WEBVTT 00:00:11.210 --> 00:00:13.610 Cybersecurity I'm Tom Kerr. 00:00:13.610 --> 00:00:15.230 And before we get started, I would 00:00:15.230 --> 00:00:18.770 like to go over a few items so you know how to participate 00:00:18.770 --> 00:00:20.560 in today's event. 00:00:20.560 --> 00:00:23.670 You have joined the presentation listening using your computer 00:00:23.670 --> 00:00:27.440 speaker system by default if you would prefer to join over 00:00:27.440 --> 00:00:31.610 the telephone just select telephone in the Audio pane 00:00:31.610 --> 00:00:35.360 and the Darling information will be displayed. 00:00:35.360 --> 00:00:38.960 You will have the opportunity to submit text questions 00:00:38.960 --> 00:00:42.020 to today's presenters by typing your questions 00:00:42.020 --> 00:00:43.140 into the questions. 00:00:43.140 --> 00:00:45.780 Pain on the control panel. 00:00:45.780 --> 00:00:48.540 You may send in your questions at any time, 00:00:48.540 --> 00:00:50.780 and we will collect these and address them 00:00:50.780 --> 00:00:55.820 during the Q&A session at the end of today's presentation. 00:00:55.820 --> 00:01:00.350 I would now like to introduce our presenters Michelle Hibbard 00:01:00.350 --> 00:01:02.780 Jakob bocce senior v.p. 00:01:02.780 --> 00:01:07.400 of regulatory compliance management Rebecca Morgan 00:01:07.400 --> 00:01:10.730 senior director of product management and Ron 00:01:10.730 --> 00:01:12.500 scrappy senior v.p. 00:01:12.500 --> 00:01:15.440 a product management and development. 00:01:15.440 --> 00:01:17.960 So without further ado, let's get things started. 00:01:17.960 --> 00:01:19.040 So take it away. 00:01:19.040 --> 00:01:22.230 Michelle thank you. 00:01:22.230 --> 00:01:24.240 Hi and welcome everyone. 00:01:24.240 --> 00:01:26.160 There are so many industry trends 00:01:26.160 --> 00:01:29.940 that we can talk about from telemedicine cannabis 00:01:29.940 --> 00:01:33.630 opioid crisis a lot of them are probably tired of hearing about 00:01:33.630 --> 00:01:35.940 in and of themselves but they're are almost too 00:01:35.940 --> 00:01:37.170 numerous to tackle. 00:01:37.170 --> 00:01:40.350 One thing for sure that we know is that many of the trends 00:01:40.350 --> 00:01:43.770 are linked by regulatory and data solutions 00:01:43.770 --> 00:01:47.310 to highlight three trends we see in workers compensation. 00:01:47.310 --> 00:01:51.230 We decided to look toward these three trends. 00:01:51.230 --> 00:01:54.620 First what has been termed the aging workforce in the industry 00:01:54.620 --> 00:01:57.260 rather the new workforce movement 00:01:57.260 --> 00:02:00.380 while the aging workforce sticks around longer 00:02:00.380 --> 00:02:02.600 and the data driven tools used that appeal 00:02:02.600 --> 00:02:06.150 to this wide spectrum of generation still employed. 00:02:06.150 --> 00:02:10.550 Second we will review a comprehensive medication safety 00:02:10.550 --> 00:02:13.610 program that uses data to identify 00:02:13.610 --> 00:02:18.240 the most efficient and accurate services for review and lastly, 00:02:18.240 --> 00:02:21.770 one of the main concerns not only in workers compensation 00:02:21.770 --> 00:02:25.130 but anywhere private data is captured and. 00:02:25.130 --> 00:02:29.720 The element of cybersecurity and protecting the consumers data. 00:02:29.720 --> 00:02:32.510 So first we're going to be looking at our aging 00:02:32.510 --> 00:02:35.810 workforce in particular those managing claims and workers 00:02:35.810 --> 00:02:41.830 compensation yes it's true the data on the ever-growing 00:02:41.830 --> 00:02:46.090 and aging workforce in the 55 and older range is increasing. 00:02:46.090 --> 00:02:49.900 Being of course fed by the younger generation of today 00:02:49.900 --> 00:02:53.950 according to the Bureau of Labor Statistics in 2019 the last 00:02:53.950 --> 00:02:57.490 of the baby boomers will reach age 55 and transition 00:02:57.490 --> 00:03:01.090 into age groups with much lower labor force participation 00:03:01.090 --> 00:03:05.260 rates that's mainly due to in part to an aging 00:03:05.260 --> 00:03:08.140 population the labor force participation 00:03:08.140 --> 00:03:10.360 rate for all workers aged 16 and over 00:03:10.360 --> 00:03:15.460 is projected to decline 61% in 2026. 00:03:15.460 --> 00:03:18.580 So looking forward to that the data in the baby boomer 00:03:18.580 --> 00:03:22.420 workforce is very rich upon examination of 00:03:22.420 --> 00:03:24.640 and when we look at the historical view 00:03:24.640 --> 00:03:26.170 when it comes to examining claims 00:03:26.170 --> 00:03:29.620 for potential comorbidities and repetitive movement type 00:03:29.620 --> 00:03:33.460 of injuries that they see on the job the older population 00:03:33.460 --> 00:03:35.470 is more experienced at what they do 00:03:35.470 --> 00:03:39.310 they're considered to be more careful less likely to perform 00:03:39.310 --> 00:03:40.840 physical labor. 00:03:40.840 --> 00:03:43.930 People are living longer which translates into working longer 00:03:43.930 --> 00:03:46.930 than they did in the 60s and 70s jobs today 00:03:46.930 --> 00:03:49.960 use more automation and less movement making it 00:03:49.960 --> 00:03:52.150 a great Petri dish for development 00:03:52.150 --> 00:03:54.730 of technologies for our subject matter experts 00:03:54.730 --> 00:03:55.690 who are still employed. 00:03:55.690 --> 00:03:58.390 Baby boomers and also those new folks 00:03:58.390 --> 00:04:02.410 that are coming into the employment industry today 00:04:02.410 --> 00:04:05.860 in the next five years the age 55 plus segment 00:04:05.860 --> 00:04:08.270 is projected to grow by $3 million workers. 00:04:08.270 --> 00:04:09.700 And that's a time. 00:04:09.700 --> 00:04:15.720 Rebecca thanks Michelle. 00:04:15.720 --> 00:04:17.880 Know aging workforce in our industry 00:04:17.880 --> 00:04:21.240 really affects us in two different ways. 00:04:21.240 --> 00:04:23.070 First of all the aging workforce at large. 00:04:23.070 --> 00:04:24.930 And Michelle has just highlighted 00:04:24.930 --> 00:04:26.850 how the change in this demographic 00:04:26.850 --> 00:04:30.770 is really changing the way that we see claim in general 00:04:30.770 --> 00:04:34.530 for the second way it hits a little closer to home. 00:04:34.530 --> 00:04:39.450 It affects our industry within our adjuster workforce. 00:04:39.450 --> 00:04:42.570 Many of our adjusters are approaching retirement age. 00:04:42.570 --> 00:04:45.270 We have a new generation of adjusters 00:04:45.270 --> 00:04:48.120 but it can be really difficult to train this new generation 00:04:48.120 --> 00:04:50.550 with all of the expertise that they 00:04:50.550 --> 00:04:52.800 need that are more experienced adjusters 00:04:52.800 --> 00:04:56.310 have accumulated over their vast years of experience. 00:04:56.310 --> 00:04:58.830 We need to provide tools to the adjuster that will 00:04:58.830 --> 00:05:01.325 help guide them along the way. 00:05:01.325 --> 00:05:02.700 So one of the ways that we really 00:05:02.700 --> 00:05:06.090 come to understand what adjusters need 00:05:06.090 --> 00:05:11.130 is by observing them performing their job function firsthand 00:05:11.130 --> 00:05:14.580 and this is something that we do with some regularity. 00:05:14.580 --> 00:05:16.410 One of the things that we have observed 00:05:16.410 --> 00:05:19.650 is that adjusters have to use a lot of different tools 00:05:19.650 --> 00:05:22.920 and portals to help them perform their job function. 00:05:22.920 --> 00:05:24.510 They might go to one place to look 00:05:24.510 --> 00:05:26.550 at medical bills or another place 00:05:26.550 --> 00:05:29.040 to order an IV and other place to approve 00:05:29.040 --> 00:05:31.620 scripts for pharmacy. 00:05:31.620 --> 00:05:33.757 It can be you know in addition to having 00:05:33.757 --> 00:05:35.340 to go to all of those different places 00:05:35.340 --> 00:05:36.750 just to perform a function. 00:05:36.750 --> 00:05:38.490 It can also be really difficult to get 00:05:38.490 --> 00:05:45.710 a full picture of the entire medical history of a claim. 