We had just finished the national bloggers' panel at the National Workers' Compensation Conference, where one of the things we discussed was how employers can improve outcomes by being more engaged, concerned and communicative with their injured workers, especially early in the claim cycle. I was approached by an attendee who happens to be one of our customers, managing about 150 accounts in our WorkCompResearch Compliance
system for his company, a well-known national carrier. He asked a simple, yet critical question.
He said, roughly, "All of the people here are big employers, carriers or TPAs. But most of our customers are small employers. How do we reach them with information like this?"
Last July, in a similar bloggers panel at an employers association conference, I put that very question to the panel and the audience. It had dawned on me that we were speaking to a very small segment of the overall market, and that most employers simply do not have access to the type of information we were discussing.
It is a big concern. According to U.S. Census Bureau data, businesses with fewer than 500 workers accounted for 49% of private sector payrolls in 2011, and those with fewer than 100 workers employed 35%. Businesses with fewer than 20 workers employed 18%. I would suggest that not a single one of the "fewer than 100" employers attends any workers' compensation conference. Ever.
And, as difficult as it is to fathom, they probably do not read my blog, either.
While I do not have immediate access to supporting statistics, I would lay a week's wages that these employers have a reduced focus on safety, prevention and training, as well as a disproportionate number of workers' compensation claims. And the concept of "return to work" with accommodations is likely nowhere near their radar screens.
For small employers, workers' compensation is generally merely a required expense line on their operating statement. They are largely reactive to issues related to the topic.
My brother-in-law, a vice president of operations for a small medical equipment start-up in Silicon Valley, called me a couple years back with palpable exasperation in his voice. He asked, "What the hell is an experience mod, and how is it calculated?" I told him that, if he had to ask, it was probably too late, at least for the foreseeable future.
Reaching people in small businesses with culture-changing advice and training is difficult, if not impossible.
Who in our system could do this? Insurance agents? Doubtful. There is simply not enough incentive currently. I have an agent friend who told me once he won’t even sell comp to any company with fewer than four or five employees because there is little money in it and such companies are a pain to deal with because they mostly have no internal support structures and lean heavily on the agent for HR-style support and information.
Brokers? Maybe. These folks deal with the larger side of small and medium-level employers and have a bit more skin in the game. Still, driving useful, method-altering information through that channel will require a paradigm shift.
Of course, that is the key. A paradigm shift is needed not just for brokers and agents but for the industry in its entirety. And, like it or not, the shift probably should start with state regulators, followed closely by carriers.
Regulators are the key to driving process and affecting culture, but efforts can start without their immediate intervention. Carriers probably have the best ability to influence small employers across the country. They can do it through dedicated training and education materials, as well as establishing a culture of communication through their supply chains. They can do it by reinforcing positive methods and procedures for safety and, most importantly, can affect the process when a newly injured worker enters the system.
I’ve written extensively about what I believe needs to occur within the claims-handling process to improve outcomes for these employers and their injured workers. My ideal culture change involves streamlining processes, empowering claims professionals and improving medical care by rewarding performance -- but mostly relies on vastly improved lines of communications between employers, employees and the professionals who are serving them. Communication that creates a “picture of success” for recovering workers. Much of what I envision cannot occur without regulatory changes, but the idea of a culture of recovery can start with those of us within the industry today.
Comprehensive culture change will not be an easy task (if only those small employers read my blog), but it can trickle through the system if the right people and organizations pick up the torch and run with it. Truth be told, via all the blogs and conferences across the country, we are really only reaching a small percentage of large employers, let alone small. Improved process and communication can drive change from the top down and ultimately reach employers, large and small, that unfortunately feed our system all too well.
Until employers recognize the critical nature of the topic, they will continue to ignore it. It is up to us to start that change.
I’ll be damned. It turns out we are the people we’ve been waiting for after all.