Integrated Disability Management: Fulfilling the Promise
The concept of Integrated Disability Management (IDM) has been around for years, but its promise has never truly been fulfilled. Employers have had to juggle multiple platforms to manage, track and report employee absences, including workplace injuries, long- and short-term disabilities, leaves under the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA), and so on. But using multiple platforms makes it difficult to coordinate payments, reports and communications among health care providers, state and federal agencies, and other vendors, and it can increase risk of noncompliance under constantly evolving state and federal regulations.
“The real liability for the employer is if there’s a convoluted process,” says Kevin Newlin, solutions consultant in the risk management division at Ebix. “When there isn’t consistency in how employees are communicated with, it opens up the employer for liability and lawsuits, in addition to increased costs and administration.”
Now that technological advances have made integration so much easier, IDM is an achievable reality for many medium-sized and large businesses. Companies that use integrated systems can establish a single point of entry for employers to log, track, manage and report absences, whether it’s a sick day, parental leave, disability leave, a workplace injury or another absence. In short, the promise of IDM is now a reality.
The results can be remarkable: increased efficiency, reduced costs, higher compliance rates and improved employee service. By simplifying the process on the front end, service to internal and external stakeholders is markedly improved.
This white paper will examine the scope of capabilities IDM can offer, the advantages of using IDM and what your organization needs to implement it.
What Is IDM?
IDM is an integration process that brings together different platforms and provides one point of entry for different functions related to benefits, HR and compliance, including incident reporting, insurance claim management, nurse case management and compliance reporting. Each of these systems may belong to different departments, such as HR, risk management and benefits administration.
Companies that are ripe for IDM processes will have systems that support the following functions:
Initial Incident Reporting
Ensuring this first notification of loss is streamlined and easy to use gives a good experience to the employee while capturing the information necessary, Newlin says. Automated notifications then let people in risk management or claims management determine whether the injury or loss is legitimate, and how it should be further reported. This information can also be used to populate analyzable databases that leaders can use to determine whether proper safety considerations are in place, or if a process could be improved, Newlin says. These systems also should integrate with state workers’ compensation reporting systems.
Insurance Claim Management
Whether the absence will be filed under workers’ comp or the employee’s health insurance, tracking the claim through the process and ensuring compliance is vital. Integration with policies and risk assessment can help employers save money as well. And when employees are looking for answers, IDM can help get them the right ones. “It’s the employer's responsibility to correctly notify the employee of their rights such as amount of time off, reinstatement and accommodation,” says Charles Krugel, a management-side employment lawyer based in Chicago. “If the notice is messed up, that almost guarantees some sort of complaint or investigation.”
Nurse Case Management
Once a claim is processed and adjusted, information is often handed off to nurse case management. Nurse case management may include a return-to-work program or treatment plan to help people get back to work more quickly, says Karen Eaton, a project manager at Ebix. There may be accommodations such as part-time hours or a different workload, and systems are able to track these variations, Eaton says. “It’s a downstream flow from the first incident, and the more integration where providers can come in, the better,” she says.
Each state has its own workers’ comp board that requires different reporting procedures. In addition, employers must report certain types of workplace injuries to the federal Occupational Safety and Health Administration and the Centers for Medicare & Medicaid Services, each requiring its own platform. Look for ways to integrate ongoing payment and incident reporting as well as required reports to state and federal organizations, Newlin says.
Through it all, information is flowing into the system at different points from employees and managers as it flows outwards to providers, vendors, regulatory jurisdictions and other stakeholders in the cycle. But because these systems aren’t necessarily integrated, it can be difficult for one user at a certain point in the cycle to access useful information another platform holds but hasn’t passed on through the cycle. An overarching integration that a variety of internal and external users can access is the promise of IDM.
The Benefits of IDM
IDM brings several specific advantages to what is often a complicated and messy process, no matter how carefully your organization has picked its platforms and follows procedures. Companies often recognize they have a need for this level of integration, Eaton says, but they may not know how to make it happen. Integrating doesn’t replace people or resources; it supplements what they do and gives them the opportunity to be more efficient and accurate, Eaton says.
Some of the advantages that a strong IDM solution can bring include:
Managing employee absences relies on a uniform process that captures and shares the right information every time, then collects it and reports it in a way that makes it useful for other stakeholders. In addition, cleaner data means improved analysis when trying to make changes to processes for safety reasons. And a consistent approach reduces overlapping communications among vendors.
Multiple forms mean multiple filings and more time completing redundant tasks. Integrating platforms also means eliminating overlap among vendors, who can then take less time when resolving cases. In addition, every interface you use between different systems likely needs periodic upgrades, resulting in down time and sometimes incompatibility. An overarching IDM integration reduces these issues.
A uniform integration standard provided by IDM helps ensure that information doesn’t get lost and that systems stay compliant when regulations or rules change. Improved case management also reduces risk from dissatisfied employees, unpaid providers and other issues. In the long run, Newlin says, an organization can analyze trends and determine whether some areas need more resources to reduce incidents.
All of the above lead to cost savings, whether through saved time and effort, reduced fines or overpayments, or lost time to injuries. Reducing administrative costs is a big one, Newlin says, while other savings are often seen over time.
Improved Employee Relations
A person off work because of an injury wants consistent, helpful information, Eaton says. “If the right resources aren’t contacting them, their first tendency is to sit there and not get things done. But if you’ve got someone contacting you and the case is being handled well, that’s an energizer.”
“Any time we’re dealing with employees and injuries or incidents, if the process is done right, those employees are contacted immediately, the employer is aware of immediately, and they can direct them to the proper resources,” Newlin adds. This level of service is a key factor in getting people back to work and reducing time off, he says.
How to Implement IDM
Implementing an IDM solution at your organization isn’t hard, but it does require a few things before you get started. Through it all, the company must be ready for change, Eaton says. Highlighting the end result can help: “It helps people do the things they want to be able to do but can’t because they’re bogged down in process,” she says. “They say things like, ‘If I could take this up a level and research this information’; system integration is what will give them that opportunity.”
Here’s how to do it.
- Identify a point person. It helps to have one person driving the integration to keep the process consistent and moving. If necessary at larger organizations, a small team with members from HR, IT, risk management and benefits management may be appropriate.
- Get alignment across your organization. The point person or team will need a champion within the organization to create alignment and implement change. “The biggest challenge within the company is that these types of leave are handled by different levels or silos within the organization,” Newlin says. Having a C-level leader who understands the importance of buy-in from individuals in risk management, HR, benefits administration, health and safety, and other departments is key.
- Document your processes. Where is information coming from, and where is it going? How might some of your systems integrate? “It may seem like there’s existing processes in place for one or more of these types of losses or absences, but recognizing the similarities and being able to merge the two processes can be kind of a challenge,” Newlin says.
Through it all, work with a partner who can identify where these efficiencies are and who has the tech capabilities to deliver. Some of your platforms may already come from a family of systems that are easy to integrate. “Like any third-party solution, an IDM is only as good as the provider,” Krugel says. Vet potential IDM administrators as you would any vendor to get the best fit.
Absence management, tracking, reporting and analysis are ripe for automation, but until now the ability just wasn’t there. Employers were stuck with dealing with multiple systems that sometimes didn’t work well together, putting themselves at risk for noncompliance, missed payments and unhappy employees.
Things have changed. Using platforms that integrate well together and taking a big-picture approach to absence management can mean the promise of Integrated Disability Management is fulfilled, resulting in lower costs, increased compliance, improved employee service and better business outcomes over time.