|
|
|
Case Studies & White Papers
 |
White Paper
Publication: The Journal of Workers Compensation
Published: VOL 17, No.1 Fall 2007
Title: Under One Umbrella: Integrating Benefits Programs
Summary: As a result of successful workers compensation programs, employers are not only borrowing and applying workers compensation strategies across benefit silos but actually integrating and holistically managing benefit programs under one umbrella for optimal cost and operational efficiencies as well as improved service for employees. The central strategy in IDM (Integrated Disability Management) is managing all claims-whether due to work related or non-occupational incidents-centrally and consistently so that organizations holistically track and minimize lost time. Learn how five steps can help achieve IDM:
- Define Program Goals and Objectives
- Recruit an IDM Leader; Create Buy-In
- Create a One-System Infrastructure to Support your IDM Program
- Foster an IDM Culture Through a Targeted Communication Plan
- Continually Measure Performance
Data suggests that a successful IDM program can save 15 percent to as much as 74 percent depending on the organization and what controls they have put into place. The benefits of IDM to the employer include reduced incidents, cost, and lost time. The employee benefits include improved health and productivity. Find out IDM’s best practices:
- Early Reporting of Injuries
- Early Intervention with Case Management
- Return to Work Programs
- Quality Medical Management
- Data Analysis to Identify Problem Areas
|
|
|
Case Study: Iowa Municipalities Workers’ Compensation Association
Published: March 2007
Title: How a “one-system” claims solution allowed Iowa to minimize overhead expenses and optimize its in-house claims department
Summary: The Iowa Municipalities Workers’ Compensation Association (IMWCA) is a self-funded risk sharing pool that provides workers’ compensation coverage to local governments. Administered by the Iowa League of Cities (League), IMWCA is committed to providing members with stable, affordable coverage and personalized customer service. It offers a comprehensive workers’ compensation program that includes administration, claims management, technical services, underwriting, loss control, and education and training opportunities. Since its inception in 1981, membership has grown to nearly 500 members; premiums exceed $14.8 million, and the pool now covers more than 49,000 municipal employees.
The League decided to bring claims management in-house to better control costs and improve outcomes. In 1999, the League realized it needed a new claims system in order to optimize the pool’s claims operation. The key requirement was a system with a strong financial component. The League needed to track finances and expenses as they related to claims reserves. The success in continuing to operate as an in-house claims department depended on their ability to streamline operations and keep overhead low. The new system needed to automate time-consuming, labor-intensive functions in order to reduce administrative costs. |
|
|
Case Study: CIRMA
Published: March 2007
Title: Connecticut Interlocal Risk Management Agency
2006 IASA Technology Achievement Award Winner
How the iVOS® "one-system," browser-based solution enabled CIRMA to achieve outstanding service, savings, and performance
Summary: CIRMA operates two risk-sharing pools, a Workers’ Compensation Pool and a Liability-Automobile-Property Pool, and also provides risk management services to self-insured municipalities and public agencies. Since its inception, CIRMA has successfully expanded its capacity to accommodate new members and programs, and its success has been based on solid financial performance and a strong base of loyal members.
CIRMA considered claims management to be a core business process and critical "touch point" with its members. Its in-house claims department utilizes an aggressive claims-handling approach that includes early intervention, thorough investigation, proactive management for optimal savings and outcomes, continual identification of risks and exposures, and vigorous legal defense when appropriate.
With the implementation of iVOS, CIRMA achieved the following benefits:
- Integrated Infrastructure for Enterprise-wide Efficiency
- Browser-based Technology Builds Collaborative Platform
- Customization to Meet CIRMA's Unique Needs
- Enhanced Efficiency and Productivity to Handle Increased Claims Capacity
- Extensive Risk Management Reports for Improved Loss Control
- High Member Satisfaction and Retention
|
|
|
Whitepaper
Publication: The Journal of Workers' Compensation
Published: Vol. 15 No.2, Winter 2006
Title: Extreme Makeover: Seven Steps To Improve Your Return-To-Work Program
Summary: One of the biggest factors that affect workers' compensation claims
costs is a formalized return-to-work program, defined by the establishment of
transitional or modified-duty assignments and the expectation that injured workers
will participate in these assignments when they are released to do so by their
doctor.
Employers could save as much as 54 percent of current workers compensation costs by
establishing a return-to-work program, reaping an average return of $9 for every
dollar invested in these programs.
The "next-generation" return-to-work programs are thorough and systematic and unify
all stakeholders in the workers compensation return-to-work process, so everyone's
expectations and objectives are aligned.
