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WORKERS COMP OUTCOMES MADE EASY

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SANTA MONICA, Calif.-There's a hard way and an easy way to measure and improve workers compensation outcomes.

The problem is, too many employers choose the hard way.

That's partly because they're really not sure what they are trying to measure, explained Maddy Bowling, senior vp and general manager of workers compensation managed care at Intracorp in Itasca, Ill.

To illustrate her point, Ms. Bowling used the results of an informal survey of risk managers and workers compensation managers conducted before the Fifth Annual Business Insurance Workers Compensation Conference last week in Santa Monica, Calif.

Ms. Bowling asked respondents: "If outcomes measurements were an animal, what kind would it be?"

"What is it: something that's big, hairy and ugly, or something that's soft and cuddly?" she asked the audience during a session on outcomes measurements. The survey results were all across the board, she said.

"This is not as hard as you can make it," said Richard A. Victor, executive director of the Workers Compensation Research Institute in Cambridge, Mass.

"You measure outcomes all the time," Mr. Victor observed, using a simple "road trip" as a metaphor.

"You take the car on a trip and, at the end of the trip, you measure some outcomes: Did I get where I wanted to go? Did I get there safely? Did I get there on time? Did I get there in an uneventful way?" he said.

"In workers comp. . .it's no different: Did I get where I wanted to go?" Mr. Victor analogized. "Well, what are my costs? Did I get there safely? Did I get there when I wanted to get there? Are my workers productive? And, was it uneventful?"

Taking the analogy a step further, Mr. Victor likened the process of starting the car to the first report of injury, fueling the car to selecting appropriate providers, braking the car to monitoring litigation and steering the car to disability management and return-to-work programs.

Put even more simply, outcome measurements should focus primarily on how quickly an employee is returned to work after an injury and whether that return to work is sustained, suggested Ms. Bowling, who moderated the session.

"Isn't this what we're really talking about: lower costs, higher productivity and higher morale?" she asked. Those three factors: cost, productivity and employee satisfaction, are the outcomes to be measured.

The tools used to measure outcomes should serve as warning lights and signposts giving the employer directions for reaching these goals, Mr. Victor suggested.

"There needs to be an instrument panel," albeit a "simple instrument panel," he said.

"And, if something goes south and you're not getting to your destination, then you need to look under the hood," he said.

The instruments measuring workers compensation outcomes should include detailed claims data, rate of initial return to work, whether the return to work is sustained, the worker's post-injury earnings and his or her functional status.

The employer also should survey the injured employee about the experience, interjected Bill Harriman, vp of J&H Marsh & McLennan of Washington Inc. in Seattle.

"Injured workers are not asked enough what they think," he said.

While teaching a group of young workers compensation adjusters, Mr. Harriman said he asked them, "If you had a quarter and you could make one phone contact: to the injured worker, the physician or the employer, whom would you call?"

The answers varied, but none said he or she would call the injured employee, the one Mr. Harriman said should be contacted first-and continually throughout the claims adjudication process.

The attitude toward injured workers would be a lot different if the shoe were on the other foot, Mr. Harriman suggested.

To illustrate his point, Mr. Harriman asked the audience: "How many of you-especially on the employer side-have had workers compensation claims yourselves?"

After a few hands went up in a crowd of about 100, Mr. Harriman continued: "Well, I happen to have had one myself. . . .I thought I knew what was going on, but I would have given an 'F' to the carrier involved in handling my claim," he said. "I was an angry individual. And I can tell you that as a result of that, my productivity just went south fast."

To ensure good communication, good supervisor training also is essential, suggested several audience members.

The panelists agreed. Supervisor training is important to make sure they don't require injured workers to perform outside their restrictions, they said.

The extent of injury defines the work restrictions, and the job must be modified to fit those restrictions, they added.

Indeed, an Intracorp survey asking injured workers how well they were treated after filing a workers compensation claim found that those who thought they were well treated returned to work faster than those who did not, according to Ms. Bowling.

"It shows how much power that you as employers have in making a difference in workers comp," she stressed, adding "perhaps it's time to remove the 'iron curtain' in workers compensation."