When Tennessee brought CorVel Corp. on as its new third-party administrator in 2014, the state’s workers compensation program had no central reporting structure and no statewide return-to-work program. 

In five years, the third-party administrator has reduced the state’s workers comp medical costs by nearly $4 million and cut drug costs by 30% since it partnered with Tennessee. In addition, total temporary disability payments fell from $3.6 million in 2015 to $723,000 in 2019 with the implementation of a new return-to-work program. This success earned CorVel the Business Insurance 2020 US Insurance Award for TPA Team of the Year.  

When CorVel won the bid to tackle workers comp for all Tennessee state workers, the TPA had to change the way things were done in the state for 20 years, and it wasn’t all smooth sailing, said Jason Wheeler, a Nashville-based account executive with CorVel who oversaw the transition of the program. 

“At the time, it was a big hot button for them,” he said. “They had been disconnected. … Certain agencies had their own agendas. The treasury department wanted to formalize that and make everything more consistent, so everyone was accountable.”

CorVel designated about 500 of the state’s 80,000 workers as responsible for reporting claims electronically through its system. 

“It put some responsibility on their shoulders, and it took a while for them to realize that this was a good thing and was going to make their lives easier,” Mr. Wheeler said. “That was really the beginning of the success with the state, just getting those claims reported accurately and more timely.”

In 2015, the TPA introduced a return-to-work program, starting small with the Tennessee Department of Corrections, which saw substantial improvements in its indemnity costs and lost time in just one year, leading to a statewide rollout in 2016. 

Another significant challenge was learning that the state had unpaid medical bills going back nearly seven years, leading to a difficult few months for CorVel’s bill review workers and “a lot of sleepless nights,” Mr. Wheeler said. 

But Tennessee saw its total workers comp program spend drop 38% at the end of in 2019 compared with its last year with its prior TPA, and open claim counts dropped to 1,403 at year-end 2019, compared with 2,315 prior to the TPA changeover. 

“(We have) a really good partnership … working together with the goal in mind of saving money on total cost of risk and making sure employees are taken care of,” Mr. Wheeler said.

FINALISTS

• Sedgwick Claims Management Services Inc. — Sedgwick’s crisis care program provides 24/7 support to its clients to manage all aspects of care for catastrophic injuries.

• Helmsman Management Services LLC — The TPA’s OneVoice program changed the language used by its claims professionals to make it more understandable, inclusive and supportive, which has reduced confusion and stress for injured workers. 

• Broadspire Services Inc. — Broadspire’s Senior Nurse Review Program helps to effectively manage medical care at crucial points in care which reduces medical costs and improves claim closure. 

• Gallagher Bassett Services Inc. — The work of the TPA’s claims operation team in charge of handling Miami-Dade County Public Schools has resulted in a savings of $2.7 million for the district.