Rising Medical Solutions’2016 Work Comp Benchmark Study Focuses on Practical Claims Management Research
Distilling the many challenges confronting claims organizations today to a critical few is a challenge unto itself. In its fourth annual study, the Workers’ Compensation Benchmarking Study program will do just that.
From a talent landscape metamorphosis, to a shift in focus from conventional process management to outcomes management, to transformative technology trends, to a migration towards value-driven healthcare, today’s dynamic workers’ comp environment can make problem solving a moving target – not the least of which is determining which challenges to address with often limited resources. Which opportunities will have the most positive impact and ROI? What are some best practices for capitalizing on those opportunities? Is there practical research to support these strategic decisions?
Building on prior years’ research with over 700 claims leaders, these are questions the 2016 Workers’ Compensation Benchmarking Study seeks to answer as the program continues to evolve. In 2015, the study drew upon focus group research with Industry Executives as they related the 2013/14 survey responses to their strategic visions for advancing claims management in the industry. Instead of returning to the 70-question survey from 2013/14, which quantified a wide range of operational challenges, the program will continue to cover new ground.
The 2016 study will utilize a targeted survey with claims leaders that probes deeper into a handful of key operational issues/strategies highlighted in the 2015 report. This will provide greater insights into a sharp set of issues, allowing Rising Medical Solutions’ 2016 study to more fully engage in practical problem solving that will most impact claims management today.
The study’s direction continues to be guided by its expert Advisory Council and driven by a collaborative investigation with claims organizations. The 2016 Report is expected to be published in the fourth quarter. As in prior years, the 2016 Report will be available to all without cost or obligation as a contribution to the workers’ compensation industry. It may be pre-ordered at https://www.risingms.com/research-knowledge/workers-compensation-benchmarking-study/request-report/
Genex Services Acquires Med-Eval
Genex Services, a medical cost containment and disability management services provider, announced its acquisition of Virginia-based Med-Eval, a provider of independent medical examination (IME) and diagnostic network services for the workers’ compensation and automotive claims market. Financial terms were not disclosed.
The Med-Eval management team and staff will remain in place and continue to operate under its brand. Mike Valasek, Med-Eval president and CEO, will join Genex as the vice president of IME services and will assume operating responsibility for the national service.
Med-Eval, founded more than 20 years ago, manages a network which provides medical evaluations, peer reviews and diagnostic studies for several national and leading insurance carriers, third-party administrators, employers and other organizations that need assistance with medical review services.
Bailey Southwell & Co. served as the exclusive strategic and financial advisor to Med-Eval on the transaction.
Restore Rehabilitation Announces Expansion
Restore Rehabilitation, a medical and vocational case management company focused on reducing the cost of workers’ compensation claims, recently introduced field case management services into the state of Tennessee. The company has hired four, full-time medical and vocational case managers and a sales representative in the state and anticipates rapid growth.
Restore’s field case managers are registered nurses with advanced credentials and at least 10 years of experience in workers’ compensation. Most often used on complex cases involving multiple body parts, amputations, severe burns, spinal cord damage and comorbidities, field case managers are also helpful with unwitnessed or questionable injuries.
Ideally, field case managers assess injured employees immediately after an injury to determine medical status and needs. They help identify high quality medical providers and potential return-to-work hurdles, while progressing the file safely and as quickly as possible to reach full return-to-work status or maximum medical improvement.
Case managers facilitate the return-to-work process by setting expectations, obtaining full-duty job descriptions and creating realistic work restrictions with employers and providers.
Restore Rehabilitation, which also provides telephonic case management nationally, now has field case managers in 21 jurisdictions. In addition to Tennessee, these are Alabama, California, Connecticut, Delaware, Florida, Georgia, Illinois, Louisiana, Maryland, Massachusetts, Mississippi, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Texas, Virginia and Washington, DC.
RGL Forensics Opens Miami Office
RGL Forensics, a financial investigations company, specializing in the insurance, legal and corporate markets globally, announced the opening of a new Miami office, which will serve as a hub for its growing business in the Latin American market and across the US.
The Miami team will be led by RGL Partner Carlos A. Rivera, whose expertise lies in the review, analysis and measurement of US and international business interruption and property losses as well as disputes for clients in the insurance and legal markets.
Rivera has extensive experience with insurance claims in the US, Argentina, Chile, Brazil, Ecuador, Mexico, Guatemala, Costa Rica, Panama, the Dominican Republic, Jamaica, Puerto Rico, Venezuela and Colombia. He has evaluated economic damages in claims from a variety of industries including energy, manufacturing, mining, hospitality, pharmaceuticals, retail, logistics and construction. Rivera and his team in Miami are fluent in Spanish.
The new office address is: 9130 S Dadeland Boulevard, Suite 1607, Miami, FL 33156.
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