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July 2005
BenchmarkingShow Me the Metrics Money!
Lynn R. Talford Marsh Risk Consulting
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BenchmarkingCharacteristics of Companies
Those That Benchmark
And Those That Dont

• Not Afraid to Admit They can Improve
• Competitive
• Proactive
• Fear of Being Second
• Leader - Search for Best Practices
• Continuous Improvement Philosophy
• Performance Based Compensation

• Lead by perception
• Fear of change
• Perceive lack of competition
• Lack of clear goals, expectations
• Reactive
• Complacent, comfortable with status quo

Change the thought process Not better or worse
..but rather Is there money to save?
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Levels of Benchmarking

• Best Practices
• V
  Process Analysis
• A Competitor
  Analysis
• L Trend Analysis
• U
• E Informational Analysis
• C O M P L E X I T Y

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Informational Analysis

• High Level
• Quick Pulse
• Data Dump
• Carrier data
• Single point in time

• Frequency / Severity, Stratifications, Large
  Losses,
• Report Lag (accident to supervisor, supervisor to
  carrier)
• Percent indemnity claims (avg pd, inc, duration,
  lag)
• Percent of open claims (all, indemnity, by
  jurisdiction, categorize)
• Claim duration (accident to close, to assignment,
  managed care, rtw)
• Medical/Indemnity/Expense trends
• Repeat claimants
• Cost drivers - what body parts, causes, natures

Identify Opportunity
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Competitive Analysis

• Add new perspective
• Is it us or an industry trend? Jurisdictional
  issue?
• Is there money to save?
• Where? How?

• Avoid Inappropriate Peers / Correlations
• Compare like industries / processes
• Similar activities
• Consistent Time periods
• Related Jurisdictions

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Measuring Best Practices
Client Avg
Industry Avg
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Benchmarking Pitfalls

• Provide Clarity (definitions (indemnity) venti,
  grande?, subjects, etc)
• Minority Business Owners Recently Complained
  that They Received Only 6 of the contracts for
  the 600 million Stadium Project.
• 6 of All Contracts? 6 of What They Bid? Or 6
  of 600 million?
• What percent of contractors were minority?, What
  is a minority contractor?
• Insufficient sample sizes
• One-time comparisons
• Irrelevant comparisons
• Forcing results
• About 6 Billion People Live on the Earth
• World Population Growth is Under Control, at
  Only 1 per Year
• We Must Do Something! Each Year the World Has
  60,000,000 More People on it
• Keep a constant ground floor (baseline, time
  moves to right)
• Unknown data / unreliable data
• Numbers are only one dimension

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CONSULTATIVE Benchmarking
Putting it together tell a story.

• RANK - WC Program to Industry Peers
• How are my WC costs compared to Industry Peers?
• QUANTIFY Place Dollar Value to Rank
• Industry Position Financial Advantage /
  Disadvantage
• IDENTIFY RETURN ON INVESTMENT
• Savings Potential Where?
• Identify location and/or job classes
• IDENTIFY STRENGTHS WEAKNESSES
• How do I compare to my peers?
• What programs should be better? Where can I make
  improvements?
• What are my loss causes?
• STRATEGY CONTINUOUS IMPROVEMENT
• Develop cost savings strategy and next steps for
  improvement

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QUESTIONS ?/ COMMENTS
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Wellness Programs A Critical Step in Managing
Workplace Health
Marie Potty RN Marsh Risk Consulting
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Wellness Objectives, Impact and Value

• Major Employer Wellness Objectives
• Attempt to control rising healthcare costs
• Assist senior management in addressing employee
  health issues
• Employer / Employee Wellness Impact
• Improve overall employee health and productivity
• Reduce incidence of injury / illness and
  fatalities
• Reduce sick days and unscheduled absences
• Wellness Priorities and Value Proposition
• Employers offering employee incentives to
  participate in wellness programs for sustained,
  positive outcomes
• Employee health is crucial to the overall
  business success
• ROI Employer uncertainty of continued employee
  success

