Emerging Issues for a Workers’ Compensation Manager
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Transcript of Emerging Issues for a Workers’ Compensation Manager
Emerging Issues for a Workers’ Compensation ManagerPresented by Ben Reynolds
Leighton Contractors Pty Limited
NATIONAL CONFERENCE & EXHIBITION 2014
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National Conference & Exhibition 2014
As a Workers’ Compensation Manager I see the following emerging issues as something we all need to consider;
Available Resources
Comcare
Management of claims
Provider Networks
Scheme Changes
National Conference & Exhibition 2014
Each Business is different
My issues may not be your issues
My solutions may not be your solutions
I have plenty of questions too, but that’s where it starts....
National Conference & Exhibition 2014
Available Resources
National Conference & Exhibition 2014
Available Resources
Money – There just isn’t enough!
How do you fund your initiatives? • How do you convince management to spend money?
How do you fund your day to day operations? • Continued justification?
What does value look like?
What does ROI look like?
National Conference & Exhibition 2014
Available Resources
In general availability of Funds across the scheme is limited;
• Fund Scheme agents borderline profitability
• Authorities in varying states of financial status
• Fee limitations on providers
• Increasing salaries of employees
• Increasing operational costs
• Downward pressure on premiums
National Conference & Exhibition 2014
Available Resources
Shortage of quality workers’ comp professional
Scheme improvements have impacted on the available resource pool;•Decrease case loads•Increased salaries•More time spent managing cases•Higher level of skills needed•Reduced spend on provider fees (lawyers, allied health etc).
No one ever leaves school wanting to be a workers’ comp manager
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Increasing case manager
salaries
Case loads decreasing
Limited availability of quality staff
Decrease Salaries?
Increase Case Loads?
Employ less qualified staff?
Downward premium pressure
Increase Premiums?
Insurer Resources
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Comcare
National Conference & Exhibition 2014
ComcareWhy is Comcare such a hot topic?
• Self Insurance has for some time been seen as a solution to the high cost of workers’ compensation premiums
• Comcare being a single, national program solution could potentially remove significant administrative burden
• Allows employers to manage their own destiny
• Current changes provide an enhance attraction• Widening the eligibility criteria • Group Licenses• Comcare as WHS regulator
National Conference & Exhibition 2014
Comcare
Why do I consider Comcare an emerging issue?
• Large, national premium payers leaving scheme
• Taking the good people with them
• Pressure from Management and others who see it as “the” solution
• Scheme’s providing alternate options to avoid an exodus
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Comcare
So is Comcare “the” solution?
No, it’s just “a” solution
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Management of Claims
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Management of Claims
There is a shift in the approach to the management of workers compensation cases from a claims management approach to an injury management approach
People generally accept that early intervention injury management is “best practice”
What is the difference? • Claims Management is to resolve the claim• Injury Management is to resolve the injury
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Management of Claims
Schemes are trying to move to Injury Management, but do Authorities and Insurers really understand Injury Management?
Can you legislate the flexibility needed? • Provisional Liability in NSW• S.58b in SA• Large Vs Small employers• Good Vs Bad employers
Do we really want Authorities to drive this agenda?
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Management of Claims
How do you achieve best practice injury management?
How do you achieve this and keep your Management, Employees, Insurers and Authorities happy?
Is it possible to shift the mindset of your stakeholders?
How do you show value?
What if you don’t change focus?
National Conference & Exhibition 2014
Providers Networks
National Conference & Exhibition 2014
Provider Networks
It’s important to realise that we cannot always achieve what we need on our own. How do you manage to have a sustainable provider network?
Insurers, Doctors, Rehab, Lawyers, Investigators, Brokers face all the same challenges we do;• How do they keep quality employees?• How do they remain profitable when regulators limit fees?
How do they remain relevant and viable when employers are getting smarter and more involved?
Why is that an issue? What happens if they don’t evolve?
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Scheme Changes
National Conference & Exhibition 2014
Scheme Changes
Currently NSW, NT, QLD, SA, WA and Comcare are in the process of significant change or review.
Some changes will have significant impacts on employees and/or employers
Employers need to have a voice•Employer needs often seen as anti employee•Everyone who submits feedback to a scheme is biased.
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Conclusion
What am I doing about resources?
How will I manage the Comcare changes?
How will I manage our workers compensation claims?
What will I need from providers and can they deliver?
What will the scheme changes mean to me? How can I impact them?
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Conclusion
Two last questions;
If you were injured at work would you be happy with the treatment provided?
Would your CEO go through your workers compensation process?
Thank you.
NATIONAL CONFERENCE & EXHIBITION 2014
Platinum Sponsor
Silver Sponsor Bronze SponsorRisk Manager of the Year
Award Sponsor
Conference and Exhibition Partners