Report to the San Francisco Workers’ Compensation Council Peggy Sugarman Workers’ Compensation Director June 4, 2018
Agenda • Accomplishments & Initiatives – Banking Modernization Project • Performance Quick Facts • Claim Analytics • Financials Workers' Compensation Council Meeting June 4, 2018 2
Accomplishments & Initiatives Workers' Compensation Council Meeting June 4, 2018 3
Accomplishments & Initiatives Pharmacy Benefit Management Program: 2,396 Cards Issued (approximately 33% of open claims) >140 Monthly Department Chargeback and Loss Run Reports automated in early May, reducing ongoing manual report processing Implementation of Batch Payment Processing functionality in iVOS claims system to significantly reduce manual processing effort Successfully integrated DSW employee ID into iVOS claims system, enhancing reporting options that preserve confidentiality and minimize use of SSNs Overhauled employee import from eMerge HRIS database to improve the quality of data fed into claim records at claim setup, and update outdated job classifications Set up an interdepartmental networking group to discuss best WC practices • Section 111 Medicare reporting compliance audit schedule in progress • On-line office ergonomic training in partnership with DPH, Workforce Development, HSS and WCD scheduled to launch July 1, 2018 • Data reporting dashboard for departments to advise of claim costs, frequency, and opportunities for enhancing safety nearing completion • Request for Qualifications for Document Retrieval/Copy Services closed on June 1 • Banking modernization program is on track for phase one implementation on July 1 Workers' Compensation Council Meeting June 4, 2018 4
Banking Modernization • Phase One: Account Migration to US Bank is on schedule for July 1, 2018 • Phase One improvements focus on improving operations, and include: – Automation of Positive Pay; FSP integration for automated bank reconciliation; elimination of a complex manual process for daily funding of benefit payments; automated accounting entries for disbursed benefit payments – Positive Pay service is expanded to include payee name, enhancing fraud controls – Account formation transforms to a Master Zero Balance Account and subsidiary disbursement accounts, reducing administrative risk of accounting errors that cause WC administrative penalties and bank fees; and maximizing City funds in higher yielding accounts for as long as possible prior to disbursement Phase Two (expected Q2) and Phase Three (expected Q3) activate electronic • payments for vendors/injured workers, and medical providers (respectively). These phases will deliver further improvements and lower processing costs for the 295,000 annual payments and 80,000 checks issued annually by the Division. • The overall project is anticipated to lower direct costs by more than $100,000 per year, significantly reduce paper waste for remittance and explanation of review mailings, offer greater flexibility and convenience to all participants in the system, and significantly enhance the use of technology and automation to reduce manual effort in all financial processing activities. Workers' Compensation Council Meeting June 4, 2018 5
Performance Quick Facts Workers' Compensation Council Meeting June 4, 2018 6
FY18 Q3 Performance Quick Facts Fiscal Health Claim Volume Ratio of Actuals to Budget Count of New Claims in Period 472 Indemnity Claims FY18: 92% (estimate) 351 Medical Claims FY17: 94% Benchmark: 404 Indemnity Claims/Quarter Benchmark: 95% 267 Medical Claims/Quarter Duration Claim Cost Average Days Open of Claims Closed in Period Average Cost of Claims Closed in Period Indemnity: $14,597 234 Days Medical: $500 Benchmark: 377 Days Benchmark: Indemnity: $15,818 Medical: $600 Workers' Compensation Council Meeting June 4, 2018 7
Claim Analytics Workers' Compensation Council Meeting June 4, 2018 8
