|
Greetings!
Allow me to introduce WorkersComp Analytics LLC. home to the National WorkersComp Clearinghouse, the industry's only independent claims database for insurance carriers and self-insured companies.
Our mission, simply put, is to positively impact claims outcomes for both injured workers and claim professionals. We accomplish this by revealing the hidden drivers using the science of analytics.
- Real time data
- But not just any data...it's your data vs benchmarks
- Actionable KPIs and recommendations
- Direct correlation to your programs and markets
Analytics affords a better understanding of the complexity of an injured workers recovery. This involves many psycho-social issues as well as developing better case management and claim strategies. We protect and utilize our data stores in an ethical manner always focusing on improved outcomes. The results of data analytics will be used to produce industry-leading Benchmarks, Metrics and KPIs.
· Offer an Analytics for All approach
· Aggregate Data and Employ Economies of Scale
· Manage Vendors by Outcomes Performance
· Improve Injury Outcomes for America's Workplace
|
| Benchmarks, KPIs and KPPs
(Key Performance Indicators and Key Performance Predictors) |
|
What does the Average Cost per Claim really tell us?
Can we tell if the claim performance is better in New York, Massachusetts or Kentucky? What if additional back strains (ICD9: 847.2 ) were reported this year driving the costs higher? Or, your company experienced a downsizing? Does that mean your efforts have not been as good in the past? How do you compare to competitors or other businesses in your area?
Is the Average Cost per Claim a true Key Performance Indicator (KPI)? Are there Key Performance Predictors (KPPs) that can alert certain claim issues?
The underlying problem is that there is no one, true measure of success in workers' comp and consequently, the industry has struggled with what makes sense. And, not really knowing what to present, PowerPoint presentations proliferate with various graphics and inferences.
But now, a new tool exists that changes the way we can manage claims for better outcomes. The National WorkersComp ClearinghouseTM is comprised of various data sets that subscribers can use to understand frequency and severity drivers. It allows for an apples-to-apples comparison for carriers and employers to help impact claim outcomes and develop metrics and benchmarks.
Read more about KPIs and KPPs
|
| MRIs and Back Strains:
Comparisons of Healthcare to WC |
There is a constant struggle to bring Healthcare measures and outcomes into the workers comp arena. In healthcare, HEDIS Measures,
(Healthcare Effectiveness Data and Information Set) developed by the National Committee for Quality Assurance (http://www.ncqa.org) are used. From all measures developed, only a couple can be directly applied to a workers compensation treatment setting.
One such treatment measure is the Use of Imaging Studies for Low Back Pain. Specifically, this measure estimates the percentage of people ages 18 to 50 years who had an episode of acute low back pain with no risk factors or signs of serious pathology identified in the diagnostic visit, and who did not receive an imaging study in the following 28 days.
Higher scores are better for this measure as in the example below. Seventy three point one (73.1%) of cases DID NOT receive an MRI within 28 days of injury report.
COMMERCIAL HEALTH INSURANCE
Appropriate Use Rate: 73.1 down 1.5 pts.
MEDICAID
Appropriate Use Rate: 75.7 down 1.6 pts.
So why is this important? At an average retail of $2,100 per MRI, identification and proactive claim handling can significantly impact claim costs as well as improve the injured workers outcome. But, what is the Appropriate Use Rate in Workers Compensation?
Subscribers to the National WorkersComp Clearinghouse can find both the "overuse" in workers comp of MRI's, plus identify the claim and providers and check against the cost of MRI's in their immediate area...state-wide, regionally or nationally. |
Data Warehoused in the USA