00:05:45.710 --> 00:05:47.550 So keeping track of all of those locations 00:05:47.550 --> 00:05:51.030 can be difficult you know not to mention the fact that just 00:05:51.030 --> 00:05:53.130 keeping track of those usernames and passwords 00:05:53.130 --> 00:05:55.240 can be really challenging. 00:05:55.240 --> 00:05:59.880 But software delivery traditional software delivery 00:05:59.880 --> 00:06:04.560 has been given to a particular user such as an adjuster. 00:06:04.560 --> 00:06:06.907 Different software to perform all these functions. 00:06:06.907 --> 00:06:08.490 You know we give them one portal to do 00:06:08.490 --> 00:06:11.720 one function at another portal to do another function 00:06:11.720 --> 00:06:13.350 but if we go to the next slide, we 00:06:13.350 --> 00:06:16.770 can see that instead of looking at software 00:06:16.770 --> 00:06:20.310 s divided by a function ordering an IRB 00:06:20.310 --> 00:06:23.483 or approving a medical bill we've 00:06:23.483 --> 00:06:24.900 really started to look at software 00:06:24.900 --> 00:06:27.660 that is delivered by persona. 00:06:27.660 --> 00:06:31.230 When we talk about a persona we mean a specific role 00:06:31.230 --> 00:06:34.380 like an adjuster or a nurse. 00:06:34.380 --> 00:06:37.620 We want to give that persona a single way 00:06:37.620 --> 00:06:39.870 to access all of the function. 00:06:39.870 --> 00:06:43.180 And in fact it's streamlining their access to those functions 00:06:43.180 --> 00:06:47.800 and also help them get that full picture of the claim. 00:06:47.800 --> 00:06:50.110 So it's really about converging all of their tasks 00:06:50.110 --> 00:06:52.800 into a single place for the next slide. 00:06:52.800 --> 00:06:57.060 You're going to see a visual of what this could mean. 00:06:57.060 --> 00:06:58.950 This is a dashboard that contains 00:06:58.950 --> 00:07:00.990 a variety of functions that pertain 00:07:00.990 --> 00:07:03.490 to an adjuster in this case. 00:07:03.490 --> 00:07:05.580 So the top or representing some metrics 00:07:05.580 --> 00:07:09.138 that pertain to medical bills with drill down capabilities. 00:07:09.138 --> 00:07:10.680 So I can get to the tasks that I need 00:07:10.680 --> 00:07:13.710 to perform such as approving bills just 00:07:13.710 --> 00:07:15.690 within a single click. 00:07:15.690 --> 00:07:19.470 If I go to the second row you're seeing some aggregate metrics. 00:07:19.470 --> 00:07:22.170 This allows a supervisor or a manager 00:07:22.170 --> 00:07:25.040 to see how their team is performing 00:07:25.040 --> 00:07:28.090 their backlogs their inventories even some financial success 00:07:28.090 --> 00:07:29.185 in there. 00:07:29.185 --> 00:07:30.810 And then finally on the last row you're 00:07:30.810 --> 00:07:33.990 starting to see other functions that pertain 00:07:33.990 --> 00:07:36.270 to the adjuster such as you are what 00:07:36.270 --> 00:07:39.990 you are is happening on their plate script authorization 00:07:39.990 --> 00:07:43.560 and even pressuring reporting errors. 00:07:43.560 --> 00:07:46.590 So this really still only scratches the surface 00:07:46.590 --> 00:07:48.900 of the convergence of adjuster tasks. 00:07:48.900 --> 00:07:50.672 We know that there is a lot more to 00:07:50.672 --> 00:07:53.130 it adjusters job than what you're seeing just in a single view 00:07:53.130 --> 00:07:53.970 here. 00:07:53.970 --> 00:07:56.910 But you can begin to see the insights 00:07:56.910 --> 00:08:01.140 that we could provide to a user as well as the efficiencies 00:08:01.140 --> 00:08:01.740 to be had. 00:08:06.310 --> 00:08:08.770 And speaking of scratching the surface like Rebecca 00:08:08.770 --> 00:08:11.140 just said really the highest level for us 00:08:11.140 --> 00:08:14.200 to look at data in order to prep for these types of tools 00:08:14.200 --> 00:08:17.920 that we build is to really look at the charge patterns 00:08:17.920 --> 00:08:19.840 and what we call it. 00:08:19.840 --> 00:08:23.470 Mitchell gen-x a Mitchell price index methodology 00:08:23.470 --> 00:08:26.080 that reviews overall provider charges 00:08:26.080 --> 00:08:30.170 in the top one 12 states that we have a ton of frequency. 00:08:30.170 --> 00:08:32.140 And we collect the bill review data 00:08:32.140 --> 00:08:35.720 for these workers compensation claims and our data warehouse. 00:08:35.720 --> 00:08:38.860 And it becomes abundantly clear when reviewing data just 00:08:38.860 --> 00:08:43.600 from 2015 through 2019 that regardless of the circumstances 00:08:43.600 --> 00:08:47.830 providers continually increase unit charges almost in lockstep 00:08:47.830 --> 00:08:49.540 with the Bureau of Labor Statistics 00:08:49.540 --> 00:08:51.520 consumer price index. 00:08:51.520 --> 00:08:54.730 Using this data and provider analysis tools 00:08:54.730 --> 00:08:56.230 that Rebecca's going to talk about 00:08:56.230 --> 00:08:58.703 will assist claims handlers regardless of age 00:08:58.703 --> 00:08:59.995 where to focus their attention. 00:09:06.570 --> 00:09:10.130 OK so Michelle talked about how to focus attention 00:09:10.130 --> 00:09:13.070 you know there's really so much data available out there. 00:09:13.070 --> 00:09:14.950 The problem is not having data. 00:09:14.950 --> 00:09:17.650 The problem is having in many cases 00:09:17.650 --> 00:09:21.310 so much data that we don't know where to focus their attention. 00:09:21.310 --> 00:09:25.090 So we spoke earlier about providing actionable insights 00:09:25.090 --> 00:09:26.920 to the adjuster. 00:09:26.920 --> 00:09:29.710 Medical costs are, of course, one of the most costly 00:09:29.710 --> 00:09:32.540 if not the most costly part of a claim. 00:09:32.540 --> 00:09:34.540 And it can be really difficult to make decisions 00:09:34.540 --> 00:09:37.030 about how to manage the medical costs of a claim. 00:09:37.030 --> 00:09:40.120 If you're looking at just a single client 00:09:40.120 --> 00:09:43.180 there are a lot of great actionable insights 00:09:43.180 --> 00:09:45.870 to be had from looking at data in aggregate. 00:09:45.870 --> 00:09:49.930 So this is a view of provider analysis report. 00:09:49.930 --> 00:09:52.540 It helps us to look at billing patterns that 00:09:52.540 --> 00:09:55.390 can help us to establish appropriate care and direction 00:09:55.390 --> 00:09:58.490 of care to the best providers. 00:09:58.490 --> 00:10:00.680 So before we can really aggregate data 00:10:00.680 --> 00:10:03.300 we have to be sure that this data is good data 00:10:03.300 --> 00:10:05.900 and this is actually the more difficult problem to solve. 00:10:05.900 --> 00:10:08.990 It will come as no surprise to this audience 00:10:08.990 --> 00:10:13.670 that provider data is traditionally very messy. 00:10:13.670 --> 00:10:15.920 We see the same provider repeated 100 00:10:15.920 --> 00:10:21.070 even 1,000 different times in provider data file. 00:10:21.070 --> 00:10:23.180 So the first thing we have to do is 00:10:23.180 --> 00:10:26.270 to be able to uniquely identify that provider. 00:10:26.270 --> 00:10:28.310 Once that process is complete, we 00:10:28.310 --> 00:10:31.190 can then begin to look for patterns in that data 00:10:31.190 --> 00:10:33.932 that help lead us to actionable insight. 00:10:33.932 --> 00:10:35.390 So you're seeing a lot of data here 00:10:35.390 --> 00:10:36.932 on the screen in front of you and I'm going 00:10:36.932 --> 00:10:40.130 to walk you through piece by piece 00:10:40.130 --> 00:10:41.540 to show you the kinds of insights 00:10:41.540 --> 00:10:45.280 that you can gain by looking at that data in aggregate. 00:10:45.280 --> 00:10:47.110 There are four different quadrants here. 00:10:47.110 --> 00:10:49.090 So the first quadrant that we're looking at 00:10:49.090 --> 00:10:51.310 is a group of providers where they 00:10:51.310 --> 00:10:55.780 had five or fewer claimants but the treatment duration is 00:10:55.780 --> 00:11:01.300 51% more 51% or more greater than the expected 00:11:01.300 --> 00:11:04.580 duration for other claims with the same diagnosis group 00:11:04.580 --> 00:11:09.170 two is providers with five or fewer claimants 00:11:09.170 --> 00:11:10.970 where the duration is lower than 50% 00:11:10.970 --> 00:11:15.050 So these are providers in this case that are treating more 00:11:15.050 --> 00:11:18.620 you know closer to what we would expect the duration for a claim 00:11:18.620 --> 00:11:22.940 to be the third group is six or more claimants. 