Category Archives: Risk Management

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5 Tips for Choosing the Right TPA

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While many risk managers have had excellent experience with their third party administrators (TPAs), others have been disappointed. Unfortunately, when the match isn’t right, the risk manager may be left with poor claim outcomes, higher claims and insurance costs, and difficulty identifying issues and making corrections.

The key to successful relationships often hinges on the risk manager’s ability to set  priorities and evaluate prospective TPAs and other claim service providers accordingly, based on objective, outcome-based metrics. Here are five tips for choosing TPA and claim service providers that are best suited to meet your needs:

  1. Look beyond household names. Too often, risk managers narrow their options based on name recognition.
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    While this might appear to be a safe choice, it may not yield the best fit. And that can lead to higher costs, poor outcomes, and ineffective relationships. Even with name-brand providers, mismatches might exist between the risk professional’s priorities and the service provider’s capabilities and operating cultures of the two organizations, available industry expertise, and resources such as risk management information systems.

  2. Articulate your needs and priorities. An effective relationship starts with knowing the specific requirements of your enterprise and setting relevant priorities. Are you in an industry with unique risks? Do you have a backlog of complex and legacy claims? Is your geographic footprint local, regional or national? Do you have significant operations in states with challenging regulatory frameworks? Do you need a provider with a strong reputation for closing difficult claims or managing litigation? How valuable are the TPA’s data management resources or risk management information system to your program? What’s your claims volume? Conduct a careful assessment of your needs, establish priorities, and create a request for proposal and related scorecard for evaluating candidates.
  3. Check how closely the TPA’s capabilities and resources match your needs. Areas you might examine include: staffing and account management, geographic locations, adjuster case load, pricing structure, reserving practices, quality assurance and training, MMSEA (Medicare, Medicaid and SCHIP Extension Act of 2007) reporting, litigation and subrogation management, managed care, data handling and reporting capabilities, and transition planning.
  4. As practical, insist on outcome-based metrics and use them to compare candidates. When you break it down, the fees charged by claim service providers represent only a small percentage of claim costs. Whenever possible, try to obtain metrics on actual claim outcomes rather than process. Analyze time and cost of various types of claim closures and percentages over time that might apply to your organization, check average claim duration and costs, and examine these results by state, your industry sector and other relevant breakouts.
  5. Know which adjusters will be assigned to your program. They’re the gatekeepers who will make a big difference in your results. So, be sure you know who the adjusters will be on your account. If your largest claims typically demand experienced adjusters with proven track records make sure that’s what you’ll be getting. Find out about their adjuster turnover rates. While some attrition might be expected, you want to avoid situations where you’re constantly re-educating adjusters to get up to speed—especially on complex and legacy claims. Try to ascertain whether their adjusters fit your culture, claims handling approach and priorities.
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Once you make your TPA selection, evaluate their performance on a regular basis. Track the TPA’s results against what you anticipated based on the metrics they provided in response to your request for proposal (RFP).

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By adhering to an objective selection process, including making sure the TPA’s team and capabilities are aligned with your priorities, you’ll be in the best position to get the results you want.

U.S. Dept. of Interior Celebrates National Puppy Day

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Today, March 23 is National Puppy Day, celebrated by organizations everywhere that benefit from the smarts and loyalty of our canine friends. Dogs assist humans in a number of situations including bomb-sniffing dogs on the battlefield, TSA dogs used in airports to locate contraband and as reported in Risk Management, arson dogs are employed to determine the cause of mysterious fires for both fire and police departments. Seeing eye dogs and service dogs for veterans have important jobs as well.

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It turns out that the Dept. of the Interior also has good reason to celebrate our four-legged companions. Dogs do a number of jobs to help the Dept. of the Interior achieve its goals and accomplish its mission of “keeping Indian country, public lands, visitors and wildlife safe.”

Detector dogs work in airports, seaports, mail centers and other critical transportation points. According to the Department: “When people try to smuggle animals or illegal products (such as snakes, sea turtles or rhino horn), U.S. Fish and Wildlife Service’s Wildlife Detector dogs sniff out this hidden contraband. The agency’s seven detector dogs work in entry ports at Anchorage, Chicago, Honolulu, Houston, Los Angeles, Miami and Puerto Rico, increasing the Service’s inspection capabilities and helping surpass what a human team could do by themselves.”

Dogs also pull sleds in Denali National Park and are trained to stop the spread of invasive species and diseases in many areas. Avian botulism, often deadly to birds has become a treat in the Hanalei National Wildlife Refuge in Hawaii, the Department reports.

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Because the disease is easily spread, the U.S. Geological Survey and U.S. Fish and Wildlife Service are training dogs to track down dead birds infected by avian botulism. These dead birds are then removed before the disease can infect other birds and waterfowl.

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According to the Department of the Interior:

At national wildlife refuges, K-9 units ensure the safety of people and other animals. USFWS K-9s have tracked down Alzheimer patients who have gotten lost, sniffed out a hidden rifle used to illegally shoot animals and worked with local law enforcement to track down an armed robbery suspect hiding in water. With a sense of smell and hearing far superior to a human’s, these dogs have proven to be a vital part of the U.S. Fish and Wildlife Service’s mission.

Dogs are welcome in many national parks, but their owners are asked to follow the BARK rules:

B – Bag your waste
A – Always be on a leash
R – Respect Wildlife
K – Know where you can go

Limit Heart Attack Likelihood with Safe Snow Shoveling

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With the northeast hammered by its fourth major snowstorm this month, businesses and property owners in many areas are digging out, breaking out the salt pellets and shovels (just when they were hoping to stash them for the next eight months).

