Pandemics don’t discriminate. Though COVID-19 has undoubtedly hurt some businesses more than others, no organization is immune to the virus’s effect on its workforce. Some have had to shift almost entirely to remote work. Others without that option are charged with cutting staff and heightening safety and infection control measures for essential employees that remain. At either end of the spectrum, workers’ comp exposures have changed dramatically in a short period of time.
“The public sector and health care companies have the more obvious exposures in the COVID-19 world — first responders and medical professionals are always on the front lines in disaster scenarios. While their risks aren’t unexpected, they have certainly increased,” said Mike Cirillo, President, myMatrixx. “And then you have essential businesses like grocery stores and manufacturers, where workers are being exposed to risks that had not been anticipated before now.”
The rapid rate of change and varied impact underscore the need for clinical workers’ comp solutions that are flexible and able to respond to the changing needs of employers and their injured workers through this period of disruption and into the “new normal” — whatever shape that takes.
Custom, data-driven solutions and consultative relationships matter now more than ever.
“From our perspective, COVID-19 has amplified and accelerated the innovative strategy we put in place every day, which is to provide customized solutions to every client,” Cirillo said. Here’s how that strategy is executed.
To gain a complete picture of their clients’ risk, myMatrixx employs a two-pronged approach that draws on internal expertise as well as data analytics.
Account executives first build the foundation for a trusting and communicative relationship. Often with years of prior industry experience, they know what questions to ask and how to dig into the nuts and bolts of a client’s operations and associated exposures.
“They are our eyes and ears for clients. Because our account executives have deep experience in claims, they can connect pieces that aren’t necessarily pharmacy-related, but could be physician-related, medical management-related, or case management-related,” Cirillo said.
Through their initial conversations, account executives gain a sense of their client’s strengths and weaknesses and identify their chief concerns. This ongoing needs assessment acts as the foundation for in-depth data analysis.
Benchmarking tools compare a client’s claim history to its peers, as well as the industry average. In addition to painting a high-level picture of an employer’s risk, these tools help to pinpoint top claim drivers. These drivers then serve as foundational metrics around which interventions can be planned and measured.
“It’s up to us to use that data to highlight where things are performing well, and not so well. What factors are contributing to injury frequency or severity? What’s driving costs? What’s inhibiting injured workers from getting better? The numbers indicate where new challenges are emerging so we can partner to develop a strategy to go forward and address that,” Cirillo said.
Importantly, myMatrixx’s data platforms utilize clinical and business analytics to measure both the quality of care outcomes and cost effectiveness of interventions.
Central to the success of this strategy is a commitment to consistency and regular oversight. Identifying areas for improvement doesn’t stop after initial client onboarding, but continues regularly via quarterly brainstorming sessions. Regular check-ins enable the adjustment of clinical solutions to handle rapidly changing workplace safety risks.
Clinical solutions in workers’ compensation comprise many moving parts — pharmacy, formulary and network management, risk scoring and predictive modeling, multidisciplinary collaboration and physician outreach, to name a few.
Caring for injured workers is complicated, even in normal circumstances. Under the cloud of COVID-19, administering care safely takes on a new sense of urgency. Consultative relationships between employers and workers’ comp service providers make sweeping changes easier to implement.
Telemedicine and home prescription delivery, for example, have become critical for contactless care delivery.
“Historically, home delivery was used for only a small percentage of prescriptions because of the perception that it’s only good for 90-day maintenance medications. We’re now seeing home delivery emerge as a means to enable the injured workers to get medications in a safe environment. Use of home delivery has probably tripled in the last 40 to 60 days,” Cirillo said.
Medication monitoring also has a bigger role to play. A confirmed COVID-19 infection necessitates careful review of medication therapy for potential drug interactions and contraindications. Even for injuries unrelated to the pandemic, treatment plans should be designed with the risk of infection in mind, as some medications can inhibit immune response.
“We have clinical pharmacists engaging with our employer and payer clients, injured workers and even physicians to provide education around the exposures associated with certain drugs and suggest alternatives. We are here to help make sure the patient receives medication that does not increase their risk,” Cirillo said.
More changes are still to come. It’s not yet clear how the pandemic will impact workers’ comp regulations and formulary rules. Evidence-based guidelines related to treatment of COVID-19 and other conditions concurrent with an infection continue to evolve. Though the challenges are new and fluid, the consultative approach at myMatrixx will continue to see clients through.
“We’ll be here to guide employers through rule changes and clinical guidelines as they evolve,” Cirillo said. “We’re also providing guidance on how to minimize transmission of the virus in various workplaces, which will help companies safely scale up operations as we transition into our new normal.”
This is all achieved through regular communication — something that could be a struggle amid the disruption and distractions that come with working from home. Despite shifting its entire employee base to remote work, however, Cirillo said myMatrixx has still been able to maintain around-the-clock customer support.
“Even as we transitioned to a work-from-home environment, I’m proud to say we’ve been able to deliver the same level of service. When it comes to turnaround times on customer requests, the quality of clinical claim outcomes, or the timeliness and accuracy of data reporting, we haven’t missed a beat,” Cirillo said.
In the end, a dedication to service is really what produces results. It’s what drives the investment in the expertise and technology needed to gain a deep understanding of client needs; it’s what fuels the effort to continually refine solutions to address emerging challenges; and it’s what motivates the team at myMatrixx to help clients navigate uncertain times like these.
“Our clients’ success is our success,” said Cirillo. “That’s why we’re fully focused on providing customized solutions to help grow their business; and with us, it all starts with service.”
This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with myMatrixx. The editorial staff of Risk & Insurance had no role in its preparation.