Your SlideShare is downloading. ×
Damian Poel - Transport Accident Commission -  Returning to work after a transport accident
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

Damian Poel - Transport Accident Commission - Returning to work after a transport accident

280
views

Published on

Damian Poel delivered the presentation at the 2014 Return to Work Forum. …

Damian Poel delivered the presentation at the 2014 Return to Work Forum.

The 2014 Return to Work Forum brought together speakers from multiple sectors to share best practice in return to work, injury management and rehabilitation.

For more information about the event, please visit: http://bit.ly/returntowork14

Published in: Recruiting & HR

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
280
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
7
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Transport Accident Commission Returning to Work after a Transport Accident Presenter: Damian Poel
  • 2. ■ Sole provider of personal injury insurance for transport accidents in state of Victoria ■ Victoria’s population 5.57 million ■ No-fault scheme ■ TAC funds: □ treatment □ income □ rehabilitation □ lifetime care Overview of the TAC ■ 4.3 million vehicles registered ■ Compulsory premiums paid with annual vehicle registration ■ TAC invests in: □ Road safety □ Safer road infrastructure
  • 3. $1.1B claim payments 2013/14 $10.9B liabilities as at June 2013 CLAIMS DIVISION 2013 19,000+ new claims 2013/14 45,000+ people received funded support in 2013/14 Alex
  • 4. 2015 strategy
  • 5. Goals Core Functions Recovery – Mild to moderately injured clients Service Streamlining our processes to make it easier for clients Independence Maximising our clients’ independence Recovery Helping our clients back to work and health sooner Enablers Align to deliver on the TAC 2015 agenda Road trauma Maximise potential of Arrive Alive and explore step-out opportunities Capital Management Optimise the balance sheet for clients
  • 6. Vision and Mission for Recovery “Our vision is that by working together we enable and empower those affected by road trauma to get their lives back on track sooner” “Our mission in the Recovery branch is to support our“Our mission in the Recovery branch is to support our clients to return to work and health as quickly, sustainably and efficiently as possible. We do this by working with our clients in an innovative and person- centred way to achieve outcomes together”
  • 7. What changed? Benefit Delivery  Portfolios based on injury type  Claim movements all manual based on pre-defined time-lines and events  Multiple file handovers (5+) during life of claim  Portfolio sizes and staff not aligned to client needs Recovery  Algorithm to automatically segment claims by risk factors as claim accepted  Portfolio sizes clearly differentiated to client needs  Risk screening tool for return to work, mental health and pain risk factors  Strong focus on early intervention, expectation setting and clientaligned to client needs  Long tail claims scattered across teams  Missed opportunities for early intervention & common law expectation setting and client outcomes  Larger Client Assist stream to absorb low needs clients  Fewer file handovers  Targets review of long tail clams and outlier providers  Earlier identification of Common Law
  • 8. Recovery Phase 2 Phase 2 focussed on changes to the systems, processes and people required to better support our client’s recovery • Roll-out of Motivational Interviewing skills training • Introduction of Recovery Action Plan focussed on• Introduction of Recovery Action Plan focussed on barriers and interventions • Focus on effective interventions and pathways – particular focus on mental health, persistent pain, and return to work barriers
  • 9. Goals Core Functions Service – Impacts all clients Service Streamlining our processes to make it easier for clients Independence Maximising our clients’ independence Recovery Helping our clients back to work and health sooner Enablers Align to deliver on the TAC 2015 agenda Road trauma Maximise potential of Arrive Alive and explore step-out opportunities Capital Management Optimise the balance sheet for clients
  • 10.  Major streamlining of core Claims processes  Significant investment in building staff capability and empathy for clients Service and empathy for clients  New service options for clients to support their Recovery or Independence goals