Claim Filing Frequency FY18Q3 FY15-17 FY18Q3 Increase / Decrease Average Average Average Total Indemnity + Total Total Indemnity Medical Indemnity + Indemnity + Department Medical Indemnity Medical Indemnity Medical Claims Per Claims Per Medical Medical Claims Per Claims Claims Quarter Quarter Claims Quarter Department of 90 100 190 88 133 221 -2 or -3% 33 or 33% 31 or 16% Public Health 81 45 126 102 45 147 21 or 25% 0.5 or 1% 21 or 17% Police 70 16 77 84 20 104 23 or 38% 4 or 26% 27 or 35% Fire 37 8 45 38 19 57 1 or 2% 11 or 138% 12 or 26% Sheriff Human 20 14 34 20 13 33 0 or 0% -0.8 or -5% -0.8 or -2% Services Recreation & 19 21 39 19 22 41 0.3 or 1% 2 or 7% 2 or 4% Parks SF Airport 19 14 32 34 21 55 15 or 83% 7 or 52% 23 or 70% Department of 14 15 29 11 18 29 -3 or -22% 3 or 23% 0.3 or 1% Public Works 8 7 14 11 10 21 3 or 43% 3 or 50% 7 or 47% PUC-Water Water 6 4 10 5 7 12 -1 or -21% 3 or 96% 2 or 21% Pollution Control 405 267 672 471 352 823 66 or 16% 85 or 32% 151 or 22% Citywide Workers' Compensation Council Meeting June 4, 2018 9
Claims Incurred Per 100 FTE Top 10 Departments 25 20 Police Sheriff Fire 15 Department of Public Health Citywide SF Airport Department of Public Works 10 Recreation & Parks Human Services Agency Water Pollution Control 5 PUC-Water 0 2014 2015 2016 2017 2018 (Est.) Notes: 1. 2018 (Est.) reflects a straight line of Q1-Q3 claim volume for four quarters Workers' Compensation Council Meeting June 4, 2018 10
Claims Incurred Per 100 FTE Department 2014 2015 2016 2017 2018 (Est.) Police 23 20 23 23 21 Sheriff 22 21 23 20 21 Fire 22 21 19 19 22 Department of 12 12 12 11 13 Public Health Citywide 12 11 11 11 12 SF Airport 9 10 10 10 11 Department of 9 10 11 9 9 Public Works Recreation & Parks 9 9 9 9 10 Human Services 9 7 6 6 7 Agency PUC-Water 4 3 3 3 4 Water Pollution 3 2 2 2 1 Control Workers' Compensation Council Meeting June 4, 2018 11
Claim Cause Distribution Top 10 Claim Cause Groups by Frequency – New Claims in Q3 2017-18 250 200 150 Recreation & Parks Public Health Sheriff Fire 100 All Other Departments Police 50 0 Bodily Exposure Fall, Slip or Cumulative Struck Physcial Abrasion Caught In, Misc Vehicle Motion Trip Trauma By/Against Assault Under, Accident Between Notes: 1. Claim cause group definitions are listed in Appendix 1 Workers' Compensation Council Meeting June 4, 2018 12
Open Claim Stratification 500 450 400 Recreation & Parks Public Health 350 Sheriff 300 Fire 250 All Other Departments 200 Police 150 100 50 0 Notes: 1. $100K+ Total Incurred = $305.4 Million 2. All policy years for which incurred costs >$100k/claim Workers' Compensation Council Meeting June 4, 2018 13
Open Claim Stratification 1,294 Claims >$100k $305.4 Million $72.3M, 24% Data as of 5/10/2018 $98.4M, 32% $11.8M, 4% $31M, 10% $52.8M, 17% $39M, 13% Note: Dollar figures in millions Workers' Compensation Council Meeting June 4, 2018 14
Litigation Statistics Open Indemnity Claims Added Represented Represented % Litigated Claims Litigated % from FY14- Claims FY18Q3 Police 392 179 46% 210 54% Review of open, litigated claims is underway to ensure litigation variable is applied correctly. More data will be available in the Q4 presentation. Workers' Compensation Council Meeting June 4, 2018 15
Financials Workers' Compensation Council Meeting June 4, 2018 16
Department Expenditure Trends FY18 Estimated FY18 Variance Department FY17 Budget FY17 Actuals FY18 Budget YE Actuals Surplus/(Deficit) Police $14,668,764 $16,743,129 $15,691,689 $21,866,069 ($6,174,380) Department of Public Health $12,904,369 $10,292,642 $12,026,726 $11,247,093 $779,633 Fire $9,384,808 $8,755,681 $9,354,940 $7,888,373 $1,466,567 Sheriff $4,886,461 $6,454,201 $5,630,186 $5,464,563 $165,623 Department of Public Works $4,287,435 $2,951,404 $3,598,881 $1,644,558 $1,954,323 Recreation & Parks $3,341,363 $3,206,124 $3,569,246 $1,871,793 $1,697,453 Human Services $2,999,490 $2,263,476 $2,901,364 $2,675,118 $226,246 PUC-Water $2,277,709 $2,258,236 $2,504,098 $1,664,538 $839,560 San Francisco Airport $2,114,957 $2,325,591 $2,494,467 $2,166,143 $328,324 Juvenile Probation $1,192,594 $1,024,725 $1,079,467 $729,156 $350,311 Total Top Ten Departments $58,057,950 $56,275,209 $58,851,064 $57,217,404 $1,633,660 Total of All City $68,653,840 $64,635,152 $69,378,135 $63,851,421 $5,526,714 Departments Notes: 1. Expenditures exclude LC 4850 salary continuation benefits, and include program admin/overhead 2. All budget figures are Original Budget and do not include carry forwards Workers' Compensation Council Meeting June 4, 2018 17
Recommend
More recommend