American Association of Occupational Health
Nurses AAOHN News (Vol., 25 June 2005)
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Absence and Health Care CostsComparable and
Related
Direct absence costs are 14.2 of payroll
Equivalent to 26.6 scheduled days off 10.4
unscheduled days off per year
2.9
4.0
7.3
Fixed Holidays
Vacation/PTO/Personal Days/ Floating Holidays
Unscheduled Absence (Incidental Absence/Sick
Days, STD, SC, WC, LTD)
Cost for employees coverage is typically 50-60
of the total
Active employee health care costs are for 2003
for employers with 500 employees, from the 2004
Mercer National Survey of Employer-Sponsored
Health Plans
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Employer Structured Lifestyle Risk Modification
Program Options
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Periodic Employee Medical Screening
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Employee Disease Management
Assess employee health risk demographics
Employee validation of risk / Wellness Programs
Pilot targeted Wellness Program
Measure ROI
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2005 Total Health ContinuumAn Employers Guide
Well Life Style Modification
At Risk Periodic Screening
Acute Illness/Discretionary Care Doctor
Visits Emergency Visits

• Chronic Illness
• Disease Management

Catastrophic Life Care Planning

• Prevention
• Screenings
• Plan Incentives
• Examples
• Ergonomics
• Exercise classes
• Smoking cessation
• Stress reduction

• Health risk assessment
• Targeted risk reduction programs
• Risk modeling
• Examples
• Blood Pressure
• Cholesterol
• Diabetes

• Nurse advice line
• Web tools
• Consumer driven health plans
• Examples
• Out-patient visits
• Benefit Plan Site / Web MD
• Health Savings Accounts

• Incentive design
• Self managementtraining
• Examples
• Diabetes
• Cardiovascular disease

• Case management
• Decision support
• Predictive modeling
• Example
• ABI Acquired Brain Injury

Disability Management
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QUESTIONS ?/ COMMENTS
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POST INJURY MANAGEMENT
What You Need To Know About Modified /
Transitional Work Programs
Rick Poirier, M. A. R.C Knox Company Risk
Management Services Division
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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Overview
• Understand our goals
• Establish a collective approach
• Set benchmarks
• Evaluate program on a periodic basis
• Educate workforce, medical provider(s), and
  insurance company
• Take advantage of managed care

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Benefits
• Gives the employee an opportunity to return as
  soon as medically possible
• Provides the best medical care in a timely
  fashion
• Emphasis is on abilities not disabilities
• The injured worker benefits and so does the
  employer

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MORE BENEFITS

• Contributions to the Workforce
• Reduces Impact of Claims Reserves
• Reduces Fraud
• Contributes to Controlling Rising Insurance Costs
• Other Benefits

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Preliminary Steps
• Educate the workforce
• Establish good communications with medical
  provider
• Strengthen job descriptions
• Develop job bank
• Try it

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Employee in a temporary position
• Communications with Gatekeeper
• Follow up with medical provider
• Monitor performance / evaluate medical progress
  abilities
• Communications with insurance company claim /
  rehab representative
• Return to normal job

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Managers Responsibilities
• Investigate the incident / notify HR, Payroll,
  Ins. Co., etc.
• Fax job description to medical provider
• Ensure that medical treatment was provided in a
  timely fashion
• Determine ability level
• Initiate Temporary Modified Duty Program

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Managers Responsibilities
• Notify claim representative of employees
  temporary assignment
• Ensure that employee works within their medical
  restrictions
• Determine if program should be extended
• Return employee to their original position, if
  possible

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Gatekeepers Responsibilities
• Educate management / workforce
• Develop bank of temporary positions
• Ensure job descriptions are task oriented and
  meet ADA guidelines
• When informed of an injury requiring lost time,
  send appropriate letters to medical provider /
  employee
• Meet with employee on first day

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Gatekeepers Responsibilities (cont.)
• Meet with employee on a weekly basis
• Monitor performance and medical progress
• If no temporary position available, determine if
  they can be placed in a non-profit organization

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Employees Responsibilities
• Report all on the job accidents to their manager
  at the time of injury
• Obtain medical assistance when necessary
• Respond to letters or calls from employer
• Return to work based on temporary assignment and
  medical abilities

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HOW TO IMPLEMENT AN EFFECTIVE POST INJURY
MANAGEMENT PROGRAM

• Employees Responsibilities
• Stay within level of medical restrictions
• Meet with Gate Keeper when requested
• Get well

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SOME SUGGESTIONS

• Have a written policy
• Make sure everyone understands
• Invite medical providers to your company
• What the employee can do
• Make sure everyone knows that modified duty is
  temporary
• Monitor performance / medical progress
• Be creative

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QUESTIONS ?/ COMMENTS