Missouri Issues in Workers’ Compensation General Session
-
Upload
kurt-madel -
Category
Economy & Finance
-
view
1.063 -
download
2
description
Transcript of Missouri Issues in Workers’ Compensation General Session
![Page 1: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/1.jpg)
1419 West Main Street, Richmond, VA 23220www.captechventures.com©2009 CapTech Ventures, Inc. // All Rights Reserved.
1419 West Main Street, Richmond, VA 23220www.captechventures.com©2009 CapTech Ventures, Inc. // All Rights Reserved.
Missouri Issues in Workers’ Compensation General SessionMissouri Issues in Workers’ Compensation General Session
Brian Ronnau, Manager804-306-4915CapTech Ventures, Inc.June 8,2009
The Missouri Division of Workers’ Compensation Business Analysis: Where we have been and where we are going.
The Missouri Division of Workers’ Compensation Business Analysis: Where we have been and where we are going.
![Page 2: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/2.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Agenda
■ CapTech Background■ Broad Industry Challenges■ What is a Business Analysis?■ Findings at Missouri DWC■ Benefits to Users■ Common Areas of Concern■ Keys to Success■ Lessons Learned■ Q & A
p.2
![Page 3: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/3.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
CapTech Background
p.3
![Page 4: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/4.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
CapTech Overview
CapTech is an Information Technology Consulting Firm that manages, designs, and builds information systems.
Private consulting firm founded in 1997 Services
• Management Consulting
• Systems Integration
• Data and Business Intelligence
Proven success with Fortune 500 firms and Government Agencies
2005-2008 revenue growth of over 30%
180 employees with a client service focus
Nationally recognized leader in chosen niches
p.4
![Page 5: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/5.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Project Methodology
Interactive and comprehensive work-plans are fundamental Communication and feedback are critical to success Process engineering is a key focus Developing the right solution for the jurisdiction is the objective
Data AnalysisData Analysis
Develop ScheduleDevelop Schedule
To-be AnalysisTo-be Analysis
As-is AnalysisAs-is Analysis
Stakeholder InterviewsStakeholder Interviews
Provide Reco’sProvide Reco’s
Assess ResultsAssess Results
p.5
![Page 6: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/6.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Workers’ Compensation Experience
■ Virginia Workers’ Compensation Commission Phase 1: Comprehensive Review of Technology, Process and Organization Phase 2: IS Department Realignment, Collaboration, Content Management and
Training Phase 3: Design & Development Claims, Judicial Systems and Ancillary support
applications
■ Missouri Department of Labor (DOLIR) Phase 1: Current State, Future State Gap Analysis (DWC) Phase 2: Design of DOLIR Enterprise Target Architecture (shared services & reuse)
■ IAIABC EDI Committee Implementation Committee Claims Committee
p.6
![Page 7: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/7.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Broad Industry Challenges
p.7
![Page 8: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/8.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Management Domains
p.8
People
Process Technology
![Page 9: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/9.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Universal Problems
■ People Aging Workforce Resistance to change People are individuals (Goals/Motivations) Overlapping rolls & responsibilities Workers’ compensation is not a priority Politically managed (Constantly changing regulations)
p.9
![Page 10: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/10.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Universal Problems
■ Process Manual processes (Workarounds) Duplication of work Data Quality Engrained work habits (Decades old) Disregard for downstream systems/processes
p.10
![Page 11: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/11.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Universal Problems
■ Technology Outdated Applications & Infrastructure Data Quality Application Silos Lack of security best practices
p.11
![Page 12: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/12.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Workers’ Compensation Unique Challenges – Laws, Regs and Case Law
p.12
Laws and Statutes
Modification challenges
Dated Rules & Regulations
Paper driven process
Century of Case Law
Legal challenges to change
Federal Regulations
Data security and privacy
![Page 13: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/13.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
What is a Business Analysis
p.13
![Page 14: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/14.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Definition of a Business Analysis
■ Business Analysis is the set of tasks, knowledge, and techniques required to identify business needs and determine solutions to business problems.
