Insight, analysis & opinion from Joe Paduda

< Back to Home

Jun
2

The ignorance of arrogance

“If we didn’t come up with the idea, it isn’t worth considering.”

“That can’t be a good idea, we didn’t think of it.”

“Why would we listen to anyone from outside our company; we’re the biggest/best/most experienced/industry leader.”

Those are just three of the statements I’ve heard from large work comp insurers over the last two decades – all  from insurers who’ve fallen far from their glory days of market dominance. They may seem ignorant, or dumb, or even kind of funny – but they were real.

Sitting comfortably in leather chairs behind their nice desks, the men who made these statements were completely secure in their belief that their company, their way of doing things, their mindset and culture were completely infallible.

How wrong they were. As easy as it is for us to see that now is how impossible it was for them to see reality then. 

The next five years are going to bring profound changes to workers’ compensation, changes which – by definition – will make many of today’s business practices obsolete. It isn’t hyperbole to say that unless you completely revamp the processes, systems, technology applications, and metrics you use today, you’re toast tomorrow.

We are seeing that with Liberty’s progressive de-emphasis of workers’ comp. With the increasing outsourcing of claims functions to TPAs. With the rapid growth of what were relatively small players just a few years ago.

And that’s just the beginning.

All these changes have been driven by lower work comp claims frequency – that’s not new news to anyone. But hidden behind this is another major driver – the continued inability of major insurers to understand the business they are in.

Work comp insurers are in the business of managing medical and disability. While many think that’s what they are doing, they aren’t. Their claims management approach, predicated on the disproven model of huge provider networks delivering discounted care and the medical model of disability, overseen by overworked and under-resourced claims adjusters reporting to executives steeped in claims who don’t understand medical issues at all, only seems to work as long as premiums stay high and frequency continues to decline.

Wrenching changes are coming to employment, job availability, workplace demographics, trade and safety nets, changes that the industry is completely unprepared for.

Not to worry; the powers-that-be will schedule meetings, draft memos, write white papers, and do re-org planning, most of which will be completely ineffective, except insofar as it makes the execs feel like they are doing something. They’ll get rid of managed care departments, expertise, programs because “those programs haven’t worked.”

Of course they haven’t, because they were either the wrong programs to start with (percentage of savings network models) or the execs didn’t force adoption of intelligent medical management on a recalcitrant claims culture.

I see this happening all around the industry, and it’s like watching Antarctica melt. By the time these worthies figure out it’s real, they’ll be floating towards the tropics on a rapidly-melting iceberg.

With no landfall in sight.

 


5 thoughts on “The ignorance of arrogance”

  1. Sadly as you pointed out it is a trend across the industry not just carriers. You find this with many large organizations, and not just related to how they process business but how they market and present their services as well. You make a very good analogy. Point being failure to recognize the evolution in claims or just business in general is ultimately going to prove to be very costly.

  2. About 20 years ago, at a company, I was working for called a meeting to meet the new President. She was a business woman and came with some doubts, so we were all anxious to meet her.

    About 100 or so people came to the meeting from all sectors of the company. Her opening statement was ‘Don’t believe your own bullsh&*t.

    Everyone just stood there and looked at her. I still think of those words when I am re-evaluating things.

    1. The exact same point can be, and has been, made about US attitudes when it comes to health care generally and now climate change. The deadly attitude “other nations have nothing to teach us. We’re America”

  3. Joe, this is excellent and I could not agree more. The industry will see some big changes within the next five years. As every organization competes in finding talent, they should be asking themselves: are we prepared for the next generation of workers? The next generation of workers expect to be working with the latest technologies, embracing new innovative trends, achieving quicker results through automated workflows, etc. If innovation is not embraced, we will lose good people and the industry will suffer as a result. It comes down to change management.

Comments are closed.

Joe Paduda is the principal of Health Strategy Associates

SUBSCRIBE BY EMAIL

SEARCH THIS SITE

A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

DISCLAIMER

© Joe Paduda 2024. We encourage links to any material on this page. Fair use excerpts of material written by Joe Paduda may be used with attribution to Joe Paduda, Managed Care Matters.

Note: Some material on this page may be excerpted from other sources. In such cases, copyright is retained by the respective authors of those sources.

ARCHIVES

Archives