  • 11. 80% claims accepted in five days Services expanded to e-therapy and psycho social support service Client required to fill out 14-page hard copy claim form Claim acceptance takes up to 70 days 40% of incoming calls are from providers following up outstanding accounts 90% provider / client accounts paid in 14 days Clients no longer required to fill out a hard copy claim form Service BEFORE NOW Services pre-approved for new clients for increased chance of early RTW acupuncture, chiropractic, physiotherapy, psychology, exercise physiology, osteopathy Psychologist / psychiatrist only option for clients with mental health issues No recording of calls / no coaching for employees in customer service skills Clients must seek prior approval for most services Consistent customer service culture
  • 12. Recovery Today Structure
  • 13. Recovery Today Teams Recovery Then  9 different kinds of teams  11 teams in total  Early Support – managing both return to work and return to health claims  Return to Work – 2 complex teams and 2 less-complex teams. Recovery Now  5 different kinds of teams  10 teams in total  Early Support – managing return to work claims only  Return to Work – 5 teams managing similar mix of claims and more evenand 2 less-complex teams. Complexity linked to risk of high cost, driven by common law  Return to Health – Complex and less-complex  Client Assist – one large team  Client Review – 8 staff, both reviewing claims and assisting with other tasks similar mix of claims and more even workload  Return to Health – one team only  Client Assist – two equivalent teams  Client Focus – 3 staff, renewed focus on reviewing claims
  • 14. Recovery Today Tools & Processes Recovery Then  Client conversational tool – - questions to identify ‘high needs’ clients Recovery Now  Mental Health and Persistent Pain Screening tool – - 4 screening questions: cognition, resilience, social support, pre-existing mental health - Service catalogue to assist with identifying services / approach for  Managing common law risk  Automatic identification at intake  Flag on claims management system  Shared KPIs between Recovery & Lump Sum (who manage common law benefits) identifying services / approach for clients “at risk”  Managing common law risk - Automated identification shifted to 3 month mark to increase accuracy - Shared KPIs removed, but KPIs for Recovery in 2013/14 call out their impact on common law
  • 15. Recovery Today Tools & Processes Recovery Then  Proactive data analytics – - Claims analytically selected for review using triggers based on cost, age of claim, recent activity - Triggers able to be adjusted to address current areas of concern Recovery Now  Proactive data analytics – - Active management focusing on proactive management, reducing need for review - Streamlined up front approvals introduced, creating space for more reviews with new to criteria  Segmentation Algorithm - Flexible enough to cope with structure changes  Segmentation Algorithm  Automatic allocation of claims to appropriate teams at acceptance  Logistic regression  Combined no fault and common law models  Processed SAS and claims management system structure changes - More accurate for no fault model - Recent change to only using no fault model at acceptance - Now fully integrated in claims management system - Use of statistical models to support decision making extended to claim eligibility decision and initial income payment
  • 16. Mental Health and Persistent Pain • Secondary mental health and persistent pain are considerable issues for our clients and for scheme outcomes • We have introduced a new approach to screening clients to identify risk • This is not diagnostic but is focussed on risk • The approach is based on internal and external research
  • 17. Research on Return to Work Background (TAC): Recovery Client – Average Lifetime Cost $25K 31% $94K$81K RTW No RTW / No Pain/ No Mental Health $11K 54% * Chart is a product of Business Intelligence Produced in 2013 17 $45K 3% $32K 2% $84K 1% $94K 4% $81K 2% $161K 2% Persistent Pain Mental Health Average Cost per Claim % of claims
