In its fourth iteration, the Risk & Insurance survey of workers’ compensation professionals, sponsored by Healthesystems, illustrated the top priorities of those in the industry in terms of innovation and resiliency.

Looking at the next three years, employee retention, recruitment and development; operational efficiency; and new business developments top the list. This is no surprise coming out of 2020 and all the disruptions presented to the industry by the onset of the COVID-19 pandemic.

The good news: While disruption in 2020 brought its fair share of hurdles, it has also given the industry the opportunity to innovate and strive toward advancement, which rings true through this year’s survey results.

Here’s a closer look at the top eight priorities identified by stakeholders and why they’ve made the list.

1) Employee Retention, Recruitment and Development

COVID-19 forced businesses to support a workforce working remotely or in-person behind masks, gloves and other PPE, prompting workers’ comp to navigate how to protect this hybrid workforce.

The face of the workforce also changed with the pandemic. As many as three million Americans retired early in response to the virus, according to Bloomberg reports. Further, layoffs and businesses closing shop led to a 14.8% unemployment rate at the height of 2020.

As the older, more experienced workforce left, positions opened for younger recruits. But many in this up-and-coming generation of workers are looking for at-home work options.

It is no surprise, then, that 59% of respondents placed employee retention, recruitment and development as the top priority for workers’ compensation during the next few years. Finding and retaining a workforce that finds fulfilment in what they do will be of critical value to the industry.

In addition to placing employee retention, recruitment and development in the lead, 71% of the survey participants flagged the changing workforce/workplace as a top concern when it comes to industry resiliency as well.

2) Operational Efficiency

Operational efficiency closely followed, with 51% of respondents flagging this as a big priority for workers’ comp over the next few years.

Kristine Kennedy, SVP, product strategy and innovation, Healthesystems

Knowing that finding, recruiting and keeping talent is a key concern for stakeholders, it logically follows that there be a desire to run operations as smoothly and efficiently as possible. Efficient operations are not just cost-effective; they can keep claims on track.

Having a well-oiled machine can go a long way in claims handling; providing quick medical care to injured workers; and looping in medical providers, employers, workers and other members of the claim with the appropriate information.

“Even before the pandemic, we were facing an impending shortage of talent, both in the insurance and health care industries. As that trend has been accelerated, so has the need for greater efficiency through technology,” said Kristine Kennedy, SVP of Product Strategy and Innovation at Healthesystems.

Interestingly, when asked about process/efficiency obstacles, claims professionals cited obtaining information from medical providers (64%) as a number one concern.

This theme of communication continued, with 44% of claims professionals saying difficulty in reaching and obtaining information from injured workers further impedes the claims process.

An additional 40% likened inefficiencies to outdated or inadequate claims processing systems. Forty-eight percent of the survey’s respondents placed claims process automation as their number one technological advancement they’d like to see in the next three to five years as well.

“Claims professionals must communicate and exchange information with multiple stakeholders across a fragmented system,” Kennedy noted. “By developing and leveraging technologies that create better connectivity and improve the flow of information, we can save many hours of time, minimize missed information and improve quality, while reducing errors and costs.”

3) New Business Development

There isn’t a business operator who doesn’t wish to jump into new business development opportunities. It’s a fundamental part of a company’s growth after all.

This year, 36% of workers’ compensation stakeholders placed new business development as a top priority, rounding out the top three for respondents.

Looking at the top two again — talent recruitment and operational efficiency — business development goes hand-in-hand with both and will play a major role in the success of these other priorities.

4) Improved Customer Experience

Coming in as the number four priority for workers’ comp in the next three years, with 29% of respondents saying so, is improved customer experience.

Technology plays a big role in customer experience, and 2020 changed the face of care for injured workers. Telehealth, while not a new solution, has been put to the test thanks to a rapid shift from in-person to virtual care amid the pandemic. Injured workers have been able to confer with their providers over the phone and via videoconferencing, keeping their claims moving forward instead of standing still.

Telehealth also pushes the workers’ comp space to think differently about how customers experience comp services. Forty-seven percent of stakeholders said telemedicine advances will be the most important technological advancement to see in the industry over the next five years.

“A good customer experience naturally depends on who your customer is,” said Kennedy.

“And in workers’ comp that can vary. Employers, insurance carriers, care providers and injured workers can all be considered customers. In all cases, meeting and exceeding their expectations is highly dependent on the right technology.”

In addition to telehealth, claims processing is another area where workers’ comp professionals are hoping to see improvement in customer experience.

Injured workers are often introduced into the claims management process for the first time following an injury while on the job. If the platform they are using isn’t up to par, confusion and anger may arise. That can lead to elongated claims, discouraged attitudes toward workers’ comp or even litigation.

“Injured worker patients are the ultimate customers because they are the ones who need to be appropriately treated and restored to health,” said Silvia Sacalis, Vice President of Clinical Services at Healthesystems.

“Quality care means providing the right treatment, of course, but it also means making it as easy as possible for vulnerable patients who are usually in pain to get that treatment in a timely manner.”

5) Cost Containment

Twenty-eight percent of workers’ comp stakeholders placed cost containment as a top priority over the next three years.

