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   * Workers’ Comp Forum
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HOW INVESTING IN CLINICAL ANALYTICS CAN HELP IMPROVE PATIENT OUTCOMES AND FOSTER
A COLLABORATIVE APPROACH IN WORKERS’ COMP

Analyzing clinical data can help occupational medicine clinicians improve their
practices and provide better care for injured workers.
By: Concentra | September 3, 2024

Occupational health providers are always looking for ways to improve care.
Today, clinical data and new predictive analytic tools are helping occupational
health clinicians streamline processes, develop tailored treatment plans, and
improve outcomes. These tools can drive improved care coordination, help
clinicians improve their treatment skills, and even determine when specialist
intervention would benefit an injured employee. This can help clinicians build
positive relationships with injured employees, which can lead to improved
recoveries and high levels of patient satisfaction.


WHAT CLINICAL DATA CAN DO

Geneva Giang, Senior Vice President of Clinical Analytics, Concentra

Clinical data can be applied throughout the patient journey to help drive better
care outcomes.

Analytic models can be used to review and assess patient files to determine
whether an injured employee may be at risk for missing appointments. Then,
clinicians, adjusters, or other stakeholders can step in and implement
interventions to help the injured employee stay on their treatment path.

Machine learning models can rapidly process and audit a clinician’s notes,
providing information and insights to improve documentation and practice
patterns. These tools can also help detect when an injured employee might need
more attention and when it might be advantageous or necessary for a specialist
referral.

“Our first machine learning model gives us a heads-up when a patient is likely
to cancel or miss their appointment. These predictive analytics enable us to
identify trends or factors that potentially preclude an injured employee from
showing up or consistently following our clinician’s recommendation. Knowing
this allows us to step in and contact the patient or the employer to encourage
the employee’s compliance,” said Geneva Giang, senior vice president of clinical
analytics at Concentra.

“It’s a much more effective and efficient way to audit charts, to understand
individual practice patterns, and to achieve optimal patient outcomes,” said
John Anderson, executive vice president and chief medical officer at Concentra.

“We are training the model to understand the appropriate behavior in terms of
when specialist intervention is most appropriate,” Giang added.  “It’s the
clinician that makes the decision. It’s not the machine.”


USING DATA TO REVEAL OPPORTUNITIES FOR LEARNING

John Anderson, Executive Vice President, Chief Medical Officer, Concentra

Analyzing a clinician’s referral patterns can reveal knowledge gaps and
opportunities for learning and improving skill sets in certain areas, e.g. eye
injuries, lacerations, minor fractures, etc.

“We’re able to identify individual clinicians’ practice patterns,” Anderson
said. “We can then sit down with them and have a discussion. Maybe they need a
refresher on orthopedics or their confidence in treating eye or other injuries.
Maybe managing return to work could be improved. The data provides empirical
evidence of the clinician’s practices. This information can be used by the
medical director to direct a clinician to seek ongoing training and continuing
medical education.

“Everyone going into medicine has committed to lifelong learning, and the
information gained from machine learning can be used to focus clinicians on
areas that will result in continuous improvements in the quality of care we
provide to injured employees. We give our clinicians the building blocks and the
motivation to take them to that next level,” Anderson said.


WHY A HIGH-CALIBER ANALYTICS TEAM MAKES A DIFFERENCE

Giang joined Concentra in 1995. Since then, Concentra has been committed to
using data and evolving analytic tools such as machine learning and natural
language processing to refine and advance its clinical model. The results speak
for themselves. The company used these tools to improve patient care and shorten
the time it takes to get injured employees back to their pre-injury levels of
function.

Concentra’s data science and analytics team consists of highly skilled
technological professionals and analysts who understand how to analyze and
interpret data and share insights with clinicians to drive optimal clinical
outcomes.

“Our team looks at information and tells a story. We work to understand both
individual and group practice patterns to be able to evaluate trends,” Giang
said.


HOW ANALYTICS CAN FOSTER A COLLABORATIVE APPROACH IN WORKERS’ COMP

 “It is our job to focus on continually evolving in response to the changing
dynamic of patient behavior, but also to have a positive impact on all of our
clients, be they employers, payers or the patients,” Giang said.

The company is working to digitize its data so clients can easily consume and
electronically incorporate it into their systems to better understand how a
care-first model can improve claims outcomes and reduce costs.

“We’re investing a great deal to digitize all of our data so that we can share
it with the employer and payer directly,” Anderson said.

