to a consistent answer: the greatest performance differences emerge through execution.

Four Ways High Performers Separate Themselves

  1. They Choose Better: Higher performers rely more heavily on frontline insight and operational data to identify improvement opportunities, prioritize investments, and select high-value initiatives.
  2. They Reduce Friction: Higher performers are more effective at identifying operational pain points and designing solutions that reduce administrative burden, simplify workflows, and improve day-to-day claims execution, contributing to stronger gains in staff efficiency.
  3. They Drive Adoption: Higher performers actively engage frontline staff throughout implementation, using pilot programs and feedback loops to test, refine, and improve solutions before scaling them across the organization. They are also significantly more likely to foster innovation and change adoption through leadership behavior modeling.
  4. They Build Strength: Higher performers invest more heavily in workforce development, knowledge transfer, leadership readiness, and organizational capabilities that support ongoing improvement and future performance.

While the performance gaps associated with individual practices vary from modest to major, the findings suggest that their true impact emerges when they work together. Higher performing organizations consistently demonstrate strength across multiple dimensions of execution, creating a cumulative advantage that can compound over time. Rather than approaching improvement initiatives in isolation, they align people, process, technology, and culture in ways that reinforce one another and drive stronger outcomes.

To learn more about Rising Medical Solutions, please visit their website.

Rising Medical Solutions is a national managed care firm that provides medical cost containment and medical care management services to the workers’ compensation, auto, liability, and group health markets. Rising’s mission is to “make lives better,” by taking the pain out of the healthcare experience for those providing, receiving, and paying for medical care.

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