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A growing demand among employers for integrated disability and absence management is one of the driving forces in a new collaboration between Aetna Inc. and three workers compensation third-party administrators.
Hartford, Conn.-based Aetna announced this month that it will work with three TPAs to offer a combined filing process for workers comp and nonoccupational disability claims. Aetna's partners include Atlanta-based Broadspire Services Inc., Philadelphia-based ESIS Inc. and Itasca, Ill.-based Gallagher Bassett Services Inc.
Experts say the move by Aetna reflects an emerging movement among employers to use service providers that can combine disability and workers comp data and offer consolidated services.
“It's been a challenge for years for employers to get that data, especially on the health care side,” said Marcia Carruthers, CEO and president of the Disability Management Employers Coalition in San Diego. “So I think it's very encouraging to see this type of activity going on.”
Aetna will share certain data with each of its TPA partners for the integrated claims filing program, though the TPAs will not work with each other for the initiative. Keith Nelson, Plantation, Fla.-based head of disability benefits systems for Aetna, said the companies initially will launch the integrated program with mutual clients of Aetna and the TPA partners.
Details of the program are being discussed among Aetna and the TPAs, participants say. The initiative includes a single dial-in number where employees can report work-related and nonoccupational absences and be directed to the proper resources.
“That makes it easier for the member, the employee, because they may or may not have experience with what type of claim this is,” Mr. Nelson said.
Mr. Nelson said the partnership was driven by an increasing number of clients in recent years seeking combined claims filing and absence management for disability and comp claims.
“We're seeing a trend in the marketplace that employers really want their vendor partners to coordinate and to integrate,” he said.
Broadspire CEO Danielle Lisenbey said the company's partnership with Aetna is an expansion of a long-standing working relationship between the two firms.
“We're very tuned in to their services. They're tuned in to our services,” Ms. Lisenbey said.
Emil Bravo, Itasca, Ill.-based executive vice president with Gallagher Bassett, said the integrated claims partnership will allow his company and Aetna to cross-sell their services to companies seeking integrated claims capabilities.
Gallagher Bassett handles workers comp claims, while Aetna manages short-term and long-term disability leave and Family and Medical Leave Act leaves. The companies' ability to complement each other, Mr. Bravo says, will help with attracting new business and retaining current customers.
“We believe once you do the cross-sell, we have a greater opportunity of not losing the customer in the long run,” said Mr. Bravo, who said Gallagher Bassett has similar relationships with Chattanooga, Tenn.-based Unum Group and Hartford, Conn.-based Hartford Financial Services Group Inc.
Thomas Parry, president of the San Francisco-based Integrated Benefits Institute, said Aetna's partnership marks a shift among employers in recent years to better manage their disability and comp claims. In particular, he said the economic downturn left companies with leaner workforces, and companies are working harder to keep people on the job rather than on leave.
“What's different today is the CFO and even the CEO in the employer organization is paying attention to these issues in a way that they didn't five years ago,” Mr. Parry said.
DMEC's Ms. Carruthers said insurers and service providers are likely to start offering more integrated benefits models as employers push their providers for such support.
“I certainly applaud those companies that are willing to take the initiative and try these experiments because there is a certain risk involved with sticking your neck out,” Ms. Carruthers said. “But it is something employers want.”
Ms. Carruthers and Mr. Parry note that data sharing has been a key sticking point among companies that have considered offering integrated models in the past. However, they say service providers have been willing to push that reluctance aside to gain or retain customers that want claims data to be combined.
“You can't do anything without the right data and the employer knows it today,” Mr. Parry said.
Parties in Aetna's integrated claims partnership said the data they share is limited to comply with the Health Insurance Portability and Accountability Act.
IBI's Mr. Parry said he believes integration of nonoccupational disability and workers comp claims is likely to continue as companies look to improve return-to-work times and medical outcomes in both areas.
“I think it's being trumped by the overarching need for the health of the workforce to be looked at in a new way and to be understood as part of the business strategy of the employer,” Mr. Parry said.