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Digital EditionNational Comp 2026: The Follow-Through Gap
The highest-performing claims organizations in workers’ compensation aren’t chasing different ideas than everyone else. They’re investing in the same things: A.I., automation, workflow redesign, a better experience for their people. What separates them is what happens after the plan gets approved.
That’s the central finding of Rising Medical Solutions’ 2025 Workers’ Compensation Benchmarking Study. The share of organizations reporting claims closure ratios of 101% or better rose to 36%, up from 30% in the prior study. And those higher performers aren’t winning on easier claims. They’re more likely to carry heavier concentrations of active indemnity claims.
The challenge is focus. “Walk through the expo — you throw a pen and you hit a vendor,” said Stacey Foote, vice president of claims at The MEMIC Group. “So I think the most important thing would be to find what problem are we trying to solve.”
Foote made the remark from the stage at National Comp 2026 in Las Vegas, where Rising convened its annual panel to unpack the study. She was joined by Leslie Dunham, managing director of workers’ compensation claim product at Travelers, and Denise Zoe Algire, former director of health at Albertsons Companies, who also serves as the study’s principal researcher and report author. Foote and Dunham sit on the study’s advisory council. Rachel Fikes, Rising’s chief experience officer and study program director, led the discussion.
Choose Better
Algire distilled project selection into a few core questions: “Does this move the claim forward? Does this improve the injured worker’s ability to return to work faster? Does this help the claims professional do their job better and more efficiently?” she said. “If it doesn’t, we should be asking ourselves why are we doing it.”
The data shows higher performers lean harder on evidence and on the people doing the work. When identifying automation opportunities, 48% use data-driven analysis and 44% use frontline staff input, compared to 32% and 30% of lower performers. Lower performers are more likely to rely on leadership directives instead.
Dunham compared the temptation to a new iPhone launch: exciting, until she asks why she needs one when hers works fine. “You have to always ground yourself on what is it that we’re trying to accomplish, not something that looks good and you’re trying to later figure out what was the problem to begin with.”
Skipping the frontline is costly, Foote added. “Things go south real, real fast, and you really don’t get the adoption rate you would like. It ends up turning into a theory versus reality.”
Reduce Friction
Administrative work remains the industry’s heaviest drag: 85% of claims leaders say administrative and compliance demands hinder critical work like injured worker communication and return to work. Top AI projects look similar everywhere, clustering around summarization and decision support. But higher performers implement them more broadly and get more from them, with 35% reporting improved documentation accuracy versus 19% of lower performers.
“It’s not necessarily a sexy use case,” Algire said of medical record summarization. “But it provides a tremendous amount of value to the frontline workers actually managing claims.”
Dunham argued summarization is only the first step. When Travelers takes on new TPA-managed business, claims can arrive with years of medical history. Rather than leave adjusters reading stacks of summaries, the company mines them for insights that flag which claims need attention first.
“The injured employee shouldn’t care. They should care that someone is picking up their claim that very next minute,” she said. “It doesn’t take the human out of the loop. We’re instead serving it up in a different way to say, here are the things that need your attention immediately.”
For Foote, some of the biggest wins aren’t AI at all. MEMIC now pays 48% of its medical bills automatically. “It only takes a second” for an adjuster to push that button, she said. “Well, those seconds add up.”
Integration is the other friction point. Only 30% of organizations have implemented a centralized vendor portal, though higher performers are twice as likely to have one in development. Noted Foote: “MEMIC won’t do anything with a vendor unless it can be integrated into our system.”
Algire urged embedding as much as possible inside the claim system and judging partners on outcomes, not service-level agreements. A vendor can pass its audit and still produce poor claim results, she said, “because they’ve learned how to check boxes.”
Dunham said real-time API connections have raised expectations. “Now we’ve gotten greedy,” she said. “We want that document, but I also want these 20 different discrete data fields.”
Drive Adoption
Half of higher performers name pilot programs with staff feedback as their most effective adoption strategy, compared to 43% of lower performers. Leadership endorsement barely registers in either group.
Dunham cautioned against treating a pilot as a soft launch. “A pilot doesn’t mean that it’s a small-scale implementation. It is just that — a test,” she said. “It’s okay during a pilot to make adjustments.”
Algire’s approach is to hand over ownership first. “There’s a big difference between telling your team, here’s the new tool, and we have to have it adopted by this date,” she said, “rather than saying, help us figure out whether this will work.” Frontline staff, she added, “see around corners that we don’t.”
Foote said credibility travels through peers, especially frontline subject matter experts. “Employees look to those SMEs and those leaders without a title,” she said.
Build Strength
Higher performers are also more likely to formalize knowledge transfer through mentorship, job shadowing and coaching. “Knowledge transfer should be part of your operational model,” Dunham said. “Historically, some leave it to chance.” Travelers runs communities of practice where teams across the company share what they would do differently after a project.
Foote stressed stretch assignments at every level, from customer service up. “We want people to be problem solvers, not just fix-its,” she said. “We don’t need all the Olivia Popes out there. We actually need people that will drill down to the root cause, find a solution, and share that solution.”
Algire saw what happens without that bench during her consulting years. “Many organizations rely on a few key, highly talented people, and when those people leave or transfer to other positions, there is an enormous gap,” she said. The organizations that keep improving “are building capacity, not just programs.”
Keep Your Own Pace
The panelists closed on reassurance rather than urgency. “Wherever your company is now with adoption of AI, it’s okay,” Foote said. “It’s a race, but it’s your race. Everyone thinks they’re behind and they’re really not.”
Dunham asked leaders to audit where their energy goes. “Have I invested the same amount of time, people and effort in sustaining the change,” she said, “or am I just focused on what looked pretty to begin with?”
Algire articulated one of the study’s key takeaways: “Complexity doesn’t necessarily drive performance. It’s really the clarity and discipline that is driving execution,” she said. “You can have the best ideas in the world or the most beautiful roadmap, but without execution, it’s just a pretty picture.” &
