The New Normal for WC: Change

Nancy Grover

Sarasota, FL ( – If the pandemic has demonstrated anything, it is that resilience is key to helping companies survive and thrive despite chaos and unpredictability, say workers’ compensation experts. By embracing strategies of resilience, organizations have an opportunity to make lasting changes that will help them weather future tragedies.

“The great thing about this moment in time is no one has the playbook for what we should do now. It’s been called ‘the great reset,’” said Rachel Fikes, chief experience officer & director of the Workers’ Compensation Benchmarking Study for Rising Medical Solutions. “If ever there was a time to trash what hasn’t been working for us and to play around with a desired new state and to give our organizations and employees permission to be curious and to invent and to transform, it really is now.”

Fikes and other panelists recently presented the findings and provided their insights on the 8th annual study that looks at forces impacting claims management in workers’ compensation, including the effects of COVID-19.

“Coming out of the pandemic workers’ compensation is going to look fundamentally different. Organizations will be more agile, more digitally enabled,” said Denise Zoe Algire, director of Risk Initiatives & National Medical Director for Albertsons Companies. “Organizations that remain risk averse will certainly be left behind.”

The Study

The 2020 study represented the first time claims leaders could respond directly to the perspectives of the nearly 1,300 claims professionals who participated in the 2019 claims survey. Of the 337 respondents to the most recent study, 31 percent were defined as “higher performing organizations,” meaning they have a closing ratio of at least 100.

“We start to develop a picture of organizational resilience in the industry,” Fikes said. “We continue to look at what high performers are doing, and low performers are not, to get another view of organizational resiliency for ‘future proofing’ for the next crisis, and resilience is at the heart of the 2020 study design itself.”

Higher performers, for example, are focusing more on “what’s important, measuring core competencies … outcomes,” said Algire. “There’s a lot of discussion about outcomes in workers’ compensation. Higher performers are more likely to measure performance in these key areas.”

Additionally, higher performing organizations are more likely than others to:

  • Invest in talent and provide critical training in empathy and soft skills, as well as investing in strategies such as developing career paths. “That’s something that is critically important for us,” Algire said. “If we think about the talent shortage, where we are today, how do we invest in the current talent we have, as well as attract new entrants?”
  • Leverage claim advocacy
  • Leverage technological advancements, such as pulling in predictive modeling and tying data or outcomes to claims practices
  • Engage front line claims staff in all areas, especially communication and training
  • Provide bonusses, profit sharing or other incentives to attract and retain talent

The speakers, all of whom were involved in the 2020 study, identified five pillars they believe can help organizations navigate future uncertainty and strengthen organizational resiliency and performance.

Pillar #1: Normalizing Discomfort

Resilient organizations “encourage employees to embrace continual change as the business standard, not the exception,” according to the study.

“In developing this new playbook, we’ve got an opportunity to stop passing down to our employees, our industry’s routed and cultural aversion to risk and discomfort to really start embracing risk and discomfort as a pathway to creativity and experimentation and resilience,” Fikes said.

But doing so is difficult for many organizations due to pushback — from employees and, especially, leaders.

“Most organizations are overly risk averse in their decision making, they waste a lot of time and opportunity to grow and achieve objectives because of that fear of change,” Algire added. “From a risk management standpoint, many organizations maintain a very static view of risk with very little linkage to business operations and outcomes. This was a wake-up call for the industry to really build true resilience.”

Pillar #2: Develop a Strong Risk Culture

This pillar was defined as “fostering a culture where employees feel safe taking risks and doing the uncomfortable, such as volunteering an unsolicited idea, admitting a mistake or pointing out a process that’s not working,” which “paves the way for needed course corrections and innovation.”

One way to allow employees to take risks with the support of leadership is through pilot programs. “At Disney, we’ve had some great success and made great strides by introducing new ideas through trying new things out through pilot programs,” said Linda Butler, director of Claims Management at Walt Disney World Resort.

Pillar #3: Cultivate Diverse Talent

“Creative problem solving requires varied viewpoints,” according to the study. “Not only do organizations need to address a much documented talent shortfall, but they must prioritize diversity of thought, background, experience and cognitive profiles while doing so.”

Washington Labor & Industries, for example, does not require newly hired claims managers to have a college degree. “Learn while you earn, that’s the idea,” said Vickie Kennedy, assistant director of insurance services at L&I. “A claims manager gets 22 months of training — 10 classroom with on-the-job training and another year of on-the-job training with a coach and supervisor. We’re able to hire people with diverse backgrounds that can better reflect injury worker and employer populations. That includes those from marginalized groups for whom college may not be accessible.”

Pillar # 4: Deploy Technological Dexterity

“Automating data collection, compliance tasks, and intervention alerts should enable claims teams to engage in greater critical thinking. The more bandwidth they have to solve problems, the more resilient they and their organizations will be,” according to the study.

“[We should] encourage organizations to look at your managed care partners as an extension of your own technological capabilities; however, really to get true value out of that requires more robust data integration than what has historically been done,” Fikes said. “It means feeding more claims data to your partner to close the loop on final claims outcomes and activate those enhanced benefits.”

Pillar # 5: Measure the Past and the Future

Rather than looking only at past performance, organizations should measure forward-looking resilience to continually improve the capacity to withstand adversity and emerge stronger, the speakers said.

The study asked respondents to identify the biggest challenges to claims and achieving best outcomes. Psychosocial issues and comorbidities were among the top.

“We asked, ‘how are you tackling this, what strategies are you using?’ looking at how we can turn the table there,” Algire said. “Higher performing organizations are likely to address this concern; more likely to improve training for claims professionals on biopsychosocial risk factors and comorbidities, and leverage other resources to make sure claims professionals are better prepared to deal with psychosocial risk factors.”

The study also found that higher performing organizations were much more likely than lower performing ones to leverage predictive modeling as well as claim system workflow automation.

Building organizational trust, is key to resilience, Fikes said, encouraging employees to take risks and be successful.

“Harness the moment and capitalize on lessons learned and incorporate that to ensure organizational resiliency,” Algire added. “COVID has outpaced other risks. This has given us a defining moment for risk management and organizational resilience.”

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