For several years, the Accident Fund (HSA consulting client) has been making major investments in data analytics and working on ways to use their new-found knowledge to reduce costs and improve outcomes. Now, the results of those efforts are becoming apparent.
Claims costs are coming down, driven by rapid referral of selected claims to top occ med physicians.
AF’s program identifies higher risk claims and claimants, alerts adjusters and case managers, and, when necessary seeks to move the claimant to one of the top docs.
The program, which recently won an award for innovation, is under the direction of Jeffrey Austin White, director of Medical Management Practices and Strategy for Accident Fund Holdings. In a press release Jeff said “It’s a huge honor to receive this award and it is truly reflective of the hard work of our claims representatives, risk case managers and operating companies…This is a major accomplishment of custom software development to meet our business needs and improve efficiency while also giving us a competitive edge.”
So far, the program has helped identify high-risk claims faster, improved policyholder satisfaction, and reduced claim costs for targeted claims in excess of 20 percent.
Jeff reported on these results at several recent conferences including August’s Workers Comp Institute in Orlando. Here are a few highlights:
- the more work comp experience a physician has, the better their outcomes are.
- the most experienced docs’ claims costs were 20% below the least experienced
- a lot of claims are handled by docs with zero experience in comp
- claims handled by occ med docs were 20% less costly than average
The net -“change of provider based on experience is an effective cost containment strategy.”
While others are talking, planning, and getting ready to get ready, Accident Fund is doing. Kudos to Chief Claims Officer Pat Walsh, VP Claims Lisa Riddle, and Jeff White.