WC Magazine

Spring 2017

WC is published six time a year and covers the trends and topics of interest to professionals responsible for the cost-effective resolution of workers’ compensation claims.

Issue link: http://theclm.wcmagazine.epubxp.com/i/811983

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Page 27 of 35

Data analytics helps organizations put a number on health risks and assess when to intervene to fix a problem LOWERING THE SCORE BY MARIELLEN H. BLUE & JIM HARRIS W hat if the workers compensation industry had a crystal ball to anticipate the severity of claims? With such a tool, we'd have the foresight to know which cases would most benefit from medical management to opti- mize costs and outcomes. Workers comp organizations have seen the value in assigning nurse case managers to catastrophic claims, such as brain or spinal injuries, which require complex care coordi- nation. The challenge is in identifying claims that may seem routine and straightforward but have the capacity to turn complex and costly. Data analytics and scoring tools are helping to identify the cases that would gain value from clinical intervention. These tools take many factors into account and provide a short-hand assessment — in the form of a score — to gauge a case's risk. 28 SPRING 2017 WC M A R K E T I N S I G H T S

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