00:11:22.940 --> 00:11:27.140 So these are now providers that are treating more claimants 00:11:27.140 --> 00:11:30.888 but where the duration is less than 50% 00:11:30.888 --> 00:11:32.930 So again, where we want to see that pattern where 00:11:32.930 --> 00:11:33.602 they want to be. 00:11:33.602 --> 00:11:35.060 We want to see them treating closer 00:11:35.060 --> 00:11:37.070 to the expected duration. 00:11:37.070 --> 00:11:39.080 And then finally the final and fourth group 00:11:39.080 --> 00:11:42.820 is six or greater claimants but again 00:11:42.820 --> 00:11:47.650 treatment duration is lasting longer than 50% 50% greater 00:11:47.650 --> 00:11:49.540 than the expected duration. 00:11:49.540 --> 00:11:52.150 So this is a particularly important quadrant 00:11:52.150 --> 00:11:55.000 to pay attention to because these are providers that 00:11:55.000 --> 00:11:57.260 are not only treating a lot of patients, 00:11:57.260 --> 00:11:59.110 but also their treatment is generally 00:11:59.110 --> 00:12:01.450 extending greater than average. 00:12:01.450 --> 00:12:04.740 They're starting to see a pattern emerge here right now. 00:12:04.740 --> 00:12:06.320 If we go to the next slide. 00:12:06.320 --> 00:12:08.830 Let's drill into one of these pattern. 00:12:08.830 --> 00:12:11.500 So we're actually going to drill into this section 00:12:11.500 --> 00:12:14.410 here where we've got treatment that 00:12:14.410 --> 00:12:17.800 is extending greater than the 50% 00:12:17.800 --> 00:12:19.345 greater than the expected recovery. 00:12:19.345 --> 00:12:21.220 Let's go ahead and click into that next slide 00:12:21.220 --> 00:12:24.800 and we'll drill into this pattern 00:12:24.800 --> 00:12:26.930 we're going to try to drill into group one here 00:12:26.930 --> 00:12:32.330 and we're seeing of that group bills that received 00:12:32.330 --> 00:12:35.410 greater than 20% adjustment. 00:12:35.410 --> 00:12:38.420 99 for one as a procedure code makes up 00:12:38.420 --> 00:12:41.550 62% of the charged amount for this group of claims. 00:12:41.550 --> 00:12:43.790 So this is significant because that particular code 00:12:43.790 --> 00:12:47.390 the 99 for one is for a chiropractic manipulation 00:12:47.390 --> 00:12:49.400 covering three to four regions of the spine. 00:12:49.400 --> 00:12:53.810 That's a stand out kind of procedure in and of itself. 00:12:53.810 --> 00:12:55.480 And we can see that it's making up 00:12:55.480 --> 00:12:59.300 a large percentage of the treatment 00:12:59.300 --> 00:13:01.670 in this particular quadrants. 00:13:01.670 --> 00:13:04.460 Now let's go to the next slide and look at the other part 00:13:04.460 --> 00:13:06.500 of the screen. 00:13:06.500 --> 00:13:10.270 And we can see that this is the group that 00:13:10.270 --> 00:13:13.600 makes up less than 20% of the adjustment that. 00:13:13.600 --> 00:13:18.430 But however that same code makes up 72% of the charged amount. 00:13:18.430 --> 00:13:22.360 So now we're seeing an even greater amount of the charges. 00:13:22.360 --> 00:13:24.680 And we're not getting the same level of adjustment 00:13:24.680 --> 00:13:26.170 for those charges. 00:13:26.170 --> 00:13:27.700 So this is an important insight that 00:13:27.700 --> 00:13:30.370 might prompt you to want to take a closer 00:13:30.370 --> 00:13:33.100 look at treatment patterns for the providers in this category. 00:13:35.620 --> 00:13:38.420 So let's go on to the next slide and just talk about some things 00:13:38.420 --> 00:13:43.280 that we can learn by using data like this to perform 00:13:43.280 --> 00:13:45.410 some analysis look for pattern. 00:13:45.410 --> 00:13:46.910 But this is the type of insight that 00:13:46.910 --> 00:13:50.190 would be really difficult, if not impossible, 00:13:50.190 --> 00:13:53.150 for a single claims adjuster to try to see as they're 00:13:53.150 --> 00:13:54.380 looking at individual claims. 00:13:54.380 --> 00:13:56.088 You know a single claims adjuster is only going to see 00:13:56.088 --> 00:13:59.820 individual instances of bills. 00:13:59.820 --> 00:14:02.840 And they are not going to see how that provider is treating 00:14:02.840 --> 00:14:05.460 across multiple claims. 00:14:05.460 --> 00:14:08.810 So looking at the provider and service unit cost data 00:14:08.810 --> 00:14:11.660 in this manner could really help us understand 00:14:11.660 --> 00:14:14.150 whether we're looking at industry trends 00:14:14.150 --> 00:14:17.540 or if we're looking at a trend with specific providers 00:14:17.540 --> 00:14:20.480 or groups of providers, the tools that provide 00:14:20.480 --> 00:14:23.270 actionable insights are going to be increasingly 00:14:23.270 --> 00:14:25.355 important for the new generation of adjusters. 00:14:30.640 --> 00:14:32.860 Our second trend we're going to talk about today 00:14:32.860 --> 00:14:35.500 is a common comprehensive medication safety. 00:14:35.500 --> 00:14:39.040 So we're going to address some statistics on drugs 00:14:39.040 --> 00:14:41.590 and to do this analytics again becomes 00:14:41.590 --> 00:14:45.880 a very important and invaluable tool in our analysis. 00:14:45.880 --> 00:14:47.380 According to the CDC. 00:14:47.380 --> 00:14:51.400 2016 national safety poll 99 percent of doctors 00:14:51.400 --> 00:14:54.430 are prescribing opioid medicines for longer than the three day 00:14:54.430 --> 00:14:57.430 period recommended by the Center for Disease Control 00:14:57.430 --> 00:15:01.570 and Prevention 74% of doctors incorrectly 00:15:01.570 --> 00:15:05.140 believe morphine and oxycodone both opioids are the most 00:15:05.140 --> 00:15:07.210 effective ways to treat pain. 00:15:07.210 --> 00:15:09.790 Research shows over-the-counter pain relievers 00:15:09.790 --> 00:15:12.460 such as ibuprofen and acetaminophen 00:15:12.460 --> 00:15:15.820 offer the most effective relief for acute pain 00:15:15.820 --> 00:15:18.700 injured workers receiving high doses of opioid painkillers 00:15:18.700 --> 00:15:21.880 stayed off work three times longer than those 00:15:21.880 --> 00:15:26.120 with more injuries taking lower doses and a lot of the stats 00:15:26.120 --> 00:15:29.260 I'm rattling off you're very familiar with 00:15:29.260 --> 00:15:30.910 and you've heard them. 00:15:30.910 --> 00:15:34.510 And 75% of those struggling with addiction 00:15:34.510 --> 00:15:38.050 be at alcohol pain medication marijuana et cetera 00:15:38.050 --> 00:15:42.040 they're employed people workers with substance use 00:15:42.040 --> 00:15:46.240 disorders missed nearly 50% more workdays than their peers 00:15:46.240 --> 00:15:49.900 up to six weeks annually and absenteeism leads 00:15:49.900 --> 00:15:52.330 to losses in productivity. 00:15:52.330 --> 00:15:54.490 The statistics are not all bad though 00:15:54.490 --> 00:15:56.980 and are demonstrating improvement 00:15:56.980 --> 00:15:59.200 but room for more successes. 00:15:59.200 --> 00:16:02.380 The data in the maps that you see below 00:16:02.380 --> 00:16:05.140 show the geographic distribution in the United States 00:16:05.140 --> 00:16:09.160 at the state level of retail retail opioid prescriptions 00:16:09.160 --> 00:16:14.620 dispensed per 100 persons in year 2015 2016 and 2017. 00:16:14.620 --> 00:16:17.500 And I wish there was a more current map available for this 00:16:17.500 --> 00:16:18.670 but there isn't. 00:16:18.670 --> 00:16:21.160 2013 hasn't been displayed yet so this is leading 00:16:21.160 --> 00:16:22.690 up to what we know today. 00:16:22.690 --> 00:16:25.000 The darker the color on these maps 00:16:25.000 --> 00:16:27.190 the more opioid prescriptions are being 00:16:27.190 --> 00:16:28.930 dispensed in these states. 00:16:28.930 --> 00:16:32.290 There has been incredible change due to the attention being 00:16:32.290 --> 00:16:35.530 given in managing drugs, especially in the workers 00:16:35.530 --> 00:16:38.110 compensation arena. 00:16:38.110 --> 00:16:42.630 Ron thanks Michelle. 00:16:42.630 --> 00:16:45.390 So what I want to lay out here over the next four slides 00:16:45.390 --> 00:16:50.100 really is a description of an integrated medication safety 00:16:50.100 --> 00:16:52.290 program design really. 