3 Steps to Help Close Workers’ Compensation Claims Performance Gap

An analysis of five years of benchmarking data from more than 1,700 claims identifies three practices that workers’ compensation claims organizations rated as low in quality should adopt to keep from falling further behind in performance.

According to the analysis by Rising Medical Solutions, just 24 percent of claims organizations are high performers. The white paper released by the study group sought to answer what the other 76 percent need to do to catch up.

The report —”How to Close the Claims Performance Gap: Top 3 Findings in 5 Years of the Workers’ Compensation Benchmarking Study— provides a picture of how outcome-based activities dominate top claims strategies and how high performers outpace lower performers up to 10 times more in their use of certain key practices.

Co-authored by study program director Rachel Fikes and industry journalist Peter Rousmaniere, the report finds that top claims performers:

Higher performers also tended to measure various core competencies, claims outcomes and utilize predictive analytics.

Better closing ratios was also found to be indicative of a well-run claims organization. “Claims experts agree that a claims ratio of 101 percent or higher is a reliable sign that the organization is managing claims outcomes effectively,” according to the report.

“With so many competencies claim departments are often asked to excel at, it can be difficult to decipher exactly which practices will actually move the needle,” said Fikes. “For those organizations that choose to close the performance gap, the data is clear on how to narrow the divide between average and superior performance.”

Source: Rising Medical Solutions