  • 18. Impacts of Recovery Model on Scheme Objectives Client Experience • Client Satisfaction has improved with a record score of achieved in June 2013 and maintained results in 2013/14 • All attributes – keep me up to date, resolve my issues, treat me as an• All attributes – keep me up to date, resolve my issues, treat me as an individual, and empathy, have shown statistically significant improvements since the introduction of the Recovery model • This score is the result of long term change and improvement
  • 19. Impact on Scheme Objectives Record client satisfaction score Overall Satisfaction with the TAC 7.12 7.27 7.44 7.40 7.52 7.62 7.35 7.06 7.16 7.31 7.43 7.25 7.24 7.34 7.33 7.40 7.50 7.63 7.5 8 8.5 9 9.5 10 Overall 6.56 6.79 6.95 6.93 7.12 7.27 7.06 7.16 7.25 7.24 5 5.5 6 6.5 7 Feb Jun Jun Jun Jun Jun Jun Jun Jun Jun Jun Feb Apr Jun Aug Oct Feb Apr Jun Oct Feb Jun 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2011 2011 2011 2011 2012 2012 2012 2012 2013 2013 Overall satisfaction
  • 20. Impact on Scheme Objectives Overall satisfaction by life of claim 8 8.5 9 9.5 10 0-12 mths 13-36 mths Overall Satisfaction by Life of Claim 5 5.5 6 6.5 7 7.5 Feb 2011 Apr 2011 Jun 2011 Aug 2011 Oct 2011 Feb 2012 Apr-12 Jun 2012 Oct 2012 Feb 2013 Jun 2013 13-36 mths 37-72 mths 73+ mths
  • 21. Overall Satisfaction with the TAC- RTW 7.38 7.30 7.21 7.62 7.50 8.00 8.50 9.00 9.50 10.00 Impact on Scheme Objectives Overall client satisfaction: Return to work 6.67 6.98 7.05 7.05 6.56 7.38 7.10 7.21 7.09 5.00 5.50 6.00 6.50 7.00 7.50 Feb Apr Jun Aug Oct Feb Apr Jun Oct Feb Jun 2011 2011 2011 2011 2011 2012 2012 2012 2012 2013 2013 Satisfaction
  • 22. Impact on Scheme Objectives Scheme Viability Returning clients to work is a major focus for Recovery and is key to achieving future savings in common law payments, reductions in income and paramedical payments, and great experience and outcomes for our clientsexperience and outcomes for our clients • The main indicator of return to work success is a low percentage of clients who require income support at 6 months post accident. The result for the full year was below target at 36.7% (against a target of 39%)
  • 23. Impact on Scheme Objectives Client Outcomes A client outcomes index has been developed and incorporating outcomes survey results, income durations and scheme participation for Recovery. Used for the first time during 2012/13 we have achieved the weighted target in 2013/14 The outcome measures used include self assessed mental health, physical health and return to work outcomes. The branch has seen improvement in both 12 month income durations and Scheme Participation resultsThe branch has seen improvement in both 12 month income durations and Scheme Participation results over the last three months. Both scheme participation and 12 month Income Duration results are below target for 2013/14 The branch has specifically focussed on ensuring that return to work outcomes are sustainable and that the services we fund drive both return to work and return to work outcomes The successful launch of First Service, Streamlined Decisions and Right Payments is having a significant impact on the time it takes for clients to access the services they need to help them recover. This early intervention is a key strategy for client outcomes.
  • 24. Conclusion • Renewed focus on core purpose of returning people to work and health as quickly, efficiently, and sustainably as possible • Realignment of the branch and every role and work purpose • New processes introduced to more effectively identify claims at risk of becoming high cost and focussed on providing the best chance of achieving outcomes with our clients • Focus on tools, processes, systems and people• Focus on tools, processes, systems and people • Development of other complimentary programs to increase effectiveness • The TAC has undergone a large cultural shift towards putting client outcomes at the centre of everything we do • The successful implementation of the Recovery model has been an instrumental part of this shift and there remains considerable upside for both our clients and the organisation’s objectives
  • 25. BEYOND 2015  A future where the majority of clients self navigate the system  Fundamental shift away from scrutinizing each individual claim  Focus on influencing whole ecosystem Marcus  Focus on influencing whole ecosystem  Sophisticated analytics to manage risk  A model that aligns to the future of disability care in Australia where clients have choice and empowerment
  • 26. Damian Poel Transport Accident Commission Thank you