Nine months into the pandemic and well into the third wave, it’s time to see what’s changed – and for how long.

1.  Remote is here to stay.
   Whether you are a claims professional, case manager, executive or manager,, clinician or administrative worker, its likely most if not all of your work is now being done outside the “office”.
   I don’t see that changing – many employers are going to maintain an at-home workforce. While IT and cyber issues and costs are significant, savings in real estate and associated costs are real. And quality of life is higher and cost of life is less; no hours spent commuting, more time with family, and no need for that extra car, parking spot, train pass, and business lunch.
2. Selling and servicing is changing
   Service companies looking to sell their services or service accounts are working hard to figure out how to ply their trade remotely. Zoom calls, DoorDash lunches, virtual wine tastings and sports watching are just a few of the things we do today that would have been incomprehensible just 10 months ago
   I don’t see that changing anytime soon. With budgets slashed and travel risks high, business travel is over. As the economy tries to claw its way out of a very deep hole and companies look for any and every way to save dollars, expect financial folks to keep travel budgets near $0.00. One exception…
3. Conferences will likely return
   The proliferation of conferences was getting overwhelming, with way more conferences than people to attend or sponsors to fund.  Hopefully the less valuable ones will disappear, and the key ones will continue – after revamping their business models.
   Pay to play has to go; it’s gotten to the point that at many events, conference sponsors get speaking slots regardless of the quality of the speaker or salience of the topic.
   Exhibitors are paying gazillions to stare at each other across empty aisles.
4. Insurers are cutting back
   With premiums dropping precipitously, insurers are laying off staff, cutting IT projects, putting off investments and consolidating operations. If anything that’s going to accelerate as the winter looks long and dark, and the most optimistic projections indicating fall as the time things start to get back to what we once thought of as normal.
5. Consolidation will accelerate
   As companies of all sizes and types face declining revenues, those that are stronger financially will win. There will be horizontal and vertical mergers (companies buying others in their business, and buying companies in different businesses).
   There are billions of dollars burning holes in investors’ bank accounts, desperately seeking acquisition targets. While investors will be cautious, expect them to seek out attractive targets.

What does this mean for you?

Adapt and succeed. A minute complaining about reality is a minute not used well.

WorkCompCentral hosted a webinar last week (you can watch at no cost) diving into key issues related to Florida’s experience with COVID19 and workers’ comp. Moderated by Rafael Gonzalez (one of the nicest people you’ll ever meet), the panel included a defense attorney, judge, and managed care executive providing different perspectives on COVID’s impact.

Most of the discussion focused on solutions; we’ll touch on the ongoing issue of claim acceptance before highlighting some of the solutions discussed by the panelists.

Claims filed v accepted

Judge David Langham noted that about 7,000 of roughly 17,000 COVID claims filed have been partially or completely denied, yet to date only a handful have filed petitions seeking benefits. (A petition would lead to a formal hearing.)

Ya’Sheaka Williams, a defense attorney, spoke at length about healthcare workers’ exposure, indicating that in her experience claims filed by these workers weren’t contested. She provided good insight into differences between “essential” vs “non-essential” workers, noting sanitation workers are even more important now than ever as it is critical to safely dispose of potentially contaminated materials.

Langham also noted that 96% of accepted cases have resulted in payments <$5,000; the average is <$1,000. (consistent with data Mark Priven and I previously reported)

Of course, as Langham indicated we do NOT know what the long-term impact of COVID19 on individuals will will be; there’s evidence that some individuals have lasting chronic conditions, some of which can be quite debilitating.

Langham averred “in the United States, we aren’t reporting who has recovered, whatever that means.” That surprised me, as a slide displayed earlier in the same presentation specifically reported recoveries in the US. (the picture below is from the same site, captured this morning)

In defense of Judge Langham, I hasten to add that in fact that while there is some reporting of “recoveries”, there’s no universally-accepted definition of “recovery”, nor is the reporting of recoveries consistent across states or even counties within states.  For example, Texas has reported 680,000 “recoveries”, while New York  – a state with much higher infection counts – has only reported 77,000, and California and Florida have not reported ANY recoveries. (at least as reported by JHU)

The lack of clear and specific definitions and guidance from the Federal Government – and a Federal mandate that reporting entities stick to those definitions and guidance – is highly problematic.

