It is said that to know where you are going, you must first know where you currently are. In the world of injured worker outcomes, that advice could not prove to be more salient. Don't get me wrong, we talk a great deal about outcomes. We actually talk and talk and talk some more about outcomes. We want good outcomes, and most of us can recognize a bad outcome when we see it. It is just that, as an industry, we really do not measure the quality of outcome on any statistical level. By contrast, our analysis to date has been more of the water cooler anecdotal variety; we've all heard stories, but what are we really accomplishing?
It turns out that the Workers' Compensation Research Institute (WCRI), is turning their impressive analytic resources towards that very question.
At the 32nd WCRI Annual Issues & Research Conference, held last week in balmy (really, 73 degrees balmy) Boston, MA, the group discussed the preliminary findings of a 15 state study on injured worker outcomes. The information they presented was not earth shattering, but was interesting nonetheless. They measured a variety of data points, from satisfactory return to work percentages to medical improvement of the patient.
I have to applaud them for this attempt, as it is a Herculean effort. Of all their data points, it would seem to me that the most objective and easiest to assess would be the “Satisfactory Return to Work” criteria. The other area's, such as pre-injury and post injury assessments on pain and physical function, are much more subjective. WCRI is using for those elements the SP12 self and peer assessment survey, an industry standard survey system that does help account for the “human” variations that can affect responses. Still, a quantifiable effort in this area can only help us better identify shortcomings in our ever more complex processes.
The final numbers will not be published for another month or two, so the information presented to us was preliminary in nature. I was surprised that on average over 10% of lost time injured workers in the sample states did not have a satisfactory return to work after their injury. Georgia had the worst result of the lot, with nearly 20% of their lost time claims not returning to work at all or in an adequate capacity.
There are two points that I would like to emphasize in this discussion. First, it is fairly clear to me that legislative and regulatory environments are probably largely responsible for the widely varying percentages we saw. This does not mean that the people running the systems in the states with higher numbers are not doing their job, or that their injured workers' are more predisposed to not achieving better outcomes; it probably means that some feature provided by the legislature is contributing to a poorer result than we would prefer to see. Georgia, for instance, does not have a statutory vehicle allowing an MMI designation. Could that be a contributing factor in lengthening claims and delaying RTW? In my opinion, absolutely.
Secondly, I would point out that for the continuing effort of WCRI to be truly effective, they must include more states than the ones they are currently reviewing. Several high volume and potentially contentious states were notably absent from their sample, including California, Texas and New York. This, however, appears to be an issue with the states, and not WCRI. I spoke with study co-author Dr. Vennela Thumula about the challenges of this effort. She indicated (in a very polite and politically correct way) that they would like to include a wider grouping in their study, but it was a challenge in certain situations getting access to the data needed for the effort. They absolutely recognize that a wider review is necessary to really get a nationwide view of what is going on.
This of course is indicative of one of the three inherent problems with data in our industry. Getting states, carriers and other major players to play nice with their data and share has proven to be a difficult task. Aligning that data under common criteria is another issue. The third problem for our industry, of course, is that even if we could get access to all the “big data”, most of us wouldn't know what to do with it. When it comes to big data, we are like a dog chasing a car. If it ever happens to actually catch it, it'll have no idea what to do with the damn thing.
Fortunately, for that we have WCRI. Hopefully they will be able to expand their study in this area. Understanding injured worker outcomes on a broad and statistical level is not the final answer to our problems, but it is a critical step in the process. We have to know what the facts are if we are going to address and correct them. To be able to really know where we need to go, we absolutely need to know where we currently are.
Only with that info under our belts can we establish and measure a path to success.