00:16:52.290 --> 00:16:55.020 10 years in the making and evolving and while some 00:16:55.020 --> 00:16:58.740 of the numbers and trends around medication safety or the opioid 00:16:58.740 --> 00:17:02.730 crisis in particular have been positive I think we still would 00:17:02.730 --> 00:17:07.680 all agree that we have more road to travel the regulatory 00:17:07.680 --> 00:17:11.010 progress that has been helped the progress we've made has 00:17:11.010 --> 00:17:15.569 been helped by regulation and by awareness and education 00:17:15.569 --> 00:17:19.319 but also by the kinds of programs that I'm going 00:17:19.319 --> 00:17:23.220 to outline today in terms of integrating processes within 00:17:23.220 --> 00:17:26.190 the managed care area and in the claims process to ensure that 00:17:26.190 --> 00:17:32.940 we identify situations where interventions are needed or are 00:17:32.940 --> 00:17:37.020 valuable to produce better outcomes and then leverage 00:17:37.020 --> 00:17:42.840 analytics all throughout this program to continuously improve 00:17:42.840 --> 00:17:43.980 to measure 00:17:43.980 --> 00:17:49.530 to monitor and to identify again another cycle of improvements 00:17:49.530 --> 00:17:53.970 that can improve outcomes for injured workers 00:17:53.970 --> 00:17:58.980 for their families and for the community that they live in. 00:17:58.980 --> 00:18:02.670 So the first slide here just really 00:18:02.670 --> 00:18:05.580 outlines those three phases with analytics 00:18:05.580 --> 00:18:07.950 is sort of a backbone or a sidecar 00:18:07.950 --> 00:18:11.670 if you will to process that whether it uses medication 00:18:11.670 --> 00:18:14.250 safety triggers out of PDM or bill review 00:18:14.250 --> 00:18:18.090 or clinical triggers out of the same data sources 00:18:18.090 --> 00:18:20.550 or first note of loss first notice of loss 00:18:20.550 --> 00:18:24.480 is also a common area where we identify risk or stratify risk 00:18:24.480 --> 00:18:27.000 or predict risk case management. 00:18:27.000 --> 00:18:28.740 The people in the process, whether they 00:18:28.740 --> 00:18:33.720 be claims or employer based or case management based 00:18:33.720 --> 00:18:35.330 individuals or professionals also 00:18:35.330 --> 00:18:38.190 are active in the identification of these issues 00:18:38.190 --> 00:18:42.270 and problems or potential for the need for interventions 00:18:42.270 --> 00:18:44.040 in the interventions take as most of you 00:18:44.040 --> 00:18:46.590 know a bunch of different forms, whether that's 00:18:46.590 --> 00:18:47.860 pharmacist driven, 00:18:47.860 --> 00:18:49.830 whether it's letters from pba EMS whether it's 00:18:49.830 --> 00:18:54.180 TCM involvement or whether it's peer to peer physician 00:18:54.180 --> 00:18:57.930 a physician at some levels is the most effective way 00:18:57.930 --> 00:19:00.330 to change the course of treatment 00:19:00.330 --> 00:19:04.350 to be safer to be more effective and ultimately the way that we 00:19:04.350 --> 00:19:08.220 measure all of these identification and intervention 00:19:08.220 --> 00:19:11.730 pairings is for better outcomes as measured by health 00:19:11.730 --> 00:19:15.612 and spending and settlements. 00:19:15.612 --> 00:19:17.070 And I'll show you a little bit more 00:19:17.070 --> 00:19:20.580 about some of those measurements here and in the slides 00:19:20.580 --> 00:19:24.750 that we move forward on. 00:19:24.750 --> 00:19:27.480 So when the next look at this I wanted to I 00:19:27.480 --> 00:19:32.040 wanted to show an under the hood maybe a little 00:19:32.040 --> 00:19:34.170 bit more of how the sausage is made 00:19:34.170 --> 00:19:38.340 or how the engine works underneath these programs. 00:19:38.340 --> 00:19:41.940 Know my diagram emphasizes the things that maybe I 00:19:41.940 --> 00:19:44.190 have worked on our groups have worked on here 00:19:44.190 --> 00:19:48.810 but it's the context for this is really in an integrated claims 00:19:48.810 --> 00:19:52.260 management process that includes safety right 00:19:52.260 --> 00:19:54.570 and includes an advocacy mindset. 00:19:54.570 --> 00:20:00.420 So this is just one part of a much bigger system or process 00:20:00.420 --> 00:20:02.190 that makes these programs successful 00:20:02.190 --> 00:20:05.610 I highlight these connections between these processes 00:20:05.610 --> 00:20:09.480 and I'm focusing here on utilization review PBS bill 00:20:09.480 --> 00:20:12.360 review and case management. 00:20:12.360 --> 00:20:16.137 You know it's not surprising that we produced a slider 00:20:16.137 --> 00:20:17.220 that I'm involved in this. 00:20:17.220 --> 00:20:18.990 This is what I've spent my whole life on. 00:20:18.990 --> 00:20:21.270 So I did not dream of this by the way, when 00:20:21.270 --> 00:20:25.410 I was a child but here I am and happy and proud to be part 00:20:25.410 --> 00:20:28.830 of the programs that connect these services 00:20:28.830 --> 00:20:30.570 and rather than go through all the data 00:20:30.570 --> 00:20:32.682 flows because there's a lot here. 00:20:32.682 --> 00:20:34.140 Pick on a couple of key points here 00:20:34.140 --> 00:20:38.310 to drive home maybe the importance of continuously 00:20:38.310 --> 00:20:41.430 improving the integration between these processes 00:20:41.430 --> 00:20:44.040 towards the goals I mentioned earlier 00:20:44.040 --> 00:20:45.280 looking from left to right. 00:20:45.280 --> 00:20:47.490 If you looked at that utilization review and case 00:20:47.490 --> 00:20:51.150 management integration is important 00:20:51.150 --> 00:20:53.910 that we connect the treatment authorization 00:20:53.910 --> 00:20:57.690 requests approvals modifications with the active practice 00:20:57.690 --> 00:21:00.780 of case management in flight. 00:21:00.780 --> 00:21:04.170 One of the stats that I like to quote that we got from our data 00:21:04.170 --> 00:21:08.100 and looking at both profit prospects programs 00:21:08.100 --> 00:21:12.060 and our own is somewhere between 20% to 40% 00:21:12.060 --> 00:21:18.510 of the requests for treatment are in intersect 00:21:18.510 --> 00:21:22.410 or overlap with active case management cases. 00:21:22.410 --> 00:21:27.320 So if a fifth to 4/10 of all of the you 00:21:27.320 --> 00:21:30.080 rs had active case management on them 00:21:30.080 --> 00:21:32.730 in a concurrent modality that would 00:21:32.730 --> 00:21:35.610 be important to communicate those things it's important. 00:21:35.610 --> 00:21:37.890 And oftentimes case managers that are active 00:21:37.890 --> 00:21:40.680 know this already but oftentimes the request 00:21:40.680 --> 00:21:42.720 for a surgery, for example can become a trigger 00:21:42.720 --> 00:21:48.090 to involvement pre surgery preparation surgery pre 00:21:48.090 --> 00:21:50.760 education on the methods of pain management 00:21:50.760 --> 00:21:53.730 after that surgery that are guideline acceptable. 00:21:53.730 --> 00:21:55.770 So I think that's one example specific 00:21:55.770 --> 00:21:59.610 as it is that is important and is sometimes 00:21:59.610 --> 00:22:02.790 overlooked in program designs in terms of making sure 00:22:02.790 --> 00:22:04.530 those two processes talk to each other 00:22:04.530 --> 00:22:07.110 on the far right I'd I'd highlight what 00:22:07.110 --> 00:22:09.000 I think now has become an industry 00:22:09.000 --> 00:22:10.800 standard really converge bill review 00:22:10.800 --> 00:22:13.800 and BBM from a workflow from a data flow 00:22:13.800 --> 00:22:15.750 and from an analytics perspective. 