In TPAs and automation, part 1: Humanizing customer service, we looked at ways in which the use of features available in integrated claims management software—automation tools, push-reporting, and online portals—can help improve the level of service provided to clients and claimants. The automation and self-service features of a claims management software solution also have roles to play in another business-critical area for TPAs and organizations self-administering claims: recruiting, hiring, and retaining top talent.
Challenges to hiring and keeping qualified claims professionals
As is the case across most industries, a combination of baby boomers reaching retirement age and a strong economy continues to make it difficult for businesses in the property/casualty insurance industry to find qualified candidates. According to the Insurance Journal article Insurance Industry Facing Competitive Labor Market, the industry’s unemployment rate of 1.7% is even lower than the reported national average of 3.9%. Even so, the article points to the fact that, as of its April 2019 publication date, the “need for technology, claims and sales/marketing staff is expected to grow the greatest in the next 12 months.”
Beyond the challenge of finding qualified candidates to fill open claims department positions is the issue of employee retention. A 2018 CompData Survey shows that total turnover among organizations in the insurance industry stood at 12.8%. Although lower than the average for all industries (19.3%), this rate has trended upward in recent years.
It seems as if everywhere you turn, someone’s referencing AI. “Artificial intelligence is essential for business,” states a news article. “AI is the only way forward,” insists a colleague. And the scariest of all: “If you don’t implement AI quickly, you’ll be left in your competitors’ dust.” The constant refrain of AI, AI, AI can leave you feeling like your organization has lost the race before it has even entered it.
The truth is, AI is changing the world at a remarkable pace. And, eventually, nearly every industry and business will benefit from it. “Whether you work in retail, banking, transport or the public sector, AI will be an integral part of the way you do business in the future as it has huge potential to improve decision-making, increase efficiency and power new ways of working,” states the article How to Get Your Business AI-Ready.
But that doesn’t mean AI is the best solution for your organization right now. Implementing AI takes a massive commitment in the form of time, resources, and money. It requires a critical mass of data and properly trained staff. By prematurely jumping into a high-profile AI program, you risk ignoring the valuable tools already available and stalling other strategic projects underway. Instead, a more practical approach—one that uses software scaled to your operations—will move the most important metrics now, while developing an analytics culture that will make AI more feasible down the road.
AI has become a buzzword. What exactly does it mean?
In its prolific use, the meaning of artificial intelligence has become skewed. Some have come to view it as a magical solution capable of instantly transforming business all on its own. Others equate it with automation. Neither of these is true, however. AI requires much preparation and strategy (more on that later), and where automation follows pre-programmed rules, AI involves machine learning. AI is designed to mimic human thinking by making predictions and adjusting its processes based on new data insights. In this way, AI is quite different from many previous technological revolutions, during which technology took over specific, static roles within processes.
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.
How many members of your current RMIS vendor’s service team have come and gone over the course of your relationship? What about the number of service team leads who have guided support efforts on behalf of you and the other users of your RMIS software?
When you dial into a meeting and get introduced to yet another service team replacement, your RMIS provider is under-delivering.
Many business-to-business software providers place far too much emphasis on “software” and not enough on “service.” In terms of features and functionalities, the results of such an approach may be impressive. But the imbalance comes with a cost. Subpar support is always detrimental to client success.
The importance of consistent, knowledgeable RMIS technology support is difficult to overstate. Given the increasingly complex risks every business faces and the ever-expanding role risk managers play within their organizations, a platform implemented five or more years ago may struggle to keep pace with an organization’s changing needs. 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.
Creating a strong safety culture can be challenging for any organization. Recent regulatory changes are placing an organization’s safety culture under additional scrutiny. In the EHS Today article The Risks of Using Injury and Illness Reporting as Measurements of Success, Mark Kozeal discusses how an OSHA rule change penalizes those with cultures that discourage reporting.
“Under OSHA’s update to its 2016 rule on recording and reporting workplace injuries and illnesses, such programs would be in violation of the law,” Kozeal notes. “Whether this incentivized culture was purposeful or inadvertent doesn’t matter. What matters is that any practice that incentivizes employees for not reporting an injury or illness or denies employees incentives if they report an illness or injury, can now be cited by OSHA.” This means that a poor safety culture can now affect the bottom line.
First steps to avoiding the “culture penalty”
Now that there is the possibility of additional regulatory costs associated with failing to create a strong safety culture, the importance of near-miss reporting is multiplied. As we discussed in Using RMIS technology to improve incident and near miss reporting, two factors are essential to developing a healthy safety reporting culture:
There is no quick fix when it comes addressing the factors that inhibit reporting. However, taking a number of practical steps that include making it easier to submit reports (addressing practicality) and allowing for anonymous reporting (reducing fear) can be a foundation upon which to build an effective safety program. With more data to draw from, the ability of risk managers and safety professionals to identify, analyze, and take strategic action to reduce the likelihood of injury is vastly improved. Over time, this can contribute to a breakdown in perceptions of uselessness and acceptance of risk.
For risk and safety professionals, the new calendar year brings with it a renewed focus on improving their organization’s culture of safety. Whether looking to put a new safety program in place, make wholesale changes to an existing program, or build upon previous successes, many organizations face the challenge of ensuring that their employees are fully participating in safety efforts.
A recent EHS Today article takes a look at a potential solution for involving people across an organization in this process: safety assessments.
How safety assessments differ from safety audits
To Build Safety Culture, You Must Get People Talkingprovides an overview of a 2018 Safety Leadership Conference session — “Distracted Drivers R US — Assessment RX for Success” — led by Walter Fluharty, vice president of EHS and organizational development at Ohio-based Simon Roofing.
Where static surveys may be seen as yet another safety-related requirement, focus group-based assessments followed by the completion of self-assessments are more likely to drive engagement and add value. …read more
The idea of rowing across an ocean still eludes me—despite my frequent conversations with crew members from the Origami Risk-sponsored rowing team about their aspirations to achieve such a feat.
Watch this video about the Origami Risk rowing team
I’ve learned about the difference between rudders and sterns; the need for leg strength, even more so than upper-body strength; and how the ballast helps improve the stability of the boat to help prevent flipping and sinking. …read more
The average age of an insurance professional is 59, according to a McKinsey and Company study that highlights the not-so-far-off retirement of a vast group of individuals in the insurance industry. The forthcoming churn could mean a depletion of institutional knowledge from organizations if they don’t have younger employees in place to absorb industry veterans’ knowledge before they exit the workforce.