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Greetings!
"If you have an apple and I have an apple and we exchange apples then you and I will still each have one apple. But if you have an idea and I have an idea and we exchange these ideas, then each of us will have two ideas."
George Bernard Shaw (attributed)
Today, regional insurance carriers and large self-insured employers can compare and contrast outcomes in the National WorkersComp Clearinghouse™
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The Clearinghouse 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.
Data is collected from subscribers on a monthly or quarterly basis. It is scrubbed, depersonalized and rolled into the appropriate data format for analysis by all subscribers.
Using Shaw's context cited above, our ideas offer deeper and more meaningful metrics than the "average cost per claim". Certain measures are built-in to achieve a quick glance view and subscribers can conduct "mash-ups" of various metrics and Key Performance Indicators (KPI's). As more and more data is collected, employers and carriers of all sizes can use data to Positively Impact Claim Outcomes!
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Analytics for All
In addition to the data aggregation, the Clearinghouse collects common data elements which affords the straight-up comparisons. Once in this format, analytics can be performed on the various databases, with costs and outcomes shared by all subscribers. This action alone dramatically reduces IT costs for the carries and self-insured, self-administered programs. In essence, the Clearinghouse becomes your backroom analytics department.
A recent survey conducted through a LinkedIn® Discussion Group asked members to discuss and vote as to the reasons companies are reluctant to use analytics. Summarized in the bar chart below, the survey identifies key areas of concern with primary issue that users do not understand the benefits of an analytics project.
LinkedIn® Survey Results
A portion of the answer is making analytics digestible from agreed upon outcome improvement and better presentation of KPI's.
Further, an MIT/Sloan Management Review (FALL '10 )article lists a number of recommendations to begin a data analytics effort beginning with identifying quick wins and knowing what questions to ask in order to identify actions/outcomes.
Economies of Scale
If Pareto Law holds true, most companies do not have enough data to develop key indicators. In addition, each carrier, TPA or self administered program has different criteria for claims handling and hence, collect many different types of data.
- A small sampling of claim databases shows the number of elements collected vary anywhere from a low of 328 to a high of 1401. And, only a very few capture height and weight in order to calculate a potential Body Mass Index (BMI)...a key ingredient in understanding possible co-morbidities in a claim.
- By focusing on common data elements, it is now possible to offer analytics for all on an extremely cost effective basis.
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Barriers Removed for Data Sharing
It's well known that many workers' compensation carriers are reluctant to share data at any level. Yet, despite that reluctance, carriers routinely share data with many other entities perhaps without realizing it.
All jurisdictions receive notice of injuries and NCCI collects the majority of all workers compensation-related data. One oft-used, yet limited, data sharing arrangement is with ISO Claimsearch or as some refer to it, The Index Bureau. Here carriers agree to submit certain claim information to a third party for the purpose of identifying fraudulent claim activity against a larger aggregated database. These claim characteristics are shared among all subscribers with a claimant match.
The State of California offers a public and searchable database about claimants and their subsequent hearing dates (https://eams.dwc.ca.gov/public/GeneralPublic). As the need for better outcomes and claim handling transparency grows, many states/regulators will follow suit.
Additionally, other governmental regulations offer protection for PII (Personal Identification Information) and PHI (Protected Health Information)
However, as in traditional healthcare, more and more, barriers are breaking down as the need for better data and better outcomes becomes paramount.
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Improved Outcomes
The basic idea behind the Clearinghouse is to allow a subscriber to compare their performance, based on certain measures, against a benchmark. That benchmark could be by state, region, nation, ICD or by network type. Data is updated as soon as new data becomes available and safeguards are instituted so that a dominant insurer in one state is not revealed.
Though not as complicated as healthcare, WorkersComp Analytics™ proprietary medical and pharmacy groupers exist to help retrospectively, identify severe cases and their associated outcomes. This affords the ability to understand how care is administered and how effective providers are in their delivery.
We include data from the following categories....all standardized.
Finally, each subscriber is offered roughly 40 different Key Performance Indicators (KPIs) or metrics compared to a benchmark.
The National WorkersComp Clearinghouse is the first of its kind to allow subscriber access to a robust set of data stores and affordable analytics.
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You are invited to join the Clearinghouse effort and our Analytics for All approach as we develop claim strategies for effective return to work.
Cordially,
Jim Paugh
President
WorkersComp Analytics LLC
( 617-410-6561
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Data Warehoused in the USA