00:22:15.750 --> 00:22:18.015 Medications are dispensed in and out-of-network they 00:22:18.015 --> 00:22:19.890 are dispensed from physicians offices they're 00:22:19.890 --> 00:22:23.940 dispense from and distributed through third party builders 00:22:23.940 --> 00:22:28.650 and it's important that all of the administration of drugs 00:22:28.650 --> 00:22:33.810 has a unified look in terms of clinical oversight in terms 00:22:33.810 --> 00:22:38.210 of detection of potential problems in terms of variations 00:22:38.210 --> 00:22:40.500 of guidelines and in terms of provider scoring 00:22:40.500 --> 00:22:42.450 or stratification in terms of evaluating 00:22:42.450 --> 00:22:44.850 the performance of our treating providers 00:22:44.850 --> 00:22:47.970 as it relates to all methods and all modalities of delivery 00:22:47.970 --> 00:22:52.890 of a therapeutic or drugs treatment 00:22:52.890 --> 00:22:54.600 in the pharmaceutical area. 00:22:54.600 --> 00:22:57.630 And then the last one I would highlight in the middle maybe 00:22:57.630 --> 00:23:01.020 just the third bullet again the traditional obsession 00:23:01.020 --> 00:23:03.120 and of our industry, of connecting 00:23:03.120 --> 00:23:08.190 you are in Bill review I would suggest to you in our program 00:23:08.190 --> 00:23:09.190 suggests to us. 00:23:09.190 --> 00:23:12.030 And I suggest to you still critical upwards 00:23:12.030 --> 00:23:17.360 of 10% of surgeries today are still 00:23:17.360 --> 00:23:24.150 are performed and are build without proper utilization 00:23:24.150 --> 00:23:27.120 review without proper approval and treatment of request 00:23:27.120 --> 00:23:28.080 and treatment. 00:23:28.080 --> 00:23:29.520 And again depends on the program. 00:23:29.520 --> 00:23:30.510 But I would encourage you, as you 00:23:30.510 --> 00:23:32.640 look at how to improve your programs don't overlook 00:23:32.640 --> 00:23:35.640 that that Old Faithful of integration and from a managed 00:23:35.640 --> 00:23:38.795 care perspective and making sure that we're tracking 00:23:38.795 --> 00:23:40.170 these things tracking them timely 00:23:40.170 --> 00:23:42.337 and doing making the appropriate interventions again towards 00:23:42.337 --> 00:23:44.255 better outcomes. 00:23:44.255 --> 00:23:44.880 The next slide. 00:23:44.880 --> 00:23:49.650 I just wanted to show one one graph. 00:23:49.650 --> 00:23:51.930 We talk a lot about analytics in these programs. 00:23:51.930 --> 00:23:54.750 We talk about analytics in general today. 00:23:54.750 --> 00:23:58.650 The critical fuel for this program we're a program 00:23:58.650 --> 00:24:02.880 to work well is to be able to understand all of the data 00:24:02.880 --> 00:24:05.220 points underneath both in terms of the frequency 00:24:05.220 --> 00:24:06.780 of intervention but the total drug 00:24:06.780 --> 00:24:10.010 spend this is just a top of the funnel look at all data 00:24:10.010 --> 00:24:13.440 are basically all NDC clothes all lines 00:24:13.440 --> 00:24:17.400 of from every bill electronic or manual physician's office 00:24:17.400 --> 00:24:20.700 or through pharmacy management process 00:24:20.700 --> 00:24:23.400 that would allow us to continually monitor 00:24:23.400 --> 00:24:25.200 how this distribution is occurring 00:24:25.200 --> 00:24:26.910 what the cost factors are. 00:24:26.910 --> 00:24:30.120 Get it back down to location levels and claim levels 00:24:30.120 --> 00:24:33.300 with a goal towards continuously monitoring that and applying 00:24:33.300 --> 00:24:36.870 the same kinds of rigor to all aspects of the spend. 00:24:36.870 --> 00:24:39.210 You need to see it, all you need to record it 00:24:39.210 --> 00:24:41.280 all you need to be able to analyze it all 00:24:41.280 --> 00:24:44.290 and then act upon it in a consistent fashion. 00:24:44.290 --> 00:24:46.290 And then continually see how your actions impact 00:24:46.290 --> 00:24:49.920 outcomes to change your actions as you move forward. 00:24:49.920 --> 00:24:52.990 And then finally, just to go back to the idea of outcomes. 00:24:52.990 --> 00:24:55.830 How do you measure on what is an outcome mean for purposes 00:24:55.830 --> 00:24:57.700 of this program. 00:24:57.700 --> 00:25:01.680 I just wanted to flash a couple of pains here of results 00:25:01.680 --> 00:25:09.400 that we see in terms of direction of the numbers 00:25:09.400 --> 00:25:12.210 you'll see here that the average pharmacy costs per claim 00:25:12.210 --> 00:25:14.460 is a good metric over time you know things 00:25:14.460 --> 00:25:17.850 change within your risk within your employee base between B 00:25:17.850 --> 00:25:19.530 maybe through mergers and acquisitions 00:25:19.530 --> 00:25:22.260 even your cost pro or your risk profile 00:25:22.260 --> 00:25:25.290 but if you can look at a trend that brings down 00:25:25.290 --> 00:25:28.050 the average pharmacy costs per claim it's typically 00:25:28.050 --> 00:25:29.670 a positive one and we've seen that 00:25:29.670 --> 00:25:31.450 consistently in these programs. 00:25:31.450 --> 00:25:34.500 And again giving due credit to regulatory changes 00:25:34.500 --> 00:25:36.840 to formularies to better guidelines 00:25:36.840 --> 00:25:40.460 education there's more to be done. 00:25:40.460 --> 00:25:42.780 You know one bad case is too much. 00:25:42.780 --> 00:25:45.300 As you all know as we all have felt either personally 00:25:45.300 --> 00:25:49.890 or professionally from unsafe medication 00:25:49.890 --> 00:25:54.270 treatment the pharmacy cost is in terms of narcotics 00:25:54.270 --> 00:25:56.610 percentage at the bottom left and other important trend 00:25:56.610 --> 00:26:00.000 to want to continuously drive that down 00:26:00.000 --> 00:26:03.690 and the average scripts proclaim and the percentage of claimants 00:26:03.690 --> 00:26:04.650 receiving narcotics. 00:26:04.650 --> 00:26:09.240 Again all metrics numbers you'd much rather see go down 00:26:09.240 --> 00:26:11.610 and there is room typically to bring them down. 00:26:11.610 --> 00:26:14.880 We're not talking about unnecessarily denying 00:26:14.880 --> 00:26:17.040 medications we're not talking about allowing people 00:26:17.040 --> 00:26:19.560 to get to where they need to get to from a treatment 00:26:19.560 --> 00:26:22.470 perspective, we're talking about unnecessary risk mitigated 00:26:22.470 --> 00:26:24.870 reduced or eliminated. 00:26:24.870 --> 00:26:26.790 And then finally a couple of more metrics that 00:26:26.790 --> 00:26:29.190 are more traditional when we look at drug spending. 00:26:29.190 --> 00:26:32.220 And those really relate to the brand and generic trends which 00:26:32.220 --> 00:26:35.430 oftentimes are driven by just a really 00:26:35.430 --> 00:26:38.370 good work in the appropriate work of a PBS. 00:26:38.370 --> 00:26:43.280 But can also be ways to measure your progress or ways 00:26:43.280 --> 00:26:49.990 to identify areas of opportunity in these programs 00:26:49.990 --> 00:26:52.760 that they run. 00:26:52.760 --> 00:26:53.990 Yeah thank you. 00:26:53.990 --> 00:26:57.530 And the next trend that we're going to look at 00:26:57.530 --> 00:27:01.380 is you know probably one of the scariest 00:27:01.380 --> 00:27:05.810 that we have to deal with every single day as a business. 00:27:05.810 --> 00:27:10.040 And also you as a business for both payers and companies 00:27:10.040 --> 00:27:15.290 like Mitchell gen-x cybersecurity and the consumer. 00:27:15.290 --> 00:27:17.870 So according to risk and insurance 00:27:17.870 --> 00:27:20.090 you know when you do research for these types 00:27:20.090 --> 00:27:22.910 of presentations a lot of things kind of pop 00:27:22.910 --> 00:27:25.820 out at you especially statistics and we're all 00:27:25.820 --> 00:27:29.750 about the analytics portion according to risk and insurance 00:27:29.750 --> 00:27:34.580 the headline that read workers Comp is right for cyber attacks 00:27:34.580 --> 00:27:39.500 sort of caught our attention and it gained a lot of notoriety 00:27:39.500 --> 00:27:41.990 from companies like Mitchell gen-x 00:27:41.990 --> 00:27:44.810 and pairs that utilized protective health 00:27:44.810 --> 00:27:47.180 information to manage claims. 00:27:47.180 --> 00:27:49.250 If we look at the statistics just 00:27:49.250 --> 00:27:53.090 on health care records exposed by month and health care data 00:27:53.090 --> 00:27:56.870 breaches by month the trends are not going down. 00:27:56.870 --> 00:27:58.730 We are targets for this data. 00:27:58.730 --> 00:28:01.970 It's very valuable data for hackers. 00:28:01.970 --> 00:28:04.700 What this translates to our penalties 00:28:04.700 --> 00:28:08.240 for those that are not protected companies that are not 00:28:08.240 --> 00:28:10.490 protected it can be as simple as mailing 00:28:10.490 --> 00:28:16.350 the wrong employees the payment to the wrong address and really 00:28:16.350 --> 00:28:18.810 what's the largest element that's really driving 00:28:18.810 --> 00:28:23.190 these penalties today and consumer attention really 00:28:23.190 --> 00:28:27.720 I can't go anywhere now without talking about consumer privacy 00:28:27.720 --> 00:28:30.480 laws and looking at the legislation that's 00:28:30.480 --> 00:28:32.640 being promulgated in nearly every state. 