Setup for success

Posted by on Dec 20, 2016 in Blog

Helping older workers stay in the workforce The Great Recession was a big hit for our nation’s older workers. They lost jobs and retirement savings, forcing them to delay retirement and stay in the workforce longer. For baby boomers and older Gen Xers, who hoped to be logging retirement time about now, that’s not great news. But, for many reasons, it’s a good thing for employers. Older workers bring with them expertise, long-term knowledge and institutional history that can be a boon for today’s workplaces. And, just because their hair is graying, it doesn’t mean they’re slowing down. In fact, one study from North Carolina State University found that older computer programmers actually know as much – and even more – than their younger co-workers. Still, aging workers bring their own set of issues thanks, in large part, to one simple fact: They’re getting older. The graying workforce is forcing employers to make changes related to workers’ compensation and other insurance claims, but it’s slow going. In a survey by the Society for Human Resource Management, 36 percent of respondents said their workplace is just beginning to look at policies and practices related to older workers. We cover the issue much more in a recent article in Property Casualty 360, but here are four things to keep in mind as your workforce gets older. The risk of heart disease, diabetes and other chronic diseases increase as we age. So do medical bills. In fact, the American Diabetes Association found that medical costs are double the amount for people with diabetes. The majority of baby boomers are either overweight or obese, leading to higher risk for conditions such as hypertension, vascular disease and arthritis. Obesity also can restrict a person’s abilities at work. More time is required for bone and wound healing. In fact, aging skin can take up to four times as long to fix itself. Joint range of motion declines with age. As you celebrate the successes and wins of your older workers, it’s critical for employers to ensure they set them up for...

Read More

Nine tips for capturing and using data for predictive analysis

Posted by on Dec 13, 2016 in Blog

As the costs of claim expenses and indemnity pay outs increase, many companies are becoming more sophisticated in their data analysis. Here are nine tips for capturing and using data for predictive analysis: Claims systems capture large amounts of data. They include the names of providers, dollars spent, indemnity costs, types of injuries, body parts, comorbidities, lost time, geographic location, prescription drug use, costs associated with outside counsel, independent adjusters, case managers and various vendors. Age, comorbidities and medications can be analyzed for predictive modeling. Example: Age, obesity and diabetes all, either singularly or collectively, increase medical care costs and the time off work required for recovery and rehab. By using this information in various ways, insurance companies and payer sources can create in-depth risk analytics and claim trends. Through data collection, patterns in payments, providers, employers, injuries and more can be found. This can lead to more successful risk models and predictive analysis. Information can be analyzed to help identify emerging trends that can impact the carrier at various points along the claims continuum. This information also can be used to create other risk or claims products to assist the payer source or employer; address safety or return to work issues; or implement different claims or underwriting practices.   Analysis of providers and hospital data can identify treatment trends, patient outcomes, length of treatment and care, dollar expenditure and other issues.  This information can be obtained through claims paying or bill audit software. Outside sources, including review companies and nurses, also can obtain helpful data for analysis. Trends in hospital charges and the use of services by patients or claimants can be captured and analyzed. Comparison of hospital information in a geographic location can be invaluable to a payer source. Much of this data is used to analyze risk and claims trends, which, in turn, gives a more accurate risk profile. By providing hard data, underwriting should be improved. This information is then shared with the insured, which can help explain or justify underwriting decisions. Possible trends that can be captured to help identify various types of fraud. Need Help? At MKC Medical Management, we help claims adjusters and attorneys understand complex medical records and...

Read More

Tips, Trends & Findings

Posted by on Dec 6, 2016 in Blog

Here are studies, reports and stories that caught our eye in the last month. Return to Work: The workers’ compensation industry must focus on encouraging a timely return to work, helping employers keep a trained workforce and improving the quality of life and financial stability for people who are injured on the job, agreed most industry leaders at the third National Conversation on the Future of Workers’ Compensation. These “foundational principles” for workers’ compensation are critical as the industry faces criticism from the U.S. Department of Labor and OSHA. Medical Fee Schedule Recommendations: The Workers Compensation Research Institute recently released a new study to help policymakers adopt, reform or update the medical fee schedule in their state workers’ compensation system. Designing Workers’ Compensation Medical Fee Schedules 2016 shows how 43 states with workers’ compensation physician fee schedules and the District of Columbia made fee schedule design decisions, which have become the focus of policy debates. Opioids and Dialysis: A presentation during American Society of Nephrology’s Kidney Week linked opioid prescription with a higher mortality risk for dialysis patients. Those patients also were at a higher risk of discontinuing dialysis and hospitalization. More Marijuana?: Now that weed is legalized in California, an article in the Insurance Journal explores the question of whether the new law will increase demand for it from injured workers. The insurance industry is encouraged to start thinking ahead. Use or Abuse: Doctors are on the frontlines of the war against opioid addiction, but working as one of these “medical gatekeepers” is becoming more and more complicated. Steven Reidbord, a psychiatrist, covers the topic on MedPage Today. For more great information and topics, check out our blog on MKC Medical...

Read More