3 Ways a Technology Company Is Using Data to Move Workers’ Comp Forward
Today, data is everywhere. Companies across every industry are looking for ways to leverage analytical insights to improve performance. In workers’ comp, data insights primarily target ways to reduce costs while optimizing outcomes.
Predictive analytics can identify injured workers who may require extra resources earlier in the care process, mitigating the likelihood of that claim spiraling out of control. Pharmacy data drives safer and more effective decision-making when it comes to prescriptions, especially in the realm of pain management. Analytical tools also drive broader digitization efforts which yield administrative efficiency.
Despite these benefits, there is always some friction inherent in the move toward digitization and data analytics. People may fear that their functions will be replaced by technology, or that an algorithm will be trusted more than their own hard-earned expertise.
In some ways, the disruption of the Covid-19 pandemic has helped organizations overcome this hurdle. Forced into a remote work environment, workers’ comp organizations have had no choice but to embrace the information-sharing capabilities of analytical tools.
“The ability to capture, share and protect data has become more important than ever,” said JJ Schmidt, Conduent Casualty Claims Solutions.
One provider of technology solutions to the workers’ comp industry is showing how tapping into the power of data can produce better outcomes and prepare the industry for the trends of tomorrow.
1. Data Sharing Drives Efficient Claims Management
Analytical tools aid knowledge transfer by centralizing data and making it easier to access, ensuring consistent information across the board.
“It does give structure to the data and improves governance of information, to where organizations can now say, ‘This is the set of information that we want to use, and how you should apply it,’” said Sanjay Manocha, Conduent Legal, Compliance and Analytics.
Analytics platforms also facilitate information sharing when teams are not physically able to meet to discuss claim status, provider feedback, formulary changes and broader industry trends. Analytical tools give newer, less-experienced adjusters the opportunity to access insights they might normally glean from face-to-face meetings with mentors or company veterans.
“Objective data analytics help to get everyone on the same page and operating at the same level, even in a remote environment,” Manocha said. “This keeps claim management more streamlined, minimizes redundant or outdated information, and empowers faster decision-making.”
2. Provider Rating Tools “Nudge” Patients Toward Quality Care
In jurisdictions where injured workers may select their own providers, quality scores help to direct them toward competent physicians. Those scores represent a comprehensive reckoning of that doctor’s clinical outcomes, encompassing everything from their prescribing tendencies to their communication style.
Fair scores are only possible if they draw from large datasets. Often, that requires utilizing data sources from the workers’ comp industry as well as general healthcare, Medicare and Medicaid.
“Commercial healthcare data may not shed light on comp-specific factors like return-to-work, but things like utilization of surgery, use of certain prescriptions, and other medical outcomes do lend themselves to provider profiling,” Schmidt said.
Qualitative data matters, too. Data-driven provider rating tools must be able to weight and incorporate subjective feedback from adjusters, case managers, risk managers and other medical professionals.
“You may have a provider that scores very low on the objective metrics, but then you dig a little deeper, and you realize that this provider is treating patients who have had failed back surgery. This provider is getting the worst of the worst cases,” Schmidt said.
“You have to be able to ascertain that kind of qualitative feedback and ensure the provider score reflects those nuances in order for it to be helpful to patients and effect better clinical results.”
3. Tracking COVID-Induced Trends to Prepare for the Future of Workers’ Comp
Data analytics enables better decision-making in the present, but it also helps companies anticipate the future. Big changes are happening in the workers’ comp industry – and the world at large. Carefully tracking these changes can help organizations adjust to shifting demands.
Telemedicine utilization offers one example.
“In March and April when stay-at-home orders went into effect, we saw use of telemedicine jump by something like 1,000%. Everyone believed this was the way of the future,” Manocha said. “The very next month, in May, the numbers went down, and then they went down from that in June, and down again in July. That doesn’t mean that workers’ comp organizations shouldn’t invest in strong telemedicine platforms, but that it might not be the sea change we were gearing up for.”
Tracking macroeconomic and demographic trends has also shown that remote work has liberated employees to move away from their employers’ geographical location. There has been a mass exodus out of expensive cities like New York to regions with lower cost of living and higher quality of life.
“You’re seeing lots of people migrate to places like Florida, or Texas, or Arizona, where the jurisdictions are much easier and much more employer-friendly. That may start to have an impact on workers’ compensation,” Schmidt said.
A Technology Company with Broad Healthcare Expertise
The combination of real-time and forward-looking analytical tools, plus the benefits of large datasets, equips companies to adapt to challenges rapidly based on more than just intuition. But workers’ comp claims organizations don’t have to build and implement these tools on their own.
That’s where companies like Conduent can bring their industry-specific and technological expertise to bear.
“There are many unique tools and resources that we bring to the table outside of just being a bill review vendor,” Schmidt said.
“Conduent is probably one of the larger players on the managed care services side. Outside of what we’re doing in workers’ comp, Conduent has a very large portfolio on the healthcare side as well, touching everything from government payers to commercial health and pretty much everything in between,” Manocha said. “That means we have a more complete view of everything going on in healthcare, and much larger volumes of data to work with.”
Conduent puts that data and expertise to work building customizable technology platforms for clients across multiple sectors. Ultimately, this translates to increased productivity, reduced costs and better claim outcomes for workers’ comp organizations, setting them up for success no matter what unknowns lie ahead.
To learn more, visit https://www.conduent.com/workers-compensation-solutions/.
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Conduent. The editorial staff of Risk & Insurance had no role in its preparation.