In this series, we are focusing on ways in which a Risk Manager can add value to the bottom line of his or her organization using RMAP technology.  These avenues of added value include: lower cost, asset protection, revenue enhancement and competitive advantage through better management of tactical and strategic Risk.

Lower Cost:  Risk Manager’s typically have influence in three cost categories. 1) Pre-Loss, 2) Point of Loss and 3) Post Loss. Today’s BLOG will focus on a workers’ compensation post-loss item… Return to Work.

Once a workers’ compensation claim has occurred, control is usually transferred to the medical community. There are certain regulations in place that allow a payer to have some level of control but the two main direct cost in WC are medical and indemnity. Consequently, one of the strongest tools to assist the medical community in controlling cost and advancing rapid healing is a robust “Return to Work” program. But since these programs required extreme levels of management, complex levels of paperwork and collaboration with a large team of individuals (some with conflicting incentives) a strong RMAP⁽¹⁾ is a must to achieve the potential savings. Fortunately, there is technology available to automate the entire RTW process, including real-time electronic extracts of disability guidelines, predictive modeling and monographic information about the injury. The system uses workflow to produce, distribute and receive information electronically, manage all of the forms and regulatory reports in a paperless environment and tracks all transitional duty workers as they move from injury, to transitional duty, to full MMI and Return to full duty. No injured worker gets lost in the shuffle and the result is OPTIMAL movement through transitional duty to full duty at the LOWEST COST POSSIBLE. One health care provider saw average lost time severity go from $1,200 per claim to $500 per claim on an apples to apples evaluation date basis.   That’s about a 58% savings!  (The system even calculates savings over the predictive model on every case)