“When we do what’s best for the injured employee in terms of providing optimal
care of their injury or illness, everybody benefits. The patient benefits, the
payer benefits, the employer benefits, the community benefits, and the patient’s
family benefits. Our focus is on getting the injured employee treated and
restored to their previous pre-injury level of function as quickly as possible
by breaking down any barriers or delays that would slow that down. Our ability
to improve care and outcomes is made possible from information provided by our
clinical analytics and data science team.”

To learn more, visit: https://www.concentra.com/






This article was produced by the R&I Brand Studio, a unit of the advertising
department of Risk & Insurance, in collaboration with Concentra. The editorial
staff of Risk & Insurance had no role in its preparation.

Concentra® is America’s leading provider of occupational health services,
delivering work-related injury care, physical therapy, and workforce health
services from nearly 550 Concentra medical centers and more than 150 onsite
clinics at employer locations nationwide.





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SPONSORED: AXA XL



MAKING THE CONNECTION: ARE YOU PREPARED FOR RISING PROPERTY AND EQUIPMENT
BREAKDOWN COSTS?

Property’s biggest risk factors can directly impact the price of equipment
repairs. Risk management and loss prevention start when insureds make the
connection with valuations and work with the right partner to mitigate their
potential impact.
By: AXA XL | October 1, 2024

The commercial property insurance market has had its ups and downs in recent
years. The good news is that property rates seem to have stabilized in the
second quarter of 2024, though businesses are still seeing single-digit
increases. It’s a reminder for businesses to keep an eye on their property
exposures, especially when it comes to the large equipment they use to keep
their operations running.

Equipment breakdown can lead to property damage, business interruption, and
additional expenses for repair or replacement. This can increase the overall
cost of property risks, as organizations need to account for the potential
consequences of equipment breakdown when assessing their property risk
management strategies.

Today’s business equipment is more high-tech and specialized than ever before,
making unforeseen breakdowns, malfunctions or damages a substantial risk, should
they occur. Even the most well-maintained piece of equipment can experience
mishaps and cause significant financial loss.

“The changing nature of property risks, especially with high-tech equipment in
distribution centers and electronic sorting equipment, is a significant factor
contributing to an increase in insured property losses,” said Michele Sansone,
CUO property, Americas, AXA XL.

“The equipment breakdown aspect is critical. If specialized machinery is the
only source and there is no backup, it creates significant exposures for the
business,” added Cheryl Geidel, vice president, equipment breakdown, AXA XL.

The value of complex equipment continues to climb alongside the cost of fixing
it, as more expensive replacement parts and specialized diagnostic technicians
contribute to an uptick in pricing. Coupled with the recent strain on property
insurance, this is one risk businesses can’t afford to overlook.

For those operating large machinery and other equipment that requires regular
maintenance, it is imperative to get ahead of potential breakdown and
disruption, and to make sure they have the right risk mitigation tools in place.


TWO KEY FACTORS IMPACTING PROPERTY RATES

Michele Sansone, CUO Property, Americas, AXA XL

The first piece of the equipment protection puzzle is the need to understand
exactly what is affecting property rates and, consequently, pricing.

Verisk’s 2024 Global Modeled Catastrophe Losses reported that the average annual
loss from global natural catastrophes has reached a new high of $151 billion. In
the past five years, the actual annual insured losses from natural catastrophes
averaged $106 billion, compared with less than $83 billion in the preceding
five-year period.

“The pricing in the catastrophe insurance market is highly dependent on the
specific peril being insured. With the increased frequency and severity of
catastrophic events, insurers are seeing a significant uptick in activity in
this segment,” said Sansone.

“As a result, pricing is being adjusted to account for the heightened risk
exposure. The specific rates will vary based on the particular catastrophe being
covered, such as hurricanes, wildfires or floods.”

That can place rates at the mercy of Mother Nature — a challenge that’s led some
insureds to take on their own risk.

“To control pricing, customers are increasingly retaining more risk through
captives or larger deductibles, removing exposure from the market,” Sansone
explained.

Supply chain disruption is another big factor: “Supply chain issues and long
lead times for components and equipment have created challenges, often extending
business interruption periods to 15 to 18 months while waiting for critical
parts to arrive,” Geidel said.

Supply chain delays aren’t the only things causing strife; the rising cost of
materials and labor do as well. These factors continue to impact property
insurance, driving up the frequency and cost of claims and drawing attention to
contingent business interruption risks.

“Insureds often don’t fully understand the origin of their equipment, products
or stock. We view this lack of information as a significant risk — one that must
be addressed,” Sansone said.


