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Emerging Issues for a Workers’ Compensation Manager
The document discusses emerging issues for workers' compensation managers according to Ben Reynolds from Leighton Contractors Pty Limited. Some key issues are limited resources due to funding constraints, potential impacts from changes to the Comcare program, shifting from claims management to injury management approaches, challenges in maintaining sustainable provider networks, and implications of ongoing workers' compensation scheme changes across several Australian states and territories. Reynolds encourages considering these issues and finding solutions tailored to each individual organization and stakeholder needs.
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Emerging Issues for a Workers’ Compensation Manager
- 1. NATIONAL CONFERENCE &EXHIBITION 2014 Emerging Issues for a Workers’ Compensation Manager Presented by Ben Reynolds Leighton Contractors Pty Limited Platinum Sponsor Silver Sponsor Bronze Sponsor Risk Manager of the Year Award Sponsor Conference and Exhibition Partners
- 2. As a Workers’Compensation Manager I see the following emerging issues as something we all need to consider; Available Resources Comcare Management of claims Provider Networks Scheme Changes National Conference & Exhibition 2014
- 3. Each Business isdifferent My issues may not be your issues My solutions may not be your solutions I have plenty of questions too, but that’s where it starts.... National Conference & Exhibition 2014
- 4. Available Resources NationalConference & Exhibition 2014
- 5. National Conference &Exhibition 2014 Available Resources Money – There just isn’t enough! How do you fund your initiatives? • How do you convince management to spend money? How do you fund your day to day operations? • Continued justification? What does value look like? What does ROI look like?
- 6. National Conference &Exhibition 2014 Available Resources In general availability of Funds across the scheme is limited; • Fund Scheme agents borderline profitability • Authorities in varying states of financial status • Fee limitations on providers • Increasing salaries of employees • Increasing operational costs • Downward pressure on premiums
- 7. National Conference &Exhibition 2014 Available Resources Shortage of quality workers’ comp professional Scheme improvements have impacted on the available resource pool; •Decrease case loads •Increased salaries •More time spent managing cases •Higher level of skills needed •Reduced spend on provider fees (lawyers, allied health etc). No one ever leaves school wanting to be a workers’ comp manager
- 8. National Conference &Exhibition 2014 Increasing case manager salaries Case loads decreasing Limited availability of quality staff Decrease Salaries? Increase Case Loads? Employ less qualified staff? Downward premium pressure Increase Premiums? Insurer Resources
- 9. Comcare National Conference& Exhibition 2014
- 10. Comcare Why isComcare such a hot topic? • Self Insurance has for some time been seen as a solution to the high cost of workers’ compensation premiums • Comcare being a single, national program solution could potentially remove significant administrative burden • Allows employers to manage their own destiny • Current changes provide an enhance attraction • Widening the eligibility criteria • Group Licenses • Comcare as WHS regulator National Conference & Exhibition 2014
- 11. National Conference &Exhibition 2014 Comcare Why do I consider Comcare an emerging issue? • Large, national premium payers leaving scheme • Taking the good people with them • Pressure from Management and others who see it as “the” solution • Scheme’s providing alternate options to avoid an exodus
- 12. National Conference &Exhibition 2014 Comcare So is Comcare “the” solution? No, it’s just “a” solution
- 13. Management of Claims National Conference & Exhibition 2014
- 14. Management of Claims There is a shift in the approach to the management of workers compensation cases from a claims management approach to an injury management approach People generally accept that early intervention injury management is “best practice” What is the difference? • Claims Management is to resolve the claim • Injury Management is to resolve the injury National Conference & Exhibition 2014
- 15. Management of Claims Schemes are trying to move to Injury Management, but do Authorities and Insurers really understand Injury Management? Can you legislate the flexibility needed? • Provisional Liability in NSW • S.58b in SA • Large Vs Small employers • Good Vs Bad employers Do we really want Authorities to drive this agenda? National Conference & Exhibition 2014
- 16. Management of Claims How do you achieve best practice injury management? How do you achieve this and keep your Management, Employees, Insurers and Authorities happy? Is it possible to shift the mindset of your stakeholders? How do you show value? What if you don’t change focus? National Conference & Exhibition 2014
- 17. Providers Networks NationalConference & Exhibition 2014
- 18. National Conference &Exhibition 2014 Provider Networks It’s important to realise that we cannot always achieve what we need on our own. How do you manage to have a sustainable provider network? Insurers, Doctors, Rehab, Lawyers, Investigators, Brokers face all the same challenges we do; • How do they keep quality employees? • How do they remain profitable when regulators limit fees? How do they remain relevant and viable when employers are getting smarter and more involved? Why is that an issue? What happens if they don’t evolve?
- 19. Scheme Changes NationalConference & Exhibition 2014
- 20. National Conference &Exhibition 2014 Scheme Changes Currently NSW, NT, QLD, SA, WA and Comcare are in the process of significant change or review. Some changes will have significant impacts on employees and/or employers Employers need to have a voice •Employer needs often seen as anti employee •Everyone who submits feedback to a scheme is biased.
- 21. National Conference &Exhibition 2014 Conclusion What am I doing about resources? How will I manage the Comcare changes? How will I manage our workers compensation claims? What will I need from providers and can they deliver? What will the scheme changes mean to me? How can I impact them?
- 22. National Conference &Exhibition 2014 Conclusion Two last questions; If you were injured at work would you be happy with the treatment provided? Would your CEO go through your workers compensation process?
- 23. NATIONAL CONFERENCE &EXHIBITION 2014 Thank you. Platinum Sponsor Silver Sponsor Bronze Sponsor Risk Manager of the Year Award Sponsor Conference and Exhibition Partners