Learn how seven steps can give your return-to-work program a makeover that yields
optimal savings and results:
- Cultivate culture and core values
- Clearly delineate role and responsibilities
- Train, educate, and use targeted communications
- Track and monitor return-to-work success with performance measures, data analysis, and reports
- Create financial incentives that motivate the right behaviors and lead to achieving return-to-work goals
- Build a technological infrastructure aligned with return-to-work objectives
- Facilitate comprehensive medical management
|
|
|
Case Study: Francis Claims Insurance Services
Published: August 2006
Title: How a browser-based "one-system" solution provided Francis with enhanced claims management capabilities and an integrated bill review process that saved 55% of medical costs.
Summary: In 2004, Francis Claims Services recognized that the Internet's role in claims management had increased. Their claims managers needed remote system access and clients wanted more online services and Web-based capabilities. At that time, Francis was also using a third-party bill review company, and was dissatisfied with the disjointed process, wanting to incorporate bill review more tightly into claims management.
As a result of these two needs - Internet capabilities and integrated bill review – Francis upgraded to iVOS, Valley Oak's browser-based "one-system" solution; and they transferred their outsourced bill review process to iVOS Review Service, Valley Oak's bill review department.
Read this case study to learn how Francis achieved these main benefits and enhanced capabilities:
- Freedom and Flexibility of a Browser-based Environment
- Efficient and Proactive Claims Management
- An Integrated Bill Review Solution and Cost-Savings
- Extensive Risk Management Reports for Improved Loss Control
|
|
|
Whitepaper
Publication: The John Liner Review
Published: Vo. 20 No. 1, Spring 2006
Title: Using a "Connected" Enterprise to Manage Risk
Summary: In today's uncertain economic climate, enterprise risk management
(ERM) and business performance management (BPM) have become the hot new management
strategies that are top of mind for insurance and risk management executives.
Traditionally, organizations looked a BPM and ERM approaches separately, but
managing risk and performance together produce significant value, allowing
organizations to drive performance while identifying potential threats along the
way.
Review this white paper and learn what organizations need to do and consider in
developing their BPM and ERM strategies.
|
|
|
Case Study: Downey Insurance
Published: January 2006
Title: Downey Insurance Claims Case Study and Implementation Strategy How a
browser-based claims system provided Downey Insurance with a paperless claims
process, $2.4 million in medical savings, and a hassle-free implementation
Summary: Downey Insurance is a managing general underwriter that has
protected Indiana government entities since 1970. Their protection plans-which
include the Indiana Public Employer's Plan (IPEP), Public Entity Program (PEP),
Volunteer Fireman's Insurance Services (VFIS), Rural Special Districts Insurance
Services (RSDIS), and School Insurance Program (SIP)-provide comprehensive coverage
and service to more than 1000 cities, towns, counties, townships, volunteer
firehouses, schools and other government organizations.
As the premiere choice for Indiana municipal insurance, Downey Insurance needed a
new claims management system that would process claims efficiently and effectively,
minimize losses and expenses for clients, and allow their claims adjusters and loss
control specialists to provide the best possible service to clients. In this case
study, find out how Downey Insurance selected a new claims system to meet their
business needs and the benefits they reaped as a result. Recognizing that system
implementations and data conversions can be a project management challenge, Downey
ends the case study with some inspiring "notes" on how to achieve a hassle-free
implementation.
|
|
|
Whitepaper
Publication: The John Liner Review
Published: Vo. 18 No. 4, Winter 2005
Title: Seven Principles of Risk Management
Summary: Although risk management has always made good business sense, it has become
complicated in recent years by a string of factors, including a stagnant
economy, strict regulatory compliance and corporate governance issues,
increased litigation, rising healthcare and indemnity costs, and heightened
pressure to improve outcomes. In addition, risk professionals face the
incredible challenge of keeping pace with an ever-changing world of risk
that today must factor in e-business, reputational, and terrorism risks, all
which are difficult to quantify.
In response to risk management challenges on several fronts, organizations
need to adopt new strategies and new technology in order to automate
processes and contain costs at each critical juncture of the risk management
process
|
|
|
Case Study: Catholic Healthcare West (CHW)
Published: March 2004
Title: Catholic Healthcare West Aims to Reduce Workers' Comp Costs
Summary: As a large employer in the healthcare industry, CHW has recently been challenged, like many organizations, to control
its workers' compensation costs. For a non-profit organization like CHW, workers' comp costs and losses come right off
their bottom line, and can take funds away from their core mission to improve health and safety of patients.
By leveraging technology, CHW was able to realize their primary business objectives:
- Reduce injuries
- Reduce costs
- Improve the efficiency of the claims process
Learn how CHW accomplished their objectives to control workers' compensation costs.
|
|
|
Case Study: Golden State Risk Management Authority and San Bernardino City Unified School District
Published: March 2004
Title: Streamlining the Bill Review Process in Worker's Compensation
Summary:
Case Study 1:
Golden State Risk Management Authority had a problem in their workers' compensation medical bill review process. They
were drowning in paper, and troubled by a complex data exchange process with a third-party bill review vendor.