Matthew Landon, Chief Strategy Officer of MTI America, suggested employers ensure they are using the same processes, procedures, and strategies to evaluate COVID19-related claims that they use for all claims. Consistency is critical to demonstrate objectivity.

Lessons learned

Judge Langham noted that virtual hearings are proving we can use technology to speed up hearings, engage with claimants more effectively, and get to resolution quickly despite the inability to get together in person. He also encouraged all of us to “protect ourselves mentally and physically” so we can help others.

Kudos to Judge Langham for reminding us that before one can help others, one has to take care of oneself.

Landon identified telephonic translation services a key tool speeding up claims handling and ensuring the right care is getting to workers with language limitations. He also noted care within medical offices seems to be more effective as patients are seen more quickly with lower waiting times; office managers are working to keep the number of patients in offices as low as possible.

More care is being delivered in the home of late, a response to workers’ desire to avoid medical facilities.

Ms Williams reported Tampa Airport is partnering with BayCare Health Systems to provide passengers coronavirus tests on-site at no cost to the passenger, highlighting one example of companies working together to come up with creative solutions to reduce risk and personal stress levels.

She also was encouraged that the delays in accessing care experienced by many injured workers seem to have abated somewhat, a promising development as more clinical practices open up for on-site care and more providers adopt tele-medical solutions.

What does this mean for you?

Good information from folks with deep knowledge of Florida’s experience, much of it applicable to other states as well.

note MTI America is an HSA consulting client

A very busy week indeed – here’s what happened.

MedRisk’s management changes

Long-time CEO Mike Ryan has stepped up to Executive Chair, and President Ken Martino is moving up to CEO. Mike has led the organization as President for more than 7 years. Founder and Chair Shelley Boyce named Mike CEO several years ago. I know Shelley, Ken and Mike very well.

MedRisk’s annual growth has averaged over 20% for the last decade. The company now employs 1,200 people, all located here in the US.

There’s no question MedRisk, perhaps the most successful company in the work comp services sector is in very good hands. (MedRisk is an HSA consulting client)

Mental health in the workplace – Great take on the big increase in workplace stress from HomeCare Connect’s Teresa Williams in today’s WorkCompWire.  Teresa notes that the percentage of adults with depression or anxiety has tripled over the last year. Her piece has helpful recommendations that employers:

• list what they are doing to protect employees
• be honest and straightforward about the employer’s financial situation
• refer workers to trusted sources for information on COVID – NOT YouTube videos from random cranks
• keep in mind that younger workers seem more vulnerable to stress than we older folks.

Progress in bringing science to claims handling

Congratulations to Gallagher Bassett’s Jeffrey Austin White and colleagues – GB’s Treatment Quality Index (TQI) was named Insurtech Initiative of the Year. The Index, coupled with Clinical Guidance, identifies which claims would benefit from what type of clinical attention and when to apply it.

There’s a lot of really good thinking behind TQI; it addresses one of the toughest challenges faced by claims handlers.

Innovate or else.

Coincidentally, GB’s Gary Anderberg PhD penned a terrific piece on what we have learned and can learn from COVID.  One of his 5 takeaways:

COVID has cast a strong light on the fact that we always act on imperfect, half developed information, that all decisions are provisional, that updating your data constantly and rigorously is not a luxury.

(GB is not an HSA client)

Gary’s piece came the same day the Harvard Business Review published a though-provoking article on innovation…noting one huge retailer spent 18 months developing and implementing curb-side pickup. This went pretty much nowhere…until COVID.

Substitute “telemedicine” for “curbside pickup” and “workers’ comp insurer” for “retailer” and you will learn a lot about the cost of not innovating.

What does this mean for you?

Great companies succeed by delivering the service customers don’t even know they want.