So… what does that mean?■ A critical foundational step■ First phase in a business transformation■ Delivers sound fundamentals in support of a broader organizational
and/or technological change
p.14
![Page 15: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/15.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Business Analysis Breakdown
p.15
•Analyze Existing Environment•Identify opportunity areas
Current State
Review
•Understand organizational vision•Apply industry best practices
Future State Dev
•Determine capabilities•Close gaps
Gapping
•Document recos•Communicate implementation plan
Road-mapping
![Page 16: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/16.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Findings at Missouri DWC
p.16
![Page 17: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/17.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Findings
p.17
Siloed Organization
Lack of Transparency Lack of Common Goals
Task Replication Procedure Duplication
Redundant Processes
Insufficient web utilization
Duplicate Entry
Paper Focused
Extraneous forms
Manual Communications
Inefficient Applications
![Page 18: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/18.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Benefits to Users
p.18
![Page 19: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/19.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Future State Benefits
p.19
Empowering stakeholders
Leverage electronic communication
On-line portal interaction with DWC
■ Recommended going from a manual, paper-based process to web-based communication
Timely Information
Eliminates paper based forms
Reduction in man hours
■ Recommended moving to R3 EDI and incorporating SROI in addition to FROI
![Page 20: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/20.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Future State Benefits
p.20
Reduce redundant activities
Consolidate processes
Reduce off-line activities
■ Recommended re-engineering of organization into focused work areas
Automated Docketing
Self-Insurance analysis supported by financial management module
Automated Claims & EDI engine
■ Recommended system automation to drive efficiencies across the division
![Page 21: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/21.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Future State Benefits
■ Recommended strong business analytics to support robust reporting and continuous improvement
p.21
Business analytics engine for reporting
Focus on continuous improvement
More prompt responses to information
![Page 22: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/22.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
The Future State Summary
■ Stop paper at the door (Data Driven Claims Management)■ Automated workflows■ Robust reporting capabilities■ Centralized, transparent docketing■ Accessibility by external stakeholders■ Automated electronic correspondence■ Effective content management■ Manager task administration■ Enhanced business intelligence capabilities
p.22
![Page 23: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/23.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Common Areas of Concern
p.23
![Page 24: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/24.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Common Areas of Concern
Insurers■ Update systems to support modernization■ Aggressive Timeframes■ Disjointed requirements from Jurisdictions
p.24
Employers■ Care and safety for workers■ Policy information delivery
Attorneys■ Client impact■ Modernizing internally
Health Care Providers■ Medical Record convergence■ Disparate communication mechanisms
![Page 25: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/25.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Keys to Success
p.25
![Page 26: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/26.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Keys to success
p.26
People
Process Technology
■ Strong leadership■ Develop deep relationships with key
members■ Solid change management foundation
■ Begin approval process early■ Show success early and often■ Insure partner needs are included■ Iterative methodology■ Involve external stakeholders
■ Use IAIABC standards■ Evaluate all technology options■ Map data requirements
![Page 27: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/27.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Lessons Learned
p.27
![Page 28: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/28.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Lessons Learned
p.28
Communication is key
Align early and often
Document requirements early
Verify and validate
![Page 29: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/29.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Q & A
p.29
![Page 30: Missouri Issues in Workers’ Compensation General Session](https://reader034.fdocuments.in/reader034/viewer/2022052619/5554c0fcb4c90503388b4e39/html5/thumbnails/30.jpg)
Proprietary and Confidential – CapTech Ventures 2009 ©
Contact Information
Brian RonnauManagerPhone:(804) 306-4915E-mail: [email protected]
Adam HofheimerDirector – Business Development Phone:(804) 545-3384E-mail: [email protected]
Steve HoldychPrincipalPhone:(804) 647-4836E-mail: [email protected]
p.30