Ancillary and medical service prices outranked both provider fees and drug prices on the list of items that participants want more visibility into, with ancillary and medical service prices ranking fourth, provider fees fifth, and drug prices sixth.

Ancillary services have become a growing portion of the workers’ compensation market, ranging from physical therapy, to prosthetics, to home care, transportation, translation services and more.

“Workers’ comp payers are responsible for all aspects of an injured workers’ care from diagnostics to work hardening,” Kennedy explained.

“Products and services included in the ‘ancillary’ category that are commonly needed in workers’ comp include durable medical equipment (DME), physical medicine, diagnostics, and home health. Both price and quality and vary between a range of vendors and these cost are typically more challenging to manage.”

All of these ancillary medical benefit offerings provide injured workers with the care they need. But it is imperative for professionals in the space to understand the costs associated with each product or service to determine the best fit for each claim.

As the repertoire of benefits grows over the next few years, keeping an eye on costs will continue to be important to stakeholders.

6) Workplace Safety

Another area impacted by the pandemic — workplace safety — has become a top priority for every industry moving forward.

Silvia Sacalis, vice president, clinical services, Healthesystems

The pandemic brought a new awareness and concern regarding infectious disease as a threat to workplace safety. Twenty-eight percent of workers’ comp stakeholders placed this as a top concern, tying it with cost containment.

“Illness in the workplace isn’t a new concept by any means,” said Silvia Sacalis.

“What COVID-19 did was raise awareness of how infectious disease can spread in the workplace and the serious impact it can have on individuals and organizations, highlighting the importance of deploying proper workplace safety protocols, coupled with an empathetic approach is crucial for employee retention.”

Those in the comp space understand that this may bring complexity moving forward, with 36% of respondents saying they are concerned COVID-19 will bring a new level of claim complexity.

“COVID-19 is a relatively new virus that we are still learning about,” Sacalis explained.

“We know that a percentage of patients experience lingering symptoms, or long COVID, and it is possible this condition could be chronic for some patients  and cause complexities in the same way that other comorbidities, such as diabetes, cause complexities for patients with more typical workers’ compensation injuries. So, keeping workers as safe as possible from injuries and infectious disease is very important.”

Presumption laws, claims costs, lost time and productivity, as well as other factors can come into play. Employers can build a safe work environment, starting with understanding the risk, setting safety guidelines, reviewing absence management plans and more.

7) Digital Transformation

Technological advancement is the way of the future. Marked as the digital age, we live at a time where anything and everything can be found online, where processes are streamlined thanks to devices and where information is available at the touch of a button.

And 25% of respondents agree, placing digital transformation as a top priority in workers’ compensation over the next three years.

This makes sense, considering 30% of stakeholders identified outdated technology as an impediment in workers’ comp, and another 41% want to improve data analytics within their medical programs.

“Digital transformation has been an ongoing, somewhat sporadic, process for some time,” according to Kennedy.

“Workers’ comp and healthcare are very complex, intertwined industries that need to share a great deal of very important and highly confidential information between disparate systems. Making those connections efficient and secure requires innovative solutions, which are increasingly available and driving much-needed change.”

Looking deeper at the technologies respondents find most important, claims process automation (48%), telemedicine (47%) and interoperability and data sharing (33%) top the list.

8) Remote Workforce Management

Finally, 24% of survey respondents identified remote workforce management as a key priority for the industry looking into the next three years.

COVID changed the game for many businesses, placing employees in remote work settings. What COVID also did was show how valuable remote work can be for both operations and employees, connecting this to the #1 priority of employee recruitment and retention.

Technology is also an important part of effective remote work management and the option to work remotely has become a priority for many workers.

“Virtual technologies have facilitated remote work in multiple ways,” said Kennedy.

“Not only can office colleagues easily meet in virtual environments, doctors, physical therapists, pharmacists can meet remotely with patients. Claims adjustors and nurse care managers can meet with injured workers. The benefits of remote work go beyond pandemic concerns and can help address access to care challenges we see in rural areas, minimize the need for transportation, and deliver more efficient care in all areas.”

Main Takeaways

While the pandemic has certainly disrupted the industry, it appears that many in the workers’ compensation space are looking ahead to line items that will build resiliency. Placing employees and business operation efficiency at the top of the list goes to show that the people and the services comp provides are key to stakeholders. One will not shine without the other.

Another takeaway of note is the technology focus, but not just the desire to have a digital transformation; it is also in where the tech focus lies: claims process automation, telemedicine and interoperability between systems.

This shows that in addition to placing people and services on top, stakeholders are truly invested in finding technologies to improve workflow and provide the best possible care to injured workers.

“The top two priorities for the industry, employee retention/recruitment and operational efficiency go hand in hand,” Kennedy concluded. “To optimize performance, you need the best people, and those people need the best technology to efficiently and effectively serve the needs of payers and their injured worker patients.” &

About the Survey

In all, 489 stakeholders took part in the survey, representing every facet of the workers’ comp industry including executives, senior claims leaders, front-line claims professionals and adjusters, brokers and agents, medical providers, clinical case managers, attorneys, medical program managers and procurement professionals.