ACCURATE VALUATIONS ARE EVERYTHING

Cheryl Geidel, Vice President, Equipment Breakdown, AXA XL

Another element businesses have to understand is that accurate valuation of
property goes a long way in managing the cost of equipment breakdown. Even with
rates showing a slow decline, it’s essential to have accurate values for
property, including equipment value.

“Regardless of whether the rate is two cents or ten cents, the starting point —
the values — must be accurate. There seems to be a misplaced sense of relief in
the industry that as pricing declines, the valuation issue will resolve itself.
However, the fundamental importance of getting the values right remains
unchanged,” Sansone explained.

If a business and its equipment are underinsured due to an incorrect valuation,
the insurance payout may not cover the full cost of repair or replacement.

Further, because of today’s higher rebuilding, repair and replacement costs,
businesses must be particularly wary about their policy limits. A loss could end
up costing significantly more than anticipated, causing insureds to quickly
erode any sublimits in place.

“It’s a challenging discussion, especially as the market softens and the focus
on values diminishes,” said Sansone.

However, this is one area where all insureds can get ahead. Partnering with
insurance professionals will ensure the right questions are being asked and
accurate values are being reported. Risk managers, brokers, the account
executive and producer all have a role to play in helping the insured to
understand their exposures.

Valuating individual equipment can be tricky, noted Geidel, especially as more
technology is incorporated into the machinery being used.

Breakdowns or failures often involve individual pieces of equipment rather than
an entire building. Insurance partners that ask questions, review and compare
values year-over-year on equipment types and rely on risk engineering reports to
better understand the equipment being used are a boon to the underwriting
process.

“Values are the basis of everything an underwriter does, so focusing on values
should be the starting point of the process,” Geidel said.


AN EMPHASIS ON PROTECTING PROPERTY AND EQUIPMENT

Technology is enabling property owners to place a larger emphasis on protection.
The unpredictability of hurricanes, earthquakes, wildfires and other Nat CATs
can’t be controlled, but technology offers some control over their impact.

Advanced weather modeling, wildfire modeling, drone inspections and other
innovations help to predict and assess damages more quickly and accurately than
ever before.

Sansone also said that data-sharing can build resiliency into the market,
putting clients in an even better position should an incident arise.

“There’s an unfortunate perception that data is proprietary and sharing it could
undermine one’s competitive advantage. However,” she said, “this reluctance to
share data can hinder the industry as a whole.”

Collaboration and data-sharing among carriers could open the door for better
risk assessment and improved underwriting practices, in addition to resiliency.

“Transparency is a game changer in risk management. Sharing data can greatly
improve how organizations handle and reduce risks,” said Sansone.


PROPERTY RISK ENGINEERING AT ITS FINEST

Effective risk management makes clients better, which ultimately improves their
overall risk profile. At AXA XL, the team takes this philosophy and brings it
into everything it does. It’s not about a transaction; it’s about maintaining
relationships with customers in order to best protect them.

“When we commit to a piece of business, we aim to maintain that relationship.
Our focus is on risk improvement rather than just transactions so that we may
build lasting partnerships with our clients,” Sansone said.

AXA XL has done this by building a team of more than 400 risk engineers who work
closely with underwriting in order to provide the most accurate and detailed
insights about each client’s needs.

“Our underwriters rely on the data and insights that our property risk engineers
collect on site to price the risk we assume. But we also share the data they
collect with our clients to help them in their loss control efforts as well as
our own,” Geidel said.

“Our approach to underwriting and risk evaluation streamlines the claims process
in several ways. By engaging in bespoke underwriting and thoroughly assessing
each risk, we gain a deep understanding of the potential claims scenarios from
the outset,” Sansone added.

This comprehensive risk evaluation allows AXA XL to anticipate and prepare for
potential claims more effectively. As a result, when a claim does occur, the
team is well-equipped to handle it efficiently, because its process has
established a clear understanding of the underlying risk factors and policy
details.

 To learn more, visit:
https://axaxl.com/insurance/products/machinery-breakdown-insurance.




This article was produced by the R&I Brand Studio, a unit of the advertising
department of Risk & Insurance, in collaboration with AXA XL. The editorial
staff of Risk & Insurance had no role in its preparation.

AXA XL, the property & casualty and specialty risk division of AXA, provides
insurance and risk management products and services for mid-sized companies
through to large multinationals, and reinsurance solutions to insurance
companies globally. We partner with those who move the world forward. To learn
more, visit www.axaxl.com.







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