Rims 2013 saving the city


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City of Knoxville Workers Compensation 2013 RIMS Presentation

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  • Cheryle: Gary may not be wearing a superhero cape, but he has won his share of accolades for his work in the City of Knoxville. Thanks to his leadership in the City of Knoxville, the City has reduced worker’s compensation costs while also improving workplace safety for city employees. (Talk about his awards and then hand over presentation to Gary)
  • As the third largest city in Tennessee, the City of Knoxville provides police, fire, parks and recreation, community development, streets and sidewalks, transit, waste management, public assemblies, animal control and related services for its 300,000 citizens. The City’s employee base is four years older than the average employee in Tennessee, with a high percentage of males over the age of 40. As a result, the City is faced with a very high chronic disease burden and propensity for orthopedic injuries. As with most municipal governments, the services are principally delivered in the field with continually changing physical demands, creating unique workers compensation and liability challenges. Between 2002 and 2009, we changed our culture and really stepped up our focus on safety. We’ve cut severe claims in half. Our workers comp expenditures were running over $5 M; we’ve brought those expenses down to less than $2M . And we have improved our return to work program.
  • case management for injured workers, with an integrated system that combines health screening, wellness guidance, on-site medical attention and physical therapy
  • Next door to The Center, more emphasis on early PT rather than later, and better coordination
  • Billing and the way we handle data changed. Now onsite services are bundled into the Total Health and Productivity Program, which is more cost-effective and puts us ina better bargaining position. We are able to focus on the effective use of resources. We use a holistic approach to combining resources. Last but not least, we changed our data processes. We produce a web-based injury report, control the consistency of information and now data is segregated for better management reporting. Departments share seats – risk is combined with health, disability and attendance data
  • For a risk management function to work like COK, many organizations need to Need better claim loss payment and loss adjustment experienceThey’re dealing with manual processes They can’t track event-related activities They struggle to consolidate claims dataClaims processing time is too longToo many processesInconsistent practices throughout organizationNo central location to access dataand they need timely, accurate and consistent customer interactions and loss payments to increase stakeholders’ satisfaction.
  • For number 6 say: As part of its loss prevention program, the City implemented CSC's RISKMASTER Accelerator for a single database that interfaces with city accounting, HR and inventory systems. Having RISKMASTER Accelerator as it risk management information system (RMIS) enables the case manager to input case notes directly into the database.
  • It doesn’t take a superhero to turn around a challenging risk management operation. But it does take strong leadership, careful planning, strong partnerships and the right kind of system for your needs. For the City of Knoxville, that system is RISKMASTER Accelerator.
  • Rims 2013 saving the city

    1. 1. SAVING THE CITY Six Steps to Superhero Risk Management Gary Eastes, Risk/Benefits Manager, City of Knoxville Cheryle Tuttle, Director, CSC Tuesday, April 23, 2013 9:00 – 10:00 am
    2. 2. Gary Eastes, City of Knoxville PRIMA Public Risk Manager of the Year Theodore Roosevelt Workers’ Compensation & Disability Management Award Champion Award for Excellence in Workers’ Compensation Management Achievement Award for Excellence in Human Resources
    4. 4. City of Knoxville Self-insured and self-administered for worker’s compensation and liability 1,700 employees: many are male and over 40, high chronic disease burden Fire department, police department, public works, et al.
    5. 5. How Things Used to Be “What We Do Is Dangerous and Employee Injuries Are Unavoidable” “Employee Safety Is Not My Responsibility” “What Works in the Private Sector Will Not Work Here” “Safety Rules Prevent Getting the Job Done” “The Public “The Public Does Not Care” Does Not Care” “What Matters is Getting the Job Done, Not How It is Done”
    6. 6. Needs • Managing the rate of injuries • Managing claims • Data analysis
    7. 7. Hurdles to Get Over • • • • • Decentralized Management Lack of a Safety Culture Lack of Safety Expertise Poor Data Limited Data Expertise
    8. 8. Workers’ Compensation Costs $6,000,000 $5,000,000 $4,000,000 $3,000,000 $2,000,000 $1,000,000 $0
    9. 9. Number of Disability Settlements
    10. 10. Number of Claims over $70,000
    11. 11. Key Stakeholders Key Stakeholders Employer Risk Management Supervisor Department Civil Services Case Management Case Manager Injured Worker Payer Insurer Employer Medical Providers Primary Care Provider MRO Physical Therapist/Rehab Specialist Specialist Provider
    13. 13. First Steps Improving Use of Data Upgrading Risk Staff Reopening the Health, Education and Wellness Center Closing On-Site Medical Clinic Contracting for Higher Health Care Education
    14. 14. The Leap • Dramatic expansion of the contract for on-site medical services (2011) • Included on-site/dedicated physical therapy, ergonomics expertise, and case management • Integrating the occupational/health resources in a holistic approach (on-site diabetic educator/nutritionist and fitness specialist) • Team approach to data analysis
    15. 15. Two Key Organizational Changes On-site Physical Therapy Therapy therapist puts • Full-time emphasis on best use of resource rather than managing billing • Better use of work conditioning • Resource for safety and work assignments • Some PT services at employee’s work location On-site Case Management • Close coordination with claims adjuster as well as on-site treatment staff • Direct communication with supervision • Resource for claims adjuster on medications and other issues • Familiar to employees
    16. 16. Coordination with The Center • Coordination of appointments to department needs • Service delivery at work locations (blood draws, drug tests, physical therapy/work conditioning, classes, disease mgmt coaching) • Light duty coordination • Case Reviews include treatment staff, case manager and claims adjuster • Safety Program/Training consultation • Ergonomic consultation • Injury trend reviews
    17. 17. Structure + Process = Outcomes
    18. 18. Process Changes Improved Billing •Total Health and Productivity Program •Use of a holistic approach to combining resources Improved Data Processing •Web-based injury report •Control consistency of information •Segregation of data 18
    20. 20. Success Stories Drivers & Goals • Improve claim loss payment and loss adjustment experience • Gain efficiencies – speed to close claim • Increase stakeholders’ satisfaction
    21. 21. Keys to Success 1. Establish ownership by all key management 2. Engage strong partners committed to our success 3. Design processes for improvement 4. Educate employees 5. Analyze results 6. Optimize Claims Solution
    22. 22. CSC’s RISKMASTER Accelerator Policy Management Claims Management Legal Management Workers Comp Property Vehicle Liability Workers Comp Property Vehicle Liability Non-Occupational eBill Legal Matter Management Legal Bill Review Event to Claim Model Flexible System Easily Integrated Modules Automate and Streamline Workflow
    23. 23. QUESTIONS?