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In this blog, we recap our panel discussion, “Workers’ Comp Claims Administration: How to Adapt and Thrive During Times of Change,” and provide the key takeaways in a 5-minute read.

An already complex line of business, workers’ compensation claims adjudicators saw a flurry of challenges during the pandemic. Origami’s President of Core Solutions, Chris Bennett, moderated our November panel with two Origami clients adjudicating claims today: Shannon Cole, Director of Operations at Inspirien/Healthcare Workers’ Compensation Self-Insurance Fund and Hiawatha Franks, Workers’ Compensation Claims Administration Division Director for the Texas Association of School Boards.*

During their engaging 50 minute discussion, our panelists covered trends in the workers’ comp industry and how their organizations were impacted over the last 18 months. They also shared some best practices for leveraging the digital capabilities built into the Origami platform to help navigate workplace shifts caused by the pandemic. While our panelists focused on the healthcare and education industries, their themes were relatable to any organization that abruptly converted to a total or hybrid remote workforce and experienced staffing shifts and shortages.

Shift to Remote Work, Telehealth

Shannon pointed out that at the onset of the pandemic there were delays in getting needed treatment for injured workers. Some surgeries were postponed which translated into longer periods of indemnity benefits and extended return to work time. Inspirien hadn’t used telehealth technology very much before the pandemic. One positive outcome was that telehealth allowed them to get workers the care they needed remotely and were even able to leverage it for physical therapy appointments. Today, Inspirien still has claimants using telehealth, and find that it’s been especially useful for re-checks. Because of its ease of use, they ultimately believe it’s here to stay.

Hiawatha commented that since schools shut down early in the pandemic and shifted to remote learning, their workers’ comp claims volume went down significantly, by as much as 75%. Many employees retired early, while some changed occupations and left education altogether. An unexpected perk from the decrease in claim volume was that it allowed TASB’s claim adjusters a little extra time to help their own children get acclimated to remote learning.

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Pre-pandemic, Hiawatha pointed out, TASB ran a telemedicine pilot in 2018 which was being used by 3 of their member educational institutions and was prepared at the onset of COVID-19, at which point they saw utilization quickly spiked to 90 members. He also noted that three of their workers’ compensation network providers offered telemedicine pre-pandemic, which jumped to 86 providers during the pandemic. He believes that most larger practices will continue to use the technology as it has been very effective and its usage has now been widely adopted.

Risk Profile Changes

Chris asked the panelists if their risk profiles have changed over the last 18 months. Hiawatha discussed how staffing has been a big issue for their members. They’ve had to incentivize some employees to come into work or take on expanded roles with bonuses. Mechanics are being asked, or in some cases required, to drive school buses. They’ve seen a lot of their workers’ comp injuries that are complicated by the employee's emotional challenges and depression. TASB has encouraged their members to leverage EAP services for addressing mental health challenges for their staff and continue to explore how best to care for the “whole employee”, beyond just their physical injuries. 

Shannon noted that Inspirien has also seen workers’ comp claim volume decrease, which can be expected when there is less staff. Comp claims were already on a downward trend, but they are the lowest she’s seen in her 30-plus years managing comp claims. Many healthcare employees are making career shifts and getting out of the front line. Traveling nurse organizations pay higher salaries so many nurses, especially in rural areas where they can’t compete with wages, are moving in that direction. She pointed out that we are all seeing this trend everywhere we go [in our day to day activities]. 

Retirement, Recruitment, and Retention

Chris brought up how the Bureau of Labor & Statistics expects labor growth to slow with the aging workforce and inquired if our panelists noticed this trend in their industries.

Shannon pointed out how the healthcare industry has been experiencing an aging workforce for some time, which creates more of a challenge when injuries occur. Some of their employees have preexisting conditions, so their injuries are more severe and take longer to treat. To counteract the departure of employees, hospitals have been working with local colleges to recruit students into the healthcare field.

WC claims webinar quote from Shannon

Shannon provided additional creative ways that Inspirien is keeping its collaborative culture strong during the audience Q&A portion of the webinar recording. Link provided below.

Chris chimed in to add that stress and burnout are common employment concerns we are hearing from across our client base. Hiawatha agreed that this is a similar trend with schools in Texas. They saw accelerated retirement from all levels including their risk managers, human resources department, and superintendents. The drawback is that they missed out on important knowledge-transfer to their successors. TASB employees have to explain not only what their organization does and what the risk pool’s value proposition is to its members, but also in some cases, what workers’ compensation is. They are experiencing unprecedented turnover in their otherwise very stable employment base. 

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Chris asked Shannon to expand on how the ‘gig’ economy, with more people shifting to freelance work (e.g., traveling nurses), impacted their business strategy. Inspirien now includes more questions on their coverage applications and added additional language to participation agreements. In the Origami platform, they added a new payroll coding field to identify contract employees. With a large population wanting to work from home they get a lot of questions about how workers’ compensation applies in that situation. They are still working out the logistics for this potentially permanent shift and how to move forward long term.

Leveraging Technology

Hiawatha noted that people don’t want to pick up and use the phone anymore. They want self-service and they expect it when and how they want it. The customer journey is critical and TASB strives to provide more customized services to their members, which span from large urban areas to small rural districts. They leverage the dashboards built into the Origami platform to help adjusters manage their claims. And they also offer tailored dashboards for their supervisors. 

Tip from Hiawatha: Get adjuster input into the system and dashboard configuration since the ease of use of the claims administration platform may dictate their level of satisfaction with their job.

For Inspirien, customer experience is a top priority. They invested in technology that allowed them to make the necessary pivots to keep up with rapid changes. As Hiawatha also mentioned, society has shifted to a self-service environment and people want to access their claim info when they want/need it. The Origami platform allows Inspirien to provide their customers with a real-time view of their claims and policies information. They have developed widgets to provide a quick snapshot to their clients based on their needs. Their information consists of loss ratios, claims trends, and the ability to generate reports. An added Benefit to their customers is making OSHA reporting available to them through the Origami platform.

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For Shannon, it’s equally important to get buy-in from the claims and underwriting teams and seek input on what would make their jobs easier and adjust their claims admin technology platform accordingly. They want to make the experience remarkable for their customers.

Key Takeaways

  • Changes brought on by the pandemic aren’t going away. Organizations need to continue to operate with agility and perseverance under the “new normal”
  • Telemedicine will remain an important service to help employees get access to medical care with less disruption to their schedules - and ultimately helping to close claims faster when care is not delayed
  • Staffing shifts and shortages pose unique challenges for each industry. Employees in many industries have been under extremely stressful working conditions. With creative thinking, organizations can help boost morale and retain ​employees
  • Digital capabilities of your insurance admin platform can help adjusters, underwriters, and risk managers do their jobs more efficiently while making it easy for employers to file comp claims online and stay updated throughout the claim   

The discussion continues...

Our panelists concluded by addressing some very thought-provoking questions from our audience. Watch the webinar recording to hear their insights on how remote work affected their company culture, what their predictions were on whether ‘the great resignation’ will continue beyond the pandemic or taper off, and what one thing would they have done differently at the onset of the pandemic knowing what they know now.

Watch the full panel discussion, including audience Q&A, here. To learn more about how Origami’s claims administration solution can be a partner to your organization’s workers’ compensation program, check out our workers’ compensation professionals page or start a conversation with us.

*Inspirien provides TPA services for Inspirien Insurance Company and the Healthcare Workers’ Compensation Self Insurance Fund, a group self insurance fund for healthcare providers in the state of Alabama. Texas Association of School Boards (TASB) is a risk pool that includes 500 school districts and 8 community colleges in Texas.