Claims Solutions Track Offers Advice on Increasing Efficiencies

A look at some of the sessions featured in the 2014 NWCDC Claims Solutions track.
By: | May 23, 2014

The 23rd annual National Workers’ Compensation and Disability Conference® & Expo takes place Nov. 19-21 at the Mandalay Bay Resort and Casino in Las Vegas. The confer­ence is produced by LRP Publications, the publisher of Risk & Insurance®.

ConferenceFrom analytics and predictive modeling to addressing nontraditional and legacy claims and a landmark study of claims managers, the Claims Solutions track offers advice to cut costs and increase efficiencies. Below is a look at some of the sessions.

Strategies for Overcoming Operational Challenges and Benchmarking Program Performance

    • Speakers:
    • Denise Zoe Algire, workers’ compensation, disability management consultant.
    • Jason Beans, CEO, Rising Medical Solutions.
    • Ray Jacobsen, managing director, Aon.
    • John Smolk, principal manager, workers’ compensation, Southern California Edison.

Claims managers face critical challenges overseeing their day-to-day operations without opportunities to benchmark their organizations’ performance against industry peers. A recent workers’ compensation benchmarking study surveyed management and executive-level claims leaders across the industry to document their most pressing operational challenges. The study and this session provide an opportunity for organizations to benchmark core competencies, best practices, technology, medical management performance, and talent development. The study’s architects will present their findings and opportunities for claims managers and executives to benchmark and address industrywide priorities and hurdles.

Going Beyond a Hunch: How Analytics and Predictive Modeling Can Identify and Prevent Drug Abuse


  • Jim Andrews, executive vice president of pharmacy services, Healthcare Solutions Inc.
  • David Smith, divisional vice president of risk management, Family Dollar Stores Inc.

The prescription drug landscape is ever-changing with generic uncertainty and the introduction of many dangerous drugs, and 2014 is no exception. Meanwhile, the threat of drug abuse and misuse are well-documented problems for risk managers, with narcotic opioids accounting for more than 60 percent of the drugs prescribed to injured workers. But analytics and predictive modeling can identify and stem potential abuse problems. The speakers discuss how Family Dollar used utilization management programs and early intervention to address claimant prescription use while reducing drug expenditures. They will discuss how predictive modeling can identify potential prescription abuse, ways to fight the problem through coordination between claims payers and pharmacy benefit managers, and the impact of narcotic prescriptions on claims costs and durations.

Approaches to Managing Nontraditional Claims, Including Unions, Legacy Claims, and Co-Morbidities


  • Patti Colwell, manager, injury recovery resources, Southwest Airlines.
  • Tron Emptage, chief claims officer, Progressive Medical/PMSI.
  • Julie Fortune, senior vice president and chief claims officer, Arrowpoint Capital.

Complex scenarios involving union agreements, legacy cases, and co-morbidities may require a nonconventional approach rather than the typical practice of quickly closing claims. This session takes a closer look at those issues while the speakers offer direct experience and insight on how to assess and address factors creating barriersto restoring function such as treatment type, dependence,comorbidities,aberrant behavior, and other psychosocial factors. They will also discuss when it may be appropriate to keep a claim open, factors that can prolong claims durations, how to detect nontraditional barriers to claim resolutions, and offer strategies to control reserves.

Loss Mitigation of High Value Workers’ Compensation Claims


  • David R. Kunz, managing partner, Kunz & Germick.
  • Christianne Quinn, J.D., national workers’ compensation manager, The Pep Boys.

High-value claims hurt a company’s bottom line. But the right risk analysis can maximize loss-control strategies and identify old claims ripe for closure. A veteran workers’ comp manager and a defense attorney discuss practices to help increase the probability of successfully closing claims previously thought incapable of settlement. The two look for input from the audience while addressing cost drivers such as ineffective prescription medications, treating physician problems, and expenses frequently obscured by Medicare set-asides.

The Industry’s Top Bloggers Return to Inform and Entertain


  • David DePaolo, J.D., founder/president/CEO, author DePaolo’s Work Comp World.
  • Joseph Paduda, principal, Health Strategy Associates, author, ManagedCareMatters blog.
  • Rebecca Shafer, J.D. president, Amaxx Risk Solutions Inc., author, blog.
  • Robert Wilson, president and CEO,


  • Mark Walls, senior vice president, workers’ compensation market leader, Marsh.

From Bob Wilson’s humorous musings to Joe Paduda’s serious evaluations of market events, the workers’ compensation industry’s high-profile bloggers return to the conference after last’s year’s highly rated presentation. They are ready yet again to offer their insights into the latest issues in a session moderated by Mark Walls that also includes blogger Rebecca Shafer, known for providing practical measures for employers, and David DePaolo, leveraging his unique vantage point to reflect on the news and trends of the day. The group examines the news events shaping the workers’ comp system, offers their interpretations of the trends influencing decision-making, and presents a lively discussion on the workers’ comp issues demanding attention.

Click here for more information. To post your thoughts on the conference, join the conversation on LinkedIn’s National Workers Compensation and Disability Conference & Expo, a subgroup of the Work Comp Analysis group.

Nancy Grover is the president of NMG Consulting and the Editor of Workers' Compensation Report, a publication of our parent company, LRP Publications. She can be reached at [email protected]

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