The Three Elements of Successful Collaborative Case Management
Often, we find that people look at medical case management, particularly in the workers' compensation industry, as a static entity. Does a claim meet one of the pre-defined thresholds for the deployment of case management services? Yes, then put a nurse on it. End of conversation.
Turns out, the process is a little more complex than that.
Great medical case management companies act as air traffic controllers for upwards of 10 stakeholders, including the injured worker, the injured worker’s employer, the employer’s insurance company, doctors and medical specialists, CFOs, Risk Managers, TPAs, attorneys, admins and more.
Here at Viscardi, we’re known for some of the quickest and most efficient case management in the Northeast and getting injured workers back on the job faster than the national standard.
After nearly 20 years spearheading complex cases, here are the three elements we’ve discovered are critical to successful collaborative medical case management:
1. Encourage Direct and Transparent Communication
While each stakeholder is ultimately committed to getting the injured worker healthy and back to work, there are nuances around each person’s objectives. For example, the employer’s main priority is getting the claim resolved as quickly as possible with minimal complications. The medical specialists’ priority is to get the injured worker the care he or she needs—regardless of how long that takes. The insurance company’s priority is to keep costs predictable and their employer customers happy. As medical case managers, we want fast and efficient claims reporting so we can get the injured worker the treatment they need ASAP. (For a breakdown of workers’ compensation key players, check out this article).
To navigate these varying objectives, stakeholders must be direct and transparent with their questions, needs and concerns. To create an environment where each person feels they can speak openly, we collaborate with employers and carriers at the beginning of each case to determine the best route of communication moving forward. Technology now opens up ways to be direct, transparent and prompt in responses.
The alternative? Cases drag out, resources are wasted, the injured worker is impacted and frustration mounts.
2. Humanize the Process
We believe there’s been a palpable shift in the workers’ compensation industry as stakeholders look to increase efficiency by any means possible. Once an industry rooted in personalized, human-to-human care, automated processes and “one size fits all” models now dominate case management strategies resulting in impersonal and detached relations among stakeholders.
The relentless pursuit of efficiency should be the objective of every single stakeholder. But getting to know and relating to one another as human beings is just as crucial to the success of the case. In fact, the most powerful way to inspire people into quick and focused action is to align around a shared belief and work with people they know and trust. Think about your own work experience. Aren’t you more likely to prioritize a task for someone you trust and understand over someone you don’t?
To build that human-to-human connection with stakeholders, we do a few small but important things: we prioritize face-to-face and phone meetings over email; we continuously facilitate open conversations around what’s working and not working and iterate accordingly; and we make sure every person we work with knows the roles, responsibilities and anticipated involvement of each person on our team.
3. Stay Flexible
Each medical case management team is its own unique ecosystem. Every stakeholder brings his or her own set of objectives, expectations, assumptions and timeline which introduces nuances to the best practice strategies followed by the team. For one administration team, huddling together for a meeting every morning works well. For another, holding fewer meetings but staying in contact throughout the day via Group Chat is more productive.
If the true objective is getting an injured worker safely back to work ASAP and making sure each stakeholders’ needs are met, then staying flexible to alternative ways of getting there only increases collaboration and efficiency (and innovates the industry in the process!). When stakeholders bring a rigid approach to case management, they set themselves up for frustration and delays.
To help us stay nimble here at Viscardi, we meet weekly to stay on top of the process. It also offers an opportunity for the group to ask questions, voice concerns and foster an environment of collaboration. We also stay on top of industry news, attend events and regularly check in with clients and stakeholders to help us continue to innovate.
The Importance of Relationships
We find that successful, collaborative medical case management really comes down to relationships. When we can communicate with others in the process openly, share expertise, offer empathy and stay aligned in our objective(s), we create an environment where everyone wins.