00:28:32.640 --> 00:28:35.130 You see a lot of gray on the map but that's 00:28:35.130 --> 00:28:38.670 because they may not have a bill number yet 00:28:38.670 --> 00:28:40.290 or they're just getting one. 00:28:40.290 --> 00:28:43.560 There's a lot of states are out of session right now 00:28:43.560 --> 00:28:46.110 but they're just waiting to be pushed up 00:28:46.110 --> 00:28:47.820 through the legislatures. 00:28:47.820 --> 00:28:51.930 The issues in dealing with these laws when you are encouraged 00:28:51.930 --> 00:28:55.290 in statutes from a worker's compensation perspective 00:28:55.290 --> 00:29:00.840 to transfer data digitally and revolve around technology 00:29:00.840 --> 00:29:01.830 to protect the data. 00:29:01.830 --> 00:29:07.500 So as you can see the monetary penalties and in to the right 00:29:07.500 --> 00:29:10.163 you see that under the second and third pillars. 00:29:10.163 --> 00:29:11.580 These are the highest buckets when 00:29:11.580 --> 00:29:14.430 you add them together in their technology and health care. 00:29:14.430 --> 00:29:18.270 Not a good place to be when you're looking at someone's 00:29:18.270 --> 00:29:20.460 going to penalize you at some point in time 00:29:20.460 --> 00:29:24.300 for releasing things through a hacker or whatever. 00:29:24.300 --> 00:29:30.070 Rebecca thanks Michelle. 00:29:30.070 --> 00:29:32.640 You know I've been in technology a long time. 00:29:32.640 --> 00:29:36.060 When I started my career nearly 25 years ago 00:29:36.060 --> 00:29:39.300 security was definitely important 00:29:39.300 --> 00:29:42.330 but you could almost say it was a bit of an afterthought. 00:29:42.330 --> 00:29:45.810 It didn't have to have to be the real focus of attention 00:29:45.810 --> 00:29:48.420 or our technology team back then. 00:29:48.420 --> 00:29:51.930 But as you and I well know that has completely 00:29:51.930 --> 00:29:56.370 changed now over time and ever increasingly so 00:29:56.370 --> 00:29:58.320 in recent years. 00:29:58.320 --> 00:30:01.560 There's just nothing very exciting about security. 00:30:01.560 --> 00:30:04.780 It's hard to want to invest in it. 00:30:04.780 --> 00:30:07.650 But quite frankly, it's like paying for an insurance policy. 00:30:07.650 --> 00:30:10.110 Most of the time we don't need it. 00:30:10.110 --> 00:30:12.030 We all wish we didn't have to pay for it. 00:30:12.030 --> 00:30:15.240 But when we need it we really really need it. 00:30:15.240 --> 00:30:17.910 It's just a chance that we can't take when 00:30:17.910 --> 00:30:20.540 it comes to protecting data. 00:30:20.540 --> 00:30:23.400 So as hackers become increasingly more savvy 00:30:23.400 --> 00:30:26.700 our countermeasures have to become increasingly more 00:30:26.700 --> 00:30:28.050 sophisticated. 00:30:28.050 --> 00:30:30.690 The fact of the matter is that we will all 00:30:30.690 --> 00:30:36.060 be hiding our security from now until the day we die. 00:30:36.060 --> 00:30:42.120 So here are some best practices that pertain to security. 00:30:42.120 --> 00:30:44.750 One of the things that we do here at Mitchell gen-x 00:30:44.750 --> 00:30:46.850 is the Security Council. 00:30:46.850 --> 00:30:48.740 We meet together with our customers 00:30:48.740 --> 00:30:52.730 and with our partners to talk through the latest trends how 00:30:52.730 --> 00:30:56.890 we can all protect the data that we've been entrusted with. 00:30:56.890 --> 00:30:59.710 We live in an increasingly connected society. 00:30:59.710 --> 00:31:03.190 It's an ecosystem really that spans the globe. 00:31:03.190 --> 00:31:05.200 So this isn't a problem that we're going 00:31:05.200 --> 00:31:08.170 to be able to solve in a silo. 00:31:08.170 --> 00:31:10.320 It's really a problem that we have to band together 00:31:10.320 --> 00:31:11.737 as an industry and whether that be the insurance 00:31:11.737 --> 00:31:14.790 industry or the technology industry at large. 00:31:14.790 --> 00:31:17.910 We really have to band together to solve the problems that we 00:31:17.910 --> 00:31:21.970 see propping up the multilayer approach here 00:31:21.970 --> 00:31:24.100 refers to the fact that we have to attack this 00:31:24.100 --> 00:31:26.110 from multiple angles. 00:31:26.110 --> 00:31:29.885 Technology will always be a part of any security solution. 00:31:29.885 --> 00:31:31.510 And I'm going to talk a little bit more 00:31:31.510 --> 00:31:35.230 of the technology side of security on the next slide 00:31:35.230 --> 00:31:37.840 but another very critical component here 00:31:37.840 --> 00:31:41.290 is training human people. 00:31:41.290 --> 00:31:44.800 Of course represents one of our greatest assets. 00:31:44.800 --> 00:31:46.400 But when it comes to security. 00:31:46.400 --> 00:31:50.050 They are also present somewhat of risk. 00:31:50.050 --> 00:31:54.050 So if you think about phishing strategies phishing with a pH 00:31:54.050 --> 00:31:56.890 you know those are not attacks on technology. 00:31:56.890 --> 00:31:59.590 Those are attacks on our people. 00:31:59.590 --> 00:32:01.420 So we have to make sure our employees are 00:32:01.420 --> 00:32:04.540 prepared to handle situations they might encounter that could 00:32:04.540 --> 00:32:08.010 compromise data security. 00:32:08.010 --> 00:32:10.740 We started to see as Michelle pointed out 00:32:10.740 --> 00:32:14.610 an increase in regulatory compliance regarding security. 00:32:14.610 --> 00:32:17.700 She showed that rise like the state tour who 00:32:17.700 --> 00:32:20.160 now have pending legislation and most states 00:32:20.160 --> 00:32:23.550 now are beginning to have those discussions. 00:32:23.550 --> 00:32:25.450 A good example of this is this last year 00:32:25.450 --> 00:32:28.320 New York enacted the cybersecurity legislation that 00:32:28.320 --> 00:32:31.020 among other things required insurers 00:32:31.020 --> 00:32:35.040 to establish multi-factor authentication for users. 00:32:35.040 --> 00:32:37.050 So we have to monitor these regulations 00:32:37.050 --> 00:32:41.460 and then react within our technology solutions that 00:32:41.460 --> 00:32:44.670 do no harm philosophy means that we protect data as if it 00:32:44.670 --> 00:32:48.590 were our own trust but verify. 00:32:48.590 --> 00:32:50.860 Always a good strategy. 00:32:50.860 --> 00:32:54.350 You know but again as we live in this increasingly 00:32:54.350 --> 00:32:57.230 interconnected ecosystem it means 00:32:57.230 --> 00:32:59.600 that all of us in our industry we 00:32:59.600 --> 00:33:03.590 work with partners and vendors and customers 00:33:03.590 --> 00:33:06.380 and we trust that each entity that we are exchanging data 00:33:06.380 --> 00:33:09.710 with is doing their part to secure the data. 00:33:09.710 --> 00:33:13.220 But we just can't assume that that is the case. 00:33:13.220 --> 00:33:15.160 We have to verify. 00:33:15.160 --> 00:33:17.630 And for those of us who are providing those services 00:33:17.630 --> 00:33:20.330 we have to be willing to welcome in our customers 00:33:20.330 --> 00:33:24.810 and our partners to provide that verification. 00:33:24.810 --> 00:33:27.660 So finally the continuous training and improvement 00:33:27.660 --> 00:33:28.860 is important. 00:33:28.860 --> 00:33:31.020 Hackers will continue to become more savvy 00:33:31.020 --> 00:33:33.810 and we will all need to respond accordingly. 00:33:33.810 --> 00:33:36.450 Our technologies and our strategies 00:33:36.450 --> 00:33:41.070 will need to become increasingly more sophisticated as well. 00:33:41.070 --> 00:33:43.680 So the next slide is meant to give you 00:33:43.680 --> 00:33:47.940 a view into the security solutions the technology 00:33:47.940 --> 00:33:50.370 security solutions that we leverage here 00:33:50.370 --> 00:33:52.020 at Mitchell gen-x. 00:33:52.020 --> 00:33:55.410 If I had showed you this thought same slide maybe five 00:33:55.410 --> 00:33:57.870 years ago, we would have been looking 00:33:57.870 --> 00:34:01.010 at maybe a third of the logos. 