missouri issues in workers’ compensation general session

1419 West Main Street, Richmond, VA 23220www.captechventures.com©2009 CapTech Ventures, Inc. // All Rights Reserved.

1419 West Main Street, Richmond, VA 23220www.captechventures.com©2009 CapTech Ventures, Inc. // All Rights Reserved.

Missouri Issues in Workers’ Compensation General SessionMissouri Issues in Workers’ Compensation General Session

Brian Ronnau, Manager804-306-4915CapTech Ventures, Inc.June 8,2009

The Missouri Division of Workers’ Compensation Business Analysis: Where we have been and where we are going.

The Missouri Division of Workers’ Compensation Business Analysis: Where we have been and where we are going.

Proprietary and Confidential – CapTech Ventures 2009 ©

Agenda

■ CapTech Background■ Broad Industry Challenges■ What is a Business Analysis?■ Findings at Missouri DWC■ Benefits to Users■ Common Areas of Concern■ Keys to Success■ Lessons Learned■ Q & A

p.2


CapTech Background

p.3


CapTech Overview

CapTech is an Information Technology Consulting Firm that manages, designs, and builds information systems.

Private consulting firm founded in 1997 Services

• Management Consulting

• Systems Integration

• Data and Business Intelligence

Proven success with Fortune 500 firms and Government Agencies

2005-2008 revenue growth of over 30%

180 employees with a client service focus

Nationally recognized leader in chosen niches

p.4


Project Methodology

Interactive and comprehensive work-plans are fundamental Communication and feedback are critical to success Process engineering is a key focus Developing the right solution for the jurisdiction is the objective

Data AnalysisData Analysis

Develop ScheduleDevelop Schedule

To-be AnalysisTo-be Analysis

As-is AnalysisAs-is Analysis

Stakeholder InterviewsStakeholder Interviews

Provide Reco’sProvide Reco’s

Assess ResultsAssess Results

p.5


Workers’ Compensation Experience

■ Virginia Workers’ Compensation Commission Phase 1: Comprehensive Review of Technology, Process and Organization Phase 2: IS Department Realignment, Collaboration, Content Management and

Training Phase 3: Design & Development Claims, Judicial Systems and Ancillary support

applications

■ Missouri Department of Labor (DOLIR) Phase 1: Current State, Future State Gap Analysis (DWC) Phase 2: Design of DOLIR Enterprise Target Architecture (shared services & reuse)

■ IAIABC EDI Committee Implementation Committee Claims Committee

p.6


Broad Industry Challenges

p.7


Management Domains

p.8

People

Process Technology


Universal Problems

■ People Aging Workforce Resistance to change People are individuals (Goals/Motivations) Overlapping rolls & responsibilities Workers’ compensation is not a priority Politically managed (Constantly changing regulations)

p.9


Universal Problems

■ Process Manual processes (Workarounds) Duplication of work Data Quality Engrained work habits (Decades old) Disregard for downstream systems/processes

p.10


Universal Problems

■ Technology Outdated Applications & Infrastructure Data Quality Application Silos Lack of security best practices

p.11


Workers’ Compensation Unique Challenges – Laws, Regs and Case Law

p.12

Laws and Statutes

Modification challenges

Dated Rules & Regulations

Paper driven process

Century of Case Law

Legal challenges to change

Federal Regulations

Data security and privacy


What is a Business Analysis

p.13


Definition of a Business Analysis

■ Business Analysis is the set of tasks, knowledge, and techniques required to identify business needs and determine solutions to business problems.

So… what does that mean?■ A critical foundational step■ First phase in a business transformation■ Delivers sound fundamentals in support of a broader organizational

and/or technological change

p.14


Business Analysis Breakdown

p.15

•Analyze Existing Environment•Identify opportunity areas

Current State

Review

•Understand organizational vision•Apply industry best practices

Future State Dev

•Determine capabilities•Close gaps

Gapping

•Document recos•Communicate implementation plan

Road-mapping


Findings at Missouri DWC

p.16


Findings

p.17

Siloed Organization

Lack of Transparency Lack of Common Goals

Task Replication Procedure Duplication

Redundant Processes

Insufficient web utilization

Duplicate Entry

Paper Focused

Extraneous forms

Manual Communications

Inefficient Applications


Benefits to Users

p.18


Future State Benefits

p.19

Empowering stakeholders

Leverage electronic communication

On-line portal interaction with DWC

■ Recommended going from a manual, paper-based process to web-based communication

Timely Information

Eliminates paper based forms

Reduction in man hours

■ Recommended moving to R3 EDI and incorporating SROI in addition to FROI



p.20

Reduce redundant activities

Consolidate processes

Reduce off-line activities

■ Recommended re-engineering of organization into focused work areas

Automated Docketing

Self-Insurance analysis supported by financial management module

Automated Claims & EDI engine

■ Recommended system automation to drive efficiencies across the division



■ Recommended strong business analytics to support robust reporting and continuous improvement

p.21

Business analytics engine for reporting

Focus on continuous improvement

More prompt responses to information


The Future State Summary

■ Stop paper at the door (Data Driven Claims Management)■ Automated workflows■ Robust reporting capabilities■ Centralized, transparent docketing■ Accessibility by external stakeholders■ Automated electronic correspondence■ Effective content management■ Manager task administration■ Enhanced business intelligence capabilities

p.22


Common Areas of Concern

p.23


Common Areas of Concern

Insurers■ Update systems to support modernization■ Aggressive Timeframes■ Disjointed requirements from Jurisdictions

p.24

Employers■ Care and safety for workers■ Policy information delivery

Attorneys■ Client impact■ Modernizing internally

Health Care Providers■ Medical Record convergence■ Disparate communication mechanisms


Keys to Success

p.25


Keys to success

p.26

People

Process Technology

■ Strong leadership■ Develop deep relationships with key

members■ Solid change management foundation

■ Begin approval process early■ Show success early and often■ Insure partner needs are included■ Iterative methodology■ Involve external stakeholders

■ Use IAIABC standards■ Evaluate all technology options■ Map data requirements


Lessons Learned

p.27


Lessons Learned

p.28

Communication is key

Align early and often

Document requirements early

Verify and validate


Q & A

p.29


Contact Information

Brian RonnauManagerPhone:(804) 306-4915E-mail: [email protected]

Adam HofheimerDirector – Business Development Phone:(804) 545-3384E-mail: [email protected]

Steve HoldychPrincipalPhone:(804) 647-4836E-mail: [email protected]

p.30

mailto:[email protected]



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