Taking the time to evaluate your RMIS technology can play a part in ensuring your long-term risk management objectives are met. Equally important is an honest assessment of whether the RMIS support you’re receiving is meeting your expectations.
With apologies to the relationship health quizzes available in magazines on display in supermarket checkout lines, your responses to the following questions may indicate that the relationship between you and your RMIS service team is in trouble.
#1 Has there been significant employee turnover?
For years, the users of prominent RMIS platforms have been forced to deal with service issues that stem, in part, from the departure of experienced RMIS support personnel. Rather than reaching a point of stabilization, M&A activity over the past year has been followed by rounds of layoffs, as well as account reassignment for the service team members who remain.
This turnover can leave you at a net deficit, as constant changes mean more work for you and your risk management team. As the article A Stranger is Calling: The impact of RMIS service team turnover points out, “a revolving door of service team personnel who need to be brought up to speed on the unique aspects of a RMIS and the risk management program it was put into place to support compounds the problem” of RMIS technology that may already be struggling to keep pace.
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Adverse safety events—some that lead to serious harm—occur every day, affecting people across entire health systems. The ability to collect and analyze this data is crucial for preventing future incidents and improving patient safety. Yet, according to a 2008 study, “only 13% [of U.S. hospitals] have broad staff involvement in reporting adverse events.”
With a full schedule of patients and life-or-death situations a part of daily life in hospitals, reporting efforts, not surprisingly, may end up taking a back seat. Sometimes, however, the issues that impact reporting run deeper. Hospital staff may fear repercussions from reporting safety events. In other instances, the reporting process may be so convoluted and time consuming that, despite good intentions, staff is discouraged from doing so. Or maybe, the biggest issue comes after reporting, with hospitals failing to share or apply healthcare analytics in a way that positively impacts the quality of care provided and makes staff feel a part of something bigger.
No matter the reason, any issue that negatively impacts patient safety event reporting has consequences for every person associated with a hospital or health system—especially the patients. In fact, the ECRI Institute listed “standardizing safety efforts across large health systems” as one of the top 10 patient safety concerns for 2019. Even events that seem minor have the potential to result in grave harm. The Joint Commission reported medication error and product and device events in the list of top 10 most frequently reported sentinel events in hospitals in 2018.
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Insurance carriers that rely on multiple-vendor application stacks to manage core functions such as policy management, billing, and claims administration may be placing limits on the strategic advantage IT departments can offer. As the number of supported vendors increases, more IT resources are forced to focus on managing application stacks rather than identifying and developing competitive technological advantages.
An Ivanti survey analyzed in The CIO’s Conundrum: Can IT Move From ‘Keep the Lights On’ to Creative Thinking? underscores the tension between maintenance and innovation. “In this survey, what became crystal clear was the counterbalancing of maintaining essential IT services with the desire to be bold and to act as a creativity dynamo.” Matthew Smith, President, Demand Generation at IDG Communications, notes that the survey results indicate that organizations “need to liberate their CIOs to think ahead of the curve rather than obsess over day-to-day operations. But today IT is all too often still regarded as a support function or information leaders are too stretched to drive competitive differentiation.”
Sandra Gittlen writes in Whittle down application sprawl, “out-of-control application stacks can jack up costs, introduce vulnerabilities, add to infrastructure complexity, jeopardize licensing and waste staffing resources.” This pulls resources toward the maintenance side of the spectrum and away from the strategic side. Glitten concludes, “IT’s value is not in supporting technology, but in understanding the business and using technology to achieve business goals.”
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Automation is great, except when it isn’t. Examples of the dark side include endless button pressing in automated phone trees that often conclude by yelling the word “operator” into the phone, and receiving form letters or emails containing incorrect, basic information. It’s no wonder the Aspect Customer Experience Index states that “nearly a third of consumers would rather clean a toilet than talk to customer service.”
Yet automation, when done well, remains a central tactic TPAs can deploy to gain competitive advantages in efficiency, accuracy, and resource allocation. When mismanaged, however, it can lead to impersonal service and damaged client relationships. The key to successful automation is to take advantage of technology’s benefits without losing the “human-centric” element. Kristin Smaby explores this concept in Being human is good business.
“In an era when companies see online support as a way to shield themselves from ‘costly’ interactions with their customers, it’s time to consider an entirely different approach: building human-centric customer service through great people and clever technology. So, get to know your customers. Humanize them. Humanize yourself. It’s worth it.”