Today with iVOS review services Golden State Risk Management Authority has,
- Minimal amount of work on the front end
- Much simpler, more streamlined and efficient process
- Vital information delivered where and when needed most
- Access from anywhere anytime
- No paper storage
Case Study 2:
San Bernardino City Unified School District wanted a "one-system" solution, so their claims management department
wouldn't have to manage two processes, or endure an elaborate data transfer with a bill review company. The claims
examiners wanted medical bills and report information conveniently at their fingertips. And they wanted the capability
to scan bills directly into the system.
For San Bernardino, Valley Oak provided the "one-system" solution that streamlined their process. Not only were they
able to combine two processes but they also able to:
- Reduce staff
- Reduce turnaround time on bills
- Significantly reduce payment errors
- Eliminate paper storage
Learn how these two organizations achieved their goals, for resolving their inefficient claims bill review process.
|
|
|
Whitepaper
Publication: The Journal of Workers Compensation
Published: Vol. 13 No. 2, Winter 2004
Title: Using Internet Technology to Implement Best Practices
Summary: Today, workers compensation risk managers are being asked to do
more with less. They must manage risk financing, establish safety and
training programs, implement loss-control strategies, and determine the
effectiveness of each risk management initiative.
To Perform these functions more effectively, risk managers have begun to
leverage Internet Technology for its real-time connectivity benefits. For
instance, on-line access to the right information can help risk managers
identify exposures before they result in significant losses. Real-time
connectivity improves communication and enhances the ability to share vital
information among all key stakeholders in the claims and risk management
process. But to ensure they are leveraging the right tools, risk managers
must first understand the various types of Internet systems available and
the advantages of each.
|
|
|
Whitepaper
Publication: Discussion at PERI Symposium
Published: December 2003
Title: Internet Technology Improves Workers’ Compensation Results
Summary: Today's claims operations are challenged by many factors such as high claims volumes, processing inefficiencies,
disjointed communication between various parties, a lack of useful information, a shortage of claims professionals, and many other
frustrations. With Internet technology, however, claims managers reap the value of improved workflow and collaboration, increased
cost-containment, effective claims management capabilities, and a continual feedback loop to improve prevention and safety programs.
There is constant change afoot on the Internet front to further streamline the claims and risk management process. Although the
workers' comp industry has traditionally taken a wait-and-see approach, early adopters have already gained competitive advantages
in claims cost-savings and best practices via Internet technology. As these systems continue to change the risk management
paradigm, public entities must leverage the maximum benefits from these capabilities.
|
|
|
Case Study: Gregory B. Bragg & Associates, Inc. Claim Services
Published: June 2003
Title: VOS Portal Streamlines Claims Process for TPA
Summary: Gregory B. Bragg & Associates, Inc. Claim Services (GGBAI Claim Services) is a
third-party administrator (TPA) that specializes in quality claims handling,
investigations and risk management services in the general liability, property and
workers' compensation insurance lines.
As Bragg & Associates steadily grew, they realized their current claims system was
not fully meeting their business needs. Several critical factors contributed to the TPA
looking for a new claims system:
- Improve their workflow efficiencies to allow for greater claims capacity without additional staff
- Interfaces with other systems they used
- Meet compliance issues not just with state mandates and insurance regulations, but also with the Public Risk Database Project (PRDP).
As a result, Bragg & Associates undertook a search to find a claims administration
system that could meet these critical needs. In August 2001, the TPA signed an
agreement with Valley Oak Systems, and went live with VOS Portal in December
2001. The implementation process took four months.
|
|
|
Whitepaper
Publication: The John Liner Review
Issue: Vol. 17, No. 2, Summer 2003
Title: Better Self-Insurance Through Technology
Summary: The property and casualty insurance sector is in turmoil.In every direction, the
industry is being hit by the worst possible combination of factors, forming what many
industry experts have commonly termed a "perfect storm" that is wreaking havoc on
insurers' bottom lines. All these factors are driving organizations to seek alternatives,
with many looking at self-insurance as a way to directly control and manage claims
costs and to avoid high insurance premiums. In order to determine if self-insurance is
appropriate for certain lines and industries, it is important to first understand the
various factors influencing the market. Organizations can then make critical decisions
on whether to self-insure and how to execute a successful self-insurance program.
Companies who are experienced in self-insurance, as well as those that are newcomers to the
market, are looking to experienced software developers with years of experience in working
in the industry and a system that has been fine-tuned through many client suggestions. This
type of carefully honed technology helps meet the needs of many people involved in the
claims and risk management process, ultimately empowering a self-insured organization with
the information to reduce and prevent losses, improve outcomes and results, and enable rapid
claims management.
|
|
|
Kevin Confetti