The 2015 Workers’ Compensation Benchmarking Study has been released, and compared to previous versions there were a few changes in how they gathered and analyzed data from study results. This year the compilers of the study took responses from the study and tried to make meaning out of it, creating a “game plan” for workers’ comp claims management in the coming years.

With help from an advisory council with representatives from the country’s top workers’ comp programs, Rising Medical Solutions has released this benchmark study in 2013, 2014 and now 2015. Workers’ comp professionals can use the results to understand the state of the industry and where it may be headed. This year, the study asked a small group of industry executives to participate in more of a “focus group” session to try and turn the results from the three years’ worth of studies into a plan of action. The studies in 2013 and 2014 presented the issues and challenges facing workers’ comp without a clear plan or strategy to overcome those challenges, which this focus group hoped to address.

You can download the benchmark studies here and really go in-depth to hear what respondents had to say about work comp challenges and ways to combat those challenges.

In the 2015 study, 40 industry executives were part of a qualitative research effort to define and offer advice on the top problem areas of claims management today. The group aimed to address how to best implement technological solutions into their organizations, and how to start employing other best practices that workers’ comp organizations may currently lack. Another issue dealt with medical performance management- measuring outcomes, reigning in pharmacy costs, etc. Also on the table- how organizations can use big data as an advantage. An upcoming issue also mentioned is the “talent crisis” in workers’ comp that is occurring because younger workers are not entering insurance in big enough numbers to replace seasoned workers who are retiring from the industry.

The benchmark study outlined some big themes that resulted from this group’s conversations. They thought that the industry should shift their attitude about claims towards getting the best possible outcomes, and away from a principally process-focused effort. According to the respondents the measures of, and the ways to achieve, successful claims outcomes need to change. “Begin with the end in mind,” they said, and work backward from the successful outcome. They also suggested that employers offer better return to work or modified duty transitions for injured workers, and for claims professionals to start using the ODG evidence based benchmarks to keep their claims on track.

The executives suggested that rather than focusing a disproportionate amount of resources on recruiting new talent, to balance those resources and focus more on developing current workers. Not to say they want to stop recruiting new workers entirely, but the 2015 benchmark study reported that organizations spend 70 percent more on recruitment than they do development of existing hires. The focus group members think there is a skills gap that will be hard to close once top level workers retire or leave the industry.

The group also said that technology and predictive modeling will improve claims processes and claims outcomes by identifying claim fraud or claims severity early on, but organizations have to be willing to make these technological improvements or overhauls. They said that organizations are going to have to rethink their medical management strategies to focus more on a “value-based” model that will lead to better outcomes for patients and lower costs for payers, and to rethink the current fee-for-service model. They encourage payers to pay for results rather than services; it might help deter unnecessary treatments and could speed up the delivery of the right care. To control pharmacy costs, they suggested more pharmacy benefit networks to manage prescriptions rather than physician dispensing.

Take a look at this year’s study for yourself, you might get some good ideas to change your claims operations for the better so you can save money and workers can get better care.