That’s the conclusion I’ve reached partway thru a quick-and-dirty survey of a handful of savvy, connected brokers.
The people who buy workers’ comp insurance and or claims and/or medical management are, mostly, clueless.
They succumb to spreadsheets when comparing TPAs. Because they have no idea how to separate out the good ones, they go for the cheapest per-claim fee, then are surprised when their ALAE costs are thru the roof. But hey, that’s “claim-related” so they’re safe.
They bitch at their insurer when their claims costs go up, but won’t direct to good docs, or educate their employees before injuries, or hold management accountable.
They think bigger networks are better networks, that deeper discounts deliver big savings, that case management is the “state of the art.” Many are quite ignorant of evidence-based medicine – which to my mind is the ONLY way we’re ever going to deliver quality care at reasonable prices.
Providers who pitch outcomes and return to work get some traction with a few of the bigger employers, but nowhere near enough to change the managed care business model.
To be fair, some large employers – think Lowe’s, Costco, Safeway – are doing really great stuff, and I’m sure there are lots of others who are innovating and improving and demanding performance.
The only thing that’s protecting these “buyers” is the up-and-down insurance cycle, a driver that has a disproportionate effect on the price and availability of work comp insurance and claims services. Those that think they are safe may want to consider what’s coming. PPACA has and will dramatically affect provider behavior, provider access, and the type and quantity of care delivered.
What does this mean for you?
To paraphrase HL Mencken, you get the work comp results you deserve, and you deserve to get them good and hard.