00:34:01.010 --> 00:34:05.160 Organizations like ours are making multimillion dollar 00:34:05.160 --> 00:34:08.159 investments to protect data. 00:34:08.159 --> 00:34:10.460 This is just a critical initiative 00:34:10.460 --> 00:34:12.219 or for any organization. 00:34:12.219 --> 00:34:14.550 And one that we will have to continue to invest 00:34:14.550 --> 00:34:18.300 in for the duration of time. 00:34:18.300 --> 00:34:22.139 So in summary, this is just what it takes to keep our system 00:34:22.139 --> 00:34:24.900 and our data safe. 00:34:24.900 --> 00:34:26.929 Back to you Michelle. 00:34:26.929 --> 00:34:29.000 Thanks Rebecca. 00:34:29.000 --> 00:34:32.000 So just to come full circle with our topics today 00:34:32.000 --> 00:34:36.500 we talked about the aging workforce and AI and analytics 00:34:36.500 --> 00:34:40.670 which demonstrated tools that leverage very large data sets 00:34:40.670 --> 00:34:43.610 that can be at our subject matter experts 00:34:43.610 --> 00:34:46.730 in the newer workforce finger tips for making informed 00:34:46.730 --> 00:34:49.190 decisions and adjusting claims. 00:34:49.190 --> 00:34:53.420 And we all know consistency drives efficiency 00:34:53.420 --> 00:34:55.790 in our work environments. 00:34:55.790 --> 00:34:59.630 The success is demonstrated through the advocacy 00:34:59.630 --> 00:35:02.780 and clinical oversight and utilization of an integrated 00:35:02.780 --> 00:35:06.800 medication safety program that involves identification 00:35:06.800 --> 00:35:10.280 interventions and examinations of outcomes 00:35:10.280 --> 00:35:13.790 while using data to identify the appropriate services. 00:35:13.790 --> 00:35:17.490 And lastly Rebecca talked in-depth about cybersecurity 00:35:17.490 --> 00:35:21.650 and the consumer topic which has become more intentional. 00:35:21.650 --> 00:35:24.560 As she said for technology companies 00:35:24.560 --> 00:35:29.870 like Mitchell gen-x storing we store a lot of data based 00:35:29.870 --> 00:35:33.110 upon the data that we collect best practices and governance 00:35:33.110 --> 00:35:36.470 of the data is a very dynamic world for us 00:35:36.470 --> 00:35:40.100 as reflected said those logos are growing in number 00:35:40.100 --> 00:35:42.680 and more companies are getting into that business 00:35:42.680 --> 00:35:45.980 and frankly we're always looking at that moving target 00:35:45.980 --> 00:35:48.350 those companies that are proactive 00:35:48.350 --> 00:35:50.640 are not completely immune. 00:35:50.640 --> 00:35:53.840 But minimize bad things from happening. 00:35:53.840 --> 00:35:55.205 So thank you and t.k. 00:35:59.510 --> 00:36:00.010 great. 00:36:00.010 --> 00:36:01.110 Thanks a lot Michelle. 00:36:01.110 --> 00:36:02.050 And yeah. 00:36:02.050 --> 00:36:05.650 Now it's time to take some of your questions and folks 00:36:05.650 --> 00:36:10.000 just as a reminder, you can ask questions to the presenters 00:36:10.000 --> 00:36:11.470 by going to the questions. 00:36:11.470 --> 00:36:14.830 Pain on the panel that probably is on your right hand 00:36:14.830 --> 00:36:16.900 side of your screen. 00:36:16.900 --> 00:36:19.340 So we have a couple of questions here, 00:36:19.340 --> 00:36:21.870 but we'd love to hear from few others. 00:36:21.870 --> 00:36:23.620 So let's start off with the first one that 00:36:23.620 --> 00:36:26.410 deals with older adults. 00:36:26.410 --> 00:36:28.300 The person to ask. 00:36:28.300 --> 00:36:32.980 Aside from older adults taking fewer risks in the workplace 00:36:32.980 --> 00:36:36.190 are there other factors like improved ergonomics 00:36:36.190 --> 00:36:40.120 and adaptive equipment that are allowing aging workers to stay 00:36:40.120 --> 00:36:41.290 in the workplace. 00:36:41.290 --> 00:36:42.790 Rhonda I want to throw this off. 00:36:42.790 --> 00:36:44.260 Yeah for sure. 00:36:44.260 --> 00:36:45.490 Thanks, Tom. 00:36:45.490 --> 00:36:50.020 Yeah so consulted our ergonomic experts here in Gen X 00:36:50.020 --> 00:36:52.570 for this answer. 00:36:52.570 --> 00:36:54.190 So employers have started to realize 00:36:54.190 --> 00:36:57.010 that losing the expertise of workers over 55 00:36:57.010 --> 00:37:00.060 could have a drastic impact on their operations. 00:37:00.060 --> 00:37:03.790 And we have younger workers have not developed the expertise 00:37:03.790 --> 00:37:05.840 many of the older workers. 00:37:05.840 --> 00:37:07.870 There are ergonomic risk factors that 00:37:07.870 --> 00:37:11.590 can be reduced or eliminated for older workers. 00:37:11.590 --> 00:37:14.500 There's also typically would benefit all workers so it's not 00:37:14.500 --> 00:37:16.900 a single population benefit. 00:37:16.900 --> 00:37:19.300 And some of them are pretty simple proper lighting is 00:37:19.300 --> 00:37:23.860 a highlight that I've seen around the reducing glare 00:37:23.860 --> 00:37:28.210 and awkward postures software that identifies and interprets 00:37:28.210 --> 00:37:30.610 what is being displayed on the screen text 00:37:30.610 --> 00:37:34.270 to speech sound icons magnification larger screens 00:37:34.270 --> 00:37:40.930 all maybe a little bit of an imprint. 00:37:40.930 --> 00:37:44.720 Many of us older workers will leave in the workplace. 00:37:44.720 --> 00:37:47.530 And then many employers have implemented teen lifting 00:37:47.530 --> 00:37:50.920 for any objects over 40 to 50 pounds 00:37:50.920 --> 00:37:55.000 or installed lift assist devices to reduce or eliminate lifting 00:37:55.000 --> 00:37:57.190 again to reduce the exposure. 00:37:57.190 --> 00:38:01.420 For those of us whose backs or abs aren't as strong as 00:38:01.420 --> 00:38:02.090 they used to be. 00:38:04.900 --> 00:38:06.190 OK great. 00:38:06.190 --> 00:38:10.240 We have another question here from one of our participants. 00:38:10.240 --> 00:38:13.270 They want to know did we say that New York has 00:38:13.270 --> 00:38:17.850 a statue where you have where you have to use two factor 00:38:17.850 --> 00:38:19.640 or often. 00:38:19.640 --> 00:38:21.760 Often the case in the case. 00:38:21.760 --> 00:38:28.690 Thank you Ron for four claims and Bill review system. 00:38:28.690 --> 00:38:31.330 So the question again did you just 00:38:31.330 --> 00:38:33.280 say New York has a statute where you 00:38:33.280 --> 00:38:38.140 have to use two factor authentication for claims 00:38:38.140 --> 00:38:40.570 and they'll review systems. 00:38:40.570 --> 00:38:43.210 Michelle I'm going to send that to you. 00:38:43.210 --> 00:38:45.040 I think I actually think Rebecca is 00:38:45.040 --> 00:38:46.990 going to respond to that because we 00:38:46.990 --> 00:38:51.860 have gone through development of this and yes it did. 00:38:51.860 --> 00:38:56.910 Yes there is that but it's true there are those that do that. 00:38:56.910 --> 00:38:59.120 So that's the most important part. 00:38:59.120 --> 00:39:01.220 There are of course nuances to that statute. 00:39:01.220 --> 00:39:05.150 You know that you'd want to take a look closely at her to ensure 00:39:05.150 --> 00:39:07.970 make sure that you know who you are subject to that statute. 00:39:07.970 --> 00:39:10.430 But essentially you know what. 00:39:10.430 --> 00:39:13.970 It's what it requires is a two factor authentication 00:39:13.970 --> 00:39:16.040 or multi-factor authentication. 00:39:16.040 --> 00:39:19.160 For those of you who might be unfamiliar with what that is 00:39:19.160 --> 00:39:20.990 I'm sure that you've used it before. 00:39:20.990 --> 00:39:23.510 Whenever you log in to like your bank website 00:39:23.510 --> 00:39:26.870 from a new computer you know it requires you usually 00:39:26.870 --> 00:39:30.137 to send a code to your cell phone or to your email. 