Below are some of what we believe to be critical contributors and links to articles that provide insight to these issues.

Increasing Medical Treatment Utilization Patterns
(PDF)

WC Medical Severity Growing Faster than the Medical Consumer Price Index
(PDF- See pg. 35 of 68)

Increasing Pharmacy Costs and Utilization Patterns

Changing Workforce Demographics -
Increasing Obesity Rates

Recently the WCIRB reported (April 7, 2009) that the medical component of a 2008 California Indemnity claim will account for an estimated 65% of the total cost of the claim and will amount to $36,849 in medical expenses alone! This component of the claim represented 49% of the total claim value in 1988. This equates to a 33% growth rate over the past decade. Athens believes that it is critical for TPA’s and employers to understand the drivers behind this trend so that specific strategies can be developed to combat the financial effects of ballooning medical costs.

In recent years the growth rate of medical costs has been somewhat tempered by an even greater decline in overall indemnity claim frequency.
A major concern is that this trend could reverse. The consequence of rising frequency rates on top of inflated medical costs would be more indemnity claims and more expensive indemnity claims. This would be problematic for businesses throughout California.

At Athens we closely monitor industry trends and aggressively adapt to make sure that we deliver the best possible results for our clients.

• Constantly Evolving Medical Cost Containment Strategies designed to attack and reduce medical costs – We have fully integrated in-house medical bill review, in-house nurses, in-house utilization review and a pharmacy benefit management program in place.  Each of these functions have been specifically designed to reduce the medical cost component of a claims 
  
• Re-engineering Workflows – Utilizing the latest technological tools that allow our staff to maximize their individual efficiencies and deliver the best possible outcomes for our clients.
• Training – Continuously provided to our staff.  This arms our examiners with information which allows them to make highly impactful decisions that drive superior outcomes on their claims.
• Reasonable Caseloads and High Level of Administrative Support – Claim administration is extremely time sensitive and regulated in nature.  To achieve maximum results examiners must have reasonable caseloads and high levels of administrative support.  This frees them up to focus exclusively on the most critical functions of claims administration.  The end result is that claims that close faster and for less money.

Athens has administered claims throughout California for more than 30 years.  Our clients include public agencies, regional businesses, insurance companies and Fortune 500 companies.  For more information please visit:

www.athensadmin.com