The risk of myocardial infarction rises during snowstorms, especially for someone who is not already physically active. According to the Nationwide Children’s Hospital, snow shoveling leads to about 100 deaths and 11,500 injuries and medical emergencies each year. That is why, to be safe, you and your maintenance worker, or team, should consider some hazards before a dig-out and clearing.

The biomechanics of shoveling are unlike general cardiovascular exercise. In contrast to running or walking, shoveling puts much more stress put on the upper body, as Popular Science noted:

Each time you thrust the snow, the arms rise high, increasing blood pressure further. In addition, you typically perform the Valsalva maneuver: a natural tendency to generate lots of chest pressure without exhaling breathing out (like tennis players do when they hit a ball, or when you push hard against something). This further increases blood pressure.

The American Heart Association (AHA) warns that the potentially lethal combination of intense physical exertion paired with the cold temperatures increases the heart’s workload to sometimes dangerous levels. Some of the AHA’s tips for an incident-free shovel session include frequent breaks, avoiding alcohol and large meals before and after shoveling. The AHA also recommends that you:

  • Use a small shovel or a snow thrower. The act of lifting heavy snow can raise blood pressure during the lift. It is safer to lift smaller amounts. When possible, simply push the snow.
  • Learn the heart attack warning signs and listen to your body. Even if you’re not sure it’s a heart attack, have it checked out. Carry your cellphone in your pocket and call 911 immediately if you experience any signs of a heart attack.
  • Be aware of the dangers of hypothermia. Heart failure causes most deaths in hypothermia. To prevent hypothermia, dress in layers of warm clothing, which traps air between layers forming a protective insulation. Wear a hat because much of the body’s heat can be lost through the head.

Snowy weather often means we don’t always get the nutrients we need from nature. We normally get our daily dose of vitamin D from the sun—which promotes calcium absorption in the stomach and is needed for bone growth and remodeling—but between grayer skies and our need to dress in layers, it may also be advisable to drink a glass of milk or take a supplement to get your dose. Accuweather also cited new research that “decreased exposure to sunlight may factor into the wintertime heart attack equation.”

As the air gets colder, people bundle up before spending time outdoors, leaving less skin to be exposed to the UV rays which aid in the body’s vitamin D production. A vitamin D deficit can accentuate the inflammation of the arteries.

The Snow & Ice Management Association (SIMA) recommends that you:

  • Take a few minutes to stretch. Shoveling snow is a workout so you need to stretch to warm up your muscles particularly because you are shoveling snow in the cold weather. Stretching before you start shoveling will help prevent injury and fatigue.
  • Push don’t lift. Sounds like something a high school wrestling coach may say but if you push the snow to the side rather than trying to lift the snow to remove it, you exert less energy thereby placing less stress on your body.
  • Drink up! Water that is. SIMA recommends taking frequent breaks and staying hydrated. You should drink water as if you were enduring a tough workout at the gym or running five miles.

 

FIU Bridge Collapse Brings Up Design, Safety Concerns

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Munilla Construction Management rendering of the completed FIU pedestrian bridge.

The 950-ton section of a pedestrian bridge’s collapse at Florida International University (FIU) that claimed six lives on March 15 has put stakeholders, design and installation firms under intense scrutiny. After months of preparation, the 174-foot span had been installed on March 10, and investigators and authorities are trying to establish if negligence played a part in the tragedy on SW 8th Street on FIU’s Modesto A. Maidique Campus.

The bridge was constructed off-site and relocated using Accelerated Bridge Construction (ABC), a popular (and usually successful) industry method that aims to reduce potential risks to workers, commuters and pedestrians and minimize traffic interruptions. According to FIU, the bridge should have been a record-setter; on March 10, the University claimed it was “the largest pedestrian bridge moved via Self-Propelled Modular Transportation in U.S. history.” It was also poised to be the first in the world to be constructed entirely of self-cleaning concrete, which would have ultimately reduced maintenance costs.

Munilla Construction Management (MCM) was the Miami-based construction firm hired by FIU to manage and construct the FIU-Sweetwater UniversityCity Bridge, which jointly worked with design firm FIGG Engineering-Bridge Group. Barnhart Crane and Rigging operated the Self-Propelled Modular Transporters that placed the bridge on its permanent supports, and engineering firm BDI was subcontracted to conduct monitoring while the bridge was moved into place.

It was expected that the footbridge would be completed and operational in early 2019 and would also have served as a study and gathering space for students. The $14.2 million project was funded by Florida Department of Transportation, FIU and the City of Sweetwater, U.S. Department of Transportation (DOT) TIGER Grant, but the blame shifting has already begun. The Miami Herald reported:

…the project required “an independent, secondary design check,” and the design team, FIGG Bridge Engineers, hired another engineering firm, Louis Berger. That firm “was not FDOT pre-qualified for this service, which is required under FIU’s agreement with the state. FIU’s design build team is responsible for selecting a pre-qualified firm and ensuring this process is followed.”

The main span of the FIU-Sweetwater UniversityCity Bridge was installed in a few hours with limited disruption to traffic over the preceding weekend. FIU stated that on the morning of the collapse that MCM and FIGG met to discuss a crack on the on the structure, but ultimately concluded that “there were no safety concerns and the crack did not compromise the structural integrity of the bridge. This meeting lasted approximately two hours and included FIU and FDOT representatives.”

FIU added an FAQ page to its website in the aftermath of the collapse. It clarifies that FIU did not yet own the bridge “because it was still under construction” and names the key stakeholders, but does not yet reveal what was happening at the time of the collapse “because it still does not yet have the information.” The DOT stated that Secretary Elaine L. Chao dispatched Federal Highway Administration professional staff to the site to support the National Transportation Safety Board’s (NTSB) investigation.

An insightful article published by Wired explains the ABC process and looks at other incidents, noting that in this case the collapse could stem from design flaws and possibly loose cables burdened by the weight of the bridge.