00:39:30.137 --> 00:39:31.220 And then you type that in. 00:39:31.220 --> 00:39:33.637 Those are two factors that you're typing in your user name your 00:39:33.637 --> 00:39:35.660 password that's factor number one. 00:39:35.660 --> 00:39:39.470 The second factor is like that pin that attacks you. 00:39:39.470 --> 00:39:42.050 And so it just to there is an extra layer 00:39:42.050 --> 00:39:44.540 of identity verification that's essentially what it is. 00:39:44.540 --> 00:39:47.960 And so you know that that legislation 00:39:47.960 --> 00:39:49.790 was enacted last year. 00:39:49.790 --> 00:39:51.680 And you know there are aspects of that 00:39:51.680 --> 00:39:55.070 that would require the technology that you leverage 00:39:55.070 --> 00:40:01.500 to be able to accommodate that as well and to Rebecca's point 00:40:01.500 --> 00:40:02.250 about it. 00:40:02.250 --> 00:40:06.000 You know New York was the first in your face in our industry 00:40:06.000 --> 00:40:09.870 but there's a lot of tag along on to the consumer privacy 00:40:09.870 --> 00:40:12.690 legislation that's out there in the different states that 00:40:12.690 --> 00:40:14.550 are adding that into it. 00:40:14.550 --> 00:40:18.570 So some of the consumer privacy legislation 00:40:18.570 --> 00:40:20.730 is three are three pages long. 00:40:20.730 --> 00:40:23.880 Some are 300 others or war and peace 00:40:23.880 --> 00:40:26.490 and you have to find these little nuggets 00:40:26.490 --> 00:40:29.430 inside of a lot of these different types of legislations 00:40:29.430 --> 00:40:32.500 that are written and trying to be pushed through legislature 00:40:32.500 --> 00:40:34.800 to see if it's even doable. 00:40:34.800 --> 00:40:37.440 This is just an example one that is doable 00:40:37.440 --> 00:40:41.710 and it was something immediately period that we had to tackle 00:40:41.710 --> 00:40:44.310 but we're seeing it pop up probably 00:40:44.310 --> 00:40:49.380 in about 20 to 22 states right now moving forward. 00:40:49.380 --> 00:40:50.880 So it's a subject we're going to be 00:40:50.880 --> 00:40:54.285 tackling for the law for a very long duration. 00:40:57.670 --> 00:40:58.390 Great thank you. 00:40:58.390 --> 00:41:01.750 And Rebecca I think we have one here for you. 00:41:01.750 --> 00:41:04.810 One of our attendees is asking how 00:41:04.810 --> 00:41:07.840 he can get access to the provider analysis report. 00:41:11.070 --> 00:41:12.300 Great question. 00:41:12.300 --> 00:41:16.890 So this report is actually just launching right now. 00:41:16.890 --> 00:41:20.840 We have it in the hands of some early adopters. 00:41:20.840 --> 00:41:23.620 You know for our customers. 00:41:23.620 --> 00:41:25.230 And so we're gathering some feedback 00:41:25.230 --> 00:41:26.610 from those early adopters. 00:41:26.610 --> 00:41:28.980 It'll be rolling out to the rest of our customers 00:41:28.980 --> 00:41:32.460 probably throughout the year is how we would see that rollout 00:41:32.460 --> 00:41:33.170 to occur. 00:41:33.170 --> 00:41:35.490 But we'll really start hitting that hard as we 00:41:35.490 --> 00:41:38.330 approach kind of the end of this first quarter 00:41:38.330 --> 00:41:41.580 and we'll get that into the hands of more of our customers. 00:41:41.580 --> 00:41:43.560 And like I said just continually rolling it out 00:41:43.560 --> 00:41:47.830 throughout the year great. 00:41:47.830 --> 00:41:50.560 And we have another question here. 00:41:50.560 --> 00:41:54.185 With so many Americans living with substance abuse disorders 00:41:54.185 --> 00:41:55.810 there's a good chance an injured worker 00:41:55.810 --> 00:41:57.250 will be entering the workers Comp 00:41:57.250 --> 00:41:59.890 system with addiction issues. 00:41:59.890 --> 00:42:02.080 What interventions can be made to ensure 00:42:02.080 --> 00:42:04.450 that those who are addicted receive 00:42:04.450 --> 00:42:08.590 a pain regimen that doesn't exacerbate their condition. 00:42:08.590 --> 00:42:11.050 Ron do you want to tackle that one first. 00:42:11.050 --> 00:42:12.460 Sure sure. 00:42:12.460 --> 00:42:18.250 I think the intention of these guidelines and drug 00:42:18.250 --> 00:42:19.330 formularies. 00:42:19.330 --> 00:42:21.440 And again I'm speaking from the perspective 00:42:21.440 --> 00:42:25.390 of working with clinical people not being one. 00:42:25.390 --> 00:42:31.000 But clearly the intent of the design of both these guidelines 00:42:31.000 --> 00:42:33.940 and the formularies and also the systems and processes 00:42:33.940 --> 00:42:37.060 that we wrap around them is that really destroy 00:42:37.060 --> 00:42:41.380 strive to reduce any unnecessary exposure to addictive substance 00:42:41.380 --> 00:42:43.090 regardless of patient history first 00:42:43.090 --> 00:42:47.250 and foremost we are all potential antics maybe more 00:42:47.250 --> 00:42:49.500 of us or high have a higher probability 00:42:49.500 --> 00:42:51.000 than others after exposure. 00:42:51.000 --> 00:42:54.330 But any exposure that is unnecessary or isn't lined up 00:42:54.330 --> 00:42:57.450 with the appropriate treatment or the best treatment approach 00:42:57.450 --> 00:42:59.700 is something we're trying to identify and really steer 00:42:59.700 --> 00:43:03.060 away from here in any of these programs. 00:43:03.060 --> 00:43:06.540 We also know how important physician and patient education 00:43:06.540 --> 00:43:09.540 are to this understanding that the potential risk 00:43:09.540 --> 00:43:14.640 of these substances and that the goal 00:43:14.640 --> 00:43:17.670 of these programs of these systems 00:43:17.670 --> 00:43:19.080 these analytics and of the people 00:43:19.080 --> 00:43:21.960 that do the work is really to make sure that none of us 00:43:21.960 --> 00:43:26.730 have to really test our test unnecessarily 00:43:26.730 --> 00:43:31.400 our own resistance to addiction. 00:43:31.400 --> 00:43:33.740 Great thanks Ron. 00:43:33.740 --> 00:43:35.150 Another question here. 00:43:35.150 --> 00:43:37.580 Rebecca I think this might be for you. 00:43:37.580 --> 00:43:40.130 Do you happen to be a medical bill 00:43:40.130 --> 00:43:42.850 customer to get the provider analysis report. 00:43:45.780 --> 00:43:48.700 Well I'm really excited to feel the interest in a provider 00:43:48.700 --> 00:43:52.450 analysis report it really is a cool tool providing 00:43:52.450 --> 00:43:54.490 some really great data. 00:43:54.490 --> 00:43:58.430 So the answer that in the short term is yes. 00:43:58.430 --> 00:44:00.880 So the version of the report that we 00:44:00.880 --> 00:44:05.680 are rolling out currently is an individual customer's own data. 00:44:05.680 --> 00:44:07.570 So the view that you're going to see 00:44:07.570 --> 00:44:09.390 is really just your own provider data 00:44:09.390 --> 00:44:11.140 and start to certain to look at the trends 00:44:11.140 --> 00:44:14.950 across what you can see within your book of business 00:44:14.950 --> 00:44:19.450 future versions of the report will be more industry focused 00:44:19.450 --> 00:44:22.030 and then we'll be able to do kind of customer 00:44:22.030 --> 00:44:24.660 versus industry type analysis you 00:44:24.660 --> 00:44:29.540 know where maybe one particular carrier for instance, 00:44:29.540 --> 00:44:33.020 could be charged different amounts to then 00:44:33.020 --> 00:44:35.650 the rest of the industry for particular procedures 00:44:35.650 --> 00:44:37.150 or you know those sorts of things 00:44:37.150 --> 00:44:40.480 you can look at trending trending 00:44:40.480 --> 00:44:42.940 against the industry you know. 00:44:42.940 --> 00:44:46.930 So it is possible that future versions of the report 00:44:46.930 --> 00:44:49.300 could be more industry focused and you 00:44:49.300 --> 00:44:52.150 know it wouldn't necessarily require 00:44:52.150 --> 00:44:56.440 you to be a medical bill customer focused our focus. 00:44:56.440 --> 00:45:01.610 So I will say is this certainly on our customers. 00:45:01.610 --> 00:45:08.890 Additionally here OK, great that looks like it wraps up 00:45:08.890 --> 00:45:10.000 our question part of it. 00:45:10.000 --> 00:45:14.200 So this time I just want to thank Michelle Rebecca and Ron 00:45:14.200 --> 00:45:16.240 and thank you everyone for attending today's 00:45:16.240 --> 00:45:18.700 webinar aging workforce medication 00:45:18.700 --> 00:45:21.910 safety and cybersecurity. 00:45:21.910 --> 00:45:24.460 You'll receive a copy of this presentation and the link 00:45:24.460 --> 00:45:27.820 to view a recording of today's webinar. 00:45:27.820 --> 00:45:31.510 So on behalf of Gen X services and our presenters 00:45:31.510 --> 00:45:33.820 and Mitchell, thank you for joining us today 00:45:33.820 --> 00:45:36.840 and have a great rest of your day.