In this three-part series we’ll examine how strategically balancing the human/automation mix can deliver a competitive advantage through:
- Improving customer service
- Enhancing employee retention/recruitment
- Boosting performance KPIs
Addressing these three initiatives from a human-centric perspective allows your organization to meet the personalized service expectations your clients demand, while gaining the productivity boosts smart automation delivers.
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Implementing an enterprise risk management (ERM) program can be a daunting, intimidating project. Trying to introduce new frameworks and controls across the organization, roll up risk reporting from the unit to enterprise level, and initiate discussions with the board that lead to action can be overwhelming. Using techniques proven to work with startups, however, can make the process far more manageable and increase the odds for success.
Startup incubators often promote a few common themes:
- Let customers/market dictate the product
- Scale it down – start small and go live fast
- Do the research and learn about the market
- Get feedback as quickly as possible
- Fail silently – incorporate lessons learned without dragging the whole effort down
These techniques suggest that the traditional high-profile, enterprise-wide rollout of a new ERM program may not always be the best way to launch. Instead, focusing on the smallest scale project—one with the potential to yield meaningful results—and relying on a customer-driven approach may be the key to creating a sustainable, effective ERM program.
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Technology can play a pivotal role in improving claims management by providing adjusters, claims managers, and other stakeholders with direct, centralized access to the pertinent claims information that they need to do their jobs. As Improving claims administration with an integrated solution points out, centralizing claims data in an integrated system “that combines workflow automation tools with all of the functionality needed for end-to-end claims adjusting can be transformative.” This is especially true when the system is used to streamline claims handling processes, increase adjuster productivity, and inform decisions that contribute to swift, cost-effective claim closure.
Improving incident reporting, controlling costs, and closing claims more quickly certainly count as claim management “wins.” Yet, as Christopher Mandel points out in Next-Level Claim Strategies, there is the potential to take claims management to an even higher level.
“Just when you thought risk managers understood and had explored all the opportunities around optimizing the claims management function, next-level opportunities emerge,” he writes at the outset of the article, which examines the shared goals, motivations, and hurdles that make up the “long minimized and largely untapped synergy between casualty claims (risk management) and the benefits world.”
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Whether it’s boxes of paper forms that must be keyed into a system, pouring over spreadsheets to verify that critical requirements are met and up to date, or sending yet another email to request missing information, there’s almost always room for improvement when it comes to the management of vendor-related data and workflows.
From the submission of application forms through to the evaluation of vendor performance, businesses can add to the value of their risk management information system (RMIS) by using the system to transform their approach to vendor management. In this post, we look at four examples of how a cloud-based RMIS like Origami Risk can contribute to cost control, service excellence, and risk mitigation.
1. Streamline the vendor intake process
Simplifying the vendor application process reduces the amount of time staff spend engaged in time-consuming, repetitive activities like keying data and sending multiple emails to chase down missing details. This process can also be the first step in defining expectations and building a relationship with potential vendors. After all, as 6 essential steps for managing vendors makes clear, “A good vendor relationship starts well before you ever sign a contract with a vendor.”
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Configurability and Customization—two words you’ve no doubt come across when researching RMIS systems. More often than not, they’re used interchangeably. But do the two terms mean the same thing? If not, what’s the difference? Is one preferable?
Despite the fact that each term is often used in place of the other, there is a difference. If “This is going to be expensive.” is your first thought upon seeing or hearing the word custom (or a variation), you are correct. Customized vs. Configurable Software Solutions: Which Should You Choose? does an excellent job of breaking down why this is the case. … read more
Our recent post, “How to Tackle Total Cost of Risk (TCOR)”, discussed the roadblocks and best practices to consider when calculating TCOR. It takes cost allocation, however, to realize the benefits of a TCOR program at the unit level. Through a cost allocation model, each unit sees the direct effects of their individual strategies on TCOR at the same time that the overall success of the risk management program is evaluated.
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Public entity risk managers looking to further reduce the costs associated with workers’ compensation claims continue to recognize the value of a behavior-based risk and safety management model. According to Public Entity Risk Managers Speak Out: Results of the 2017 Public Entity Employee Safety & Loss Control Survey, “Now more than ever, the best strategy is to take a holistic approach to risk management to prevent claims from occurring in the first place with loss control strategies.”
The development and implementation of a pre-loss model that measurably drives accident reduction and workplace safety requires effective collaboration between risk management and safety teams. Transparency and the sharing of information is essential to success. Both can be severely restricted when using spreadsheets or outdated legacy software. … read more