About the Study Program:

The Workers’ Compensation Benchmarking Study is a national research program examining the complex forces impacting claims management in workers’ compensation today. The study’s mission is to advocate for the advancement of claims management by providing both quantitative and qualitative research that allows organizations to evaluate priorities, hurdles, and strategies amongst their peers. Conceived and directed by Rising Medical Solutions, the Study addresses the gap in available research focusing on how claims organizations deal with industry-wide operational challenges.

Today, the ongoing study program is a collaboration of workers’ compensation leaders who represent diverse perspectives and share a commitment to providing meaningful information about claims management trends and best opportunities for advancement. Recognizing the need for an unbiased approach, the study is guided by an independent Principal Researcher and an Advisory Council of industry experts whose involvement is critical to maintaining a framework that produces impartial and compelling research.

About the 2013, 2014, 2015 & 2016 Studies:

The first annual Workers’ Compensation Benchmarking Study, published in September 2013, illuminated several critical issues that are limiting claims organizations’ talent pool, technology potential, and performance abilities. We’ve provided a short summary of the Study results, or you may request a full copy of the 107-page report.

Building upon the robust 2013 Study, efforts in 2014 focused on: developing multi-year trend data, delivering further insights around the challenges revealed in 2013, and identifying any potential shifts in operational focus. The 2014 Study, released in November 2014, addressed these key areas: prioritizing core competencies; measuring best practices; incentivizing operational excellence; training & retaining staff; managing technology & data; evaluating medical performance management; and the impact of the Affordable Care Act (ACA). A full copy of this 115-page report is also available for request here.

In 2015, the fundamental question the Study undertook is how organizations turn the challenges identified in the 2013/14 studies into action. To do this, a new approach was used – conducting focus group research – to draw upon the perspectives of Industry Executives as they related the prior years’ survey results to their strategic visions for future advancement. The ensuing Insights Report synthesized three years of research into an incisive, “solutions roadmap” for claims leadership going forward. A full copy of the 2015 Report is available by request here and a study summary is available via this CLM WC magazine article.

The 2016 study identifies which claims best practices generate better outcomes and clearly differentiate high performing claims organizations from industry peers. Results from this nationwide survey of 492 claims leaders substantiate various methods that drive claims success. Building on the cumulative intelligence and research with nearly 1,200 claims leaders, the 2016 study provides a convincing, data-backed profile of the higher performing claims organization. The 2016 Report can be requested here.

About the Principal Researcher & Study Report Author:

Denise Zoe Algire, MBA, RN, COHN-S/CM, FAAOHN,
Director of Risk Initiatives & National Medical Director |
Albertsons Companies

Denise Zoe Algire serves as the principal researcher and report author for the studies. She is a nationally recognized expert in enterprise risk management, managed care, and integrated disability management. She is board certified in occupational and environmental health and is a fellow of the American Association of Occupational & Environmental Health Nurses. Bringing more than 20 years of industry experience, her expertise includes claim operations, medical management, risk management, and healthcare practice management.

About the Study Director & Publisher,
Rising Medical Solutions:

Rising Medical Solutions (Rising) is a national medical care and cost optimization company that serves payers of medical claims in the workers’ compensation, auto, liability, and group health markets. Rising conceived the study idea and leads the logistical, project management, industry outreach, and publication aspects of the effort. For study inquiries, please contact Vice President and Study Program Director, Rachel Fikes.