Bundled care programs – an alternative care model emphasizing quality over quantity – has gained significant adoption amongst Medicare and group health providers. Robert Evans, VP of Repricing Solutions, shares Rising’s experience as one of the first organizations to bring bundled arrangements to the workers’ comp market.
Compound prescription growth in workers’ compensation is a striking example of how the lack of consumer involvement can cause treatment to expand from reasonable to rampant care. In his Risk & Insurance Risk Insider column, Rising CEO Jason Beans outlines how state oversight and inroads from within claims payer and managed care organizations can help rein in compounding.
This article features thoughts from Mark Walls, Vice President of Communications and Strategic Analysis for Safety National and an Advisory Council member for the Workers’ Compensation Benchmarking Study, on why the study matters and its value to the workers’ compensation community.
As California officials are calling for a review of workers’ comp fraud fighting practices in the state, some cost containment providers are saying that bill review can be an effective tool for detecting fraud. Jason Beans, Rising’s Chief Executive Officer, shares some of the company’s bill review practices for detecting fraud.
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“Claims Advocacy” is fast getting the attention of workers’ comp claims leaders as a powerful approach to better claims outcomes. The on-demand economy has created cultural and multi-generational expectations around service, speed and simplicity – expectations that raise the bar for engaging injured workers. We found some claims leaders – from Starbucks, Albertsons Safeway, Nationwide Insurance, and Sedgwick – who have already figured out what to do. This article, co-authored by Rising’s Work Comp Benchmarking Study Program Director Rachel Fikes and industry journalist/consultant Peter Rousmaniere, uses interviews and study insights to describe the advocacy concept and how to walk the walk. Four minutes to read.
Federal health care regulators are paving the way for a value-based purchasing approach in workers’ compensation. Rising CEO Jason Beans outlines Medicare’s assertive advances to replace the fee-for-service model, their impressive outcomes, and takeaways for workers’ comp in his Risk & Insurance Risk Insider column.
Fraud analytics can help detect suspicious injury claims, fraudulent providers, and premium avoidance scams. In this article, Rising’s Work Comp Benchmark Study results shed light on the adoption of analytics by payers.