Guidance for the Perplexed
The task of helping injured workers recover and managing their workers’ compensation and disability claims is growing increasingly complex.
Rising medical costs amid a shifting health care-delivery system present one set of challenges. The poor overall health of the nation’s workforce and regulations such as the amended Americans with Disabilities Act are additional forces complicating matters.
That is why delivering proven strategies for tackling the issues facing employers and other claims payers has become such a priority.
Scheduled for Nov. 11-13 at Mandalay Bay in Las Vegas, the 24th Annual National Workers’ Compensation and Disability Conference® & Expo will provide opportunities to meet with industry leaders and hear directly from peers providing practical solutions for medical, legal and claims-management issues, among other topics.
While Las Vegas offers up swank restaurants and clubs for evening relaxation, conference breakout sessions promise serious information and tactics for improving injured worker health, enhancing workers’ comp program performance and boosting an employer’s bottom line.
For example, Patti Colwell, Southwest Airlines’ workers’ comp program manager, will discuss a quality-assurance strategy for selecting service providers and determining whether they are delivering on their service promises.
The presentation is part of the conference’s Program Management track, developed to help employers and others eliminate injuries, improve operational performance, support injured worker health and speed return-to-work outcomes.
The track will include a session on applying data analytics and predictive modeling that can improve the focus of claims management and risk assessment — but only if applied properly.
It makes sense to learn about properly applying predictive modeling tools from colleagues who have gained practical knowledge by actually using the tools. So, Tim Starks, director of casualty at Georgia-Pacific, joins Frank Murray, SVP of claims at ESIS, to share lessons the employer gleaned from applying predictive analytic solutions.
Medical management is another shifting factor in claims management, on top of its increasing cost. The conference’s Medical Management track will provide up-to-date information on the topic.
A panel of the foremost medical directors in workers’ comp will speak about optimally applying medical intervention’s power, and the harm done when that doesn’t happen.
Adam L. Seidner of Travelers Insurance, along with Marcos Iglesias of The Hartford, will discuss how the Affordable Care Act will make smart medical-intervention strategies even more crucial. They’ll be joined by Mel Belsky, medical director of the workers’ comp program at Albertsons Safeway Inc.
Denise Zoe Algire, director of managed care and disability corporate risk management at Albertsons Safeway, will moderate the panel.
The Medical Management track will also include Lisa Kelly, senior workers’ compensation manager at Boeing, who will share results obtained from the employer’s outcomes-based provider network and Boeing’s efforts to select quality care doctors.
Kimberly George, SVP, senior healthcare advisor at Sedgwick, and Greg Moore, president and CEO at Harbor Health Systems, will join Kelly to explain Boeing’s preparations for the coming changes in the delivery of health care to injured workers, including emerging care models like accountable care organizations and value-based pricing.
Breakout sessions for this year’s conference were also crafted with a sharper focus on disability management.
Dave Taylor, director of integrated disability management at Reyes Holdings, will explain how his company applied integrated absence management to solve disability and productivity challenges.
Renee Mattaliano, VP and practice lead of workforce management at HUB International, will join Taylor to detail how Reyes, a beer and food distributor, marshalled the necessary investment, data, vendors, corporate health resources and internal talent required to succeed at integrated absence management.
The breakout session is part of the conference’s Disability Management track highlighting strategies for mitigating drivers of employee illness and absence, whether occupational or non-occupational.
Addressing the challenges of administering disability, workers’ comp and leave laws will be discussed during “Best Practices in Leave Management and ADA Administration,” a session led by Terri L. Rhodes, CEO for the Disability Management Employer Coalition, and Karen English, a partner at Spring Consulting Group LLC.
The conference’s Claims Management track promises practical information on today’s tools for mitigating claims issues.
Stephanie Perilli, senior director of medical & health management at The Home Depot, will share her experience on leveraging data to determine when injured workers benefit from nurse case manager care.
Mary O’Donoghue, VP of medical services at Helmsman Management Services, a unit of Liberty Mutual, will team up with Perilli to discuss the art of evaluating the value of data.
Legal and Regulatory
The conference’s Legal/Regulatory track will offer the opportunity to hear opposing views on current legislative efforts to allow employers to opt out of workers’ comp systems across more states.
Trey Gillespie, senior workers’ comp director at the Property Casualty Insurers Association of America, will argue the value of existing workers’ compensation and disability programs, while Bill Minick, president at PartnerSource, will explain proponents’ goals during a breakout moderated by Dan Reynolds, editor-in-chief at Risk & Insurance®.
The Legal/Regulatory track will also feature a session titled “Extreme Violence in the Workplace: Causation, Mental Trauma and Prevention.” Albert B. Randall Jr., a trial attorney at Franklin & Prokopik, and Lori A. Severson, senior loss control consultant at Lockton Cos., will examine violence prevention and incident response.
Below is a synopsis of some of the other sessions at this year’s event. The entire agenda can be found online.
Opening Keynote: Achieving Excellence in Medical Treatment
What to expect: Providing injured workers quality health care is increasingly crucial for improved claims outcomes. But how to obtain true quality care remains a challenge. Dr. Arthur Southam will share lessons learned from group health and explain how Kaiser has successfully driven measured improvements in care quality among its 9.6 million members.
Who: Arthur M. Southam M.D., executive VP, health plan operations for Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals.
Session: Walmart’s Campaign to Manage Prescription Drug Misuse
What to Expect: After Walmart identified and mitigated legacy claims impacted by high-dose morphine prescriptions, it developed a data-driven strategy to prevent prescribing of harmful pharmaceuticals among new claims. Hear how those lessons can be applied by working with your pharmacy benefit manager.
Who: Mark Pew, SVP, PRIUM; Janice Van Allen, director of workers’ compensation, Walmart Stores Inc.
Session: Managing Risks and Claims in the Age of Legalized Marijuana
What to Expect: Clinical and legal experts will discuss shifts in workplace policies, claims management standards and service-provider guidelines that claims payers must learn about to prepare for changing marijuana-use laws.
Who: Markie Davis, director, risk management, State of Colorado; Kevin Glennon, VP, clinical education & quality assurance programs, One Call Care Management; Gregory J. McKenna, VP & counsel, Gallagher Bassett Services; moderator: Denise Algire, director, managed care and disability corporate risk management, Albertsons Safeway.
Session: PG&E Puts Telephonic Injury Assistance in Employee Hands
What to Expect: Shorter injury durations and fewer workers’ comp claims became long-term disabilities when Pacific Gas and Electric Co. changed its culture and implemented a 24/7 telephonic injury management program providing injured employees contact with occupational health nurses and physicians.
Who: Bryon Bass, director, integrated disability management, Pacific Gas & Electric Co.; Dr. Peter P. Greaney, CEO and medical director, WorkCare Inc.
Session: Proven Workers’ Comp Claims Management Strategies That Get Results
What to Expect: Approaches for analyzing claim portfolios and improving claim reviews along with lessons for effectively collaborating with insurers and third-party administrators are on tap as a senior risk analyst shares program-management practices that produced results for her employer and can help companies of any size.
Who: Stephanie Tutt, corporate senior risk analyst, Computer Sciences Corp.
Session: Employee Focused Program — What Does It Mean and Will It Work?
What to Expect: Engaging employees for the best claims outcomes requires making them the focus of your program even before an injury occurs. This session will offer practical tips for keeping the injured employee at the forefront of your program’s efforts.
Who: Drake Rogers, attorney, Young Clement Rivers; Bill Wainscott, manager, workers’ comp and occupational health, International Paper.