How Ecological Momentary Assessment and Other Behavioral Health Tools Can Impact Your Workers’ Comp Program
In part one of this series, we introduced the behavioral construct of Self-Determination Theory (SDT), which states that people have three innate psychological needs: the needs for autonomy, competence, and relatedness. Hindering or not supporting any of these needs will adversely affect well-being.
In part two, we introduced cognitive load and executive function, the former being the amount of working memory that is occupied at a given time and the latter being the mental skills required to perform a task. We proposed that the claims process could be dramatically improved by adopting insights provided by these characteristics of human behavior and psychological functioning.
SDT provides the overarching framework to guide the design of systems and interactions in the process in order to promote successful claims outcomes. Simplifying systems (e.g., through technology enablement and automation) is an effective way to reduce demands on cognition and executive function.
This third part of the series explores behavioral and psychological elements that relate to the psychosocial aspects of workers’ compensation claims.
A Better Way Forward
In the last decade, the workers’ compensation industry has begun to appreciate the impact of psychosocial issues on claims outcomes. Things like an individual’s attitude, mindset, worldview, recovery expectations, and readiness to return to work can impact outcomes.
In addition, an injured worker’s social environment, living conditions, transportation capabilities, financial well-being, interpersonal relationships and family and home responsibilities can also affect recovery trajectory.
Current claims management processes and systems rarely capture these psychosocial insights that could provide a more comprehensive view of the context in which an individual is attempting to recover. Using automated messaging capabilities (i.e., ecological momentary assessment, or EMA), real time psychosocial insights can be collected from injured workers, providing an early warning for issues that may affect their recovery and prompting action by a claims professional.
Simple queries about an injured worker’s optimism, their positive outlook, and their satisfaction with their providers or claims professionals can indicate the trajectory of a claim. Insights derived from EMA can help claims professionals navigate psychosocial issues by providing information to help start a conversation with the injured worker about things that are affecting recovery that are otherwise either unknown or are hard to talk about.
“The Workers’ Comp Benchmarking Study highlighted that psychosocial issues are a key driver of claims costs. It’s important for us to consider how we can better uncover and solve for these issues, so that we can do what’s best for the injured workers we serve and ultimately deliver the best claim outcomes.” – Daniel Brewer, AVP & WC Manager, Claims, The Cincinnati Insurance Companies
Real time assessment of the injured worker and their situation along with telephone follow-up draws from the Theory of Planned Behavior, Motivational Interviewing, and Social Cognitive Theory. It seeks to identify attitudes, beliefs, and motivations, along with identifying social and environmental factors that may affect an individual’s recovery.
Follow-up phone contact then enables the claims team to provide additional emotional support and encouragement to the injured worker.
These digital, plus phone, contacts assure the injured worker that they are not alone, not forgotten, and that there are resources to help at every step of the journey back to full functioning.
Frequent check-ins not only help identify issues and stimulate follow-up, but provide substance for deepening interpersonal connections between the injured worker and their claims team, which are foundational to building trust.
Lack of trust is a common occurrence in the claims process and is often a trigger for an injured worker seeking legal involvement, which drives up overall claim costs. Injured workers who feel they are not being heard or feel isolated and out of touch, are more likely to seek an attorney who will give them the support they crave.
“There’s no good reason why claims organizations can’t employ worker advocacy-based strategies in the interest of a better injured worker experience and the improved combined ratio that comes with it.” – William (Bill) Zachry, Board Member of California State Compensation Insurance Fund, Former Group Vice President Risk Management Safeway / Albertsons, Former Senior Fellow, Sedgwick Institute
We hope this three-part series inspires you to innovate within your own claims organization. It is not some Sisyphean task to design an injured worker experience that reduces the stress and anxiety of the process. Your efforts can enable injured workers to devote their full energy to recovery.
And you can bring the concept of “claims advocacy” to life by giving the appropriate guidance to your claims professionals, helping them focus on building a human relationship and trust with their injured workers. These are key elements to expediting recovery and reducing the need for litigation, both of which save enormous cost. &