Metrics: Quiz Part 3

Hint

– What does Lag Time mean?  Lag time is the amount of time in days between the date of injury and the date it is reported to the carrier/TPA.

– Why is it important?- More Expensive Claims In short, the longer a claim goes unreported, the greater the likelihood for a more expensive claim – reference 2000 Hartford Insurance study showing claims reported within 5 weeks were 45% more expensive than claims reported within 1 week.

– Why is it important?- More attorney involvement As reported by NCCI statistics, the likelihood of attorney involvement increases the longer a claim goes unreported.  Claims reported after 4 weeks involve attorney 31.7% of the time, a 148% increase over zero lag.

Hint

– What is the Return to Work Ratio? The Return to Work ratios is the ratio of employees that return to work following an injury within 0-4 days.  The goal for your program should be > than 90% of your employees return to work in 0-4 days.  Best-in-class programs will have a return to work ratio of  > 95%.

– How do you calculate the RTW Ratio?

Option 1 – Option 1 to calculate the RTW ratio is to simply review the loss run.  Compare the total number of claims with the total number of claims which are classified as Medical Only.  This percentage is a simple and easy representation of claims which did not incur any lost time and were therefore back to work in a few days.

The reverse of this calculation is the total number of claims and the total number of claims which are classified as Lost Time claims.  This

Option 2 – Option 2 uses excel or other software to compare the injury date to the date the employee returned to work.  Use Excel to graphically display the information and create a powerful visual representation of RTW effectiveness.  To get started with this exercise:

– Use your claims data and create columns for injury date and RTW date in excel.

– Calculate the # days to return to work for each claim.

– Calculate the % of claims that fall into each category (1-4, 5-10, 11-20, 21-50, 51-120, 120+)

– Create a simple graph. (click Insert – then Charts)

– Why is it important? The Return to Work ratio is a simple calculation, but it is a more robust leading indicator than looking at Lag Time alone.  Success with your return to work ratio will indicate success with overall workers’ compensation management

Hint

This statement is True.  Data, metrics, and benchmarking is the easiest topic in workers’ compensation to overwhelm yourself and your audience.

-Consider first your audience and their level of sophistication

-Consider the goal of your presentation

-Choose the fewest number of metrics that can tell your story

-Present the information on One Page.

Hint

– Why is tracking the number of employees out of work important? If you do not know how many employees are out of work, how are you going to get them back to work? Without focus and attention, employees out of work are often forgotten and many time never return to employment causing both a very expensive claim and devastating claim outcome for the injured worker.

– What do you do with this information? Use the team approach with your claims handler and medical provider to brainstorm what you can do to get these employees back to work.