I was talking at length last week with a good friend who works for a large payer, discussing the process of getting the organization to make significant, and very much needed, improvements to its managed care program.

Joe Paduda

This got me thinking: By no means is this situation unique to that one payer. If anything, resistance to change is a consistent thread throughout the workers' comp payer/buyer/service industry. Pondering this over the weekend, I came up with a few warning signs and reasons for the resistance.

Warnings signs

• Statements such as "We've always done it that way," "That's our policy" or "That's how we handle X here" can indicate pride and consistency, traits that are often excuses for not thinking more deeply about specific issues. Policies are good, as long as they're ruthlessly examined under a very bright light on a regular basis.
• Long, exhaustive, exhausting studies and analyses and research into a new idea, especially those that involve a large committee of folks with lots of other, higher priorities. Committees are where good ideas go to die. A culture of fear, where junior staff wait to hear what the boss says before chiming in, where criticism is pointed and personal, where people are afraid to speak up for fear of being criticized or chastised.
• A resistance to comparison and measurement, where managers seek to report the data that demonstrates positive results (or at least results that help them achieve their bonus targets) and don't look for ways to compare their performance to competitors or the industry as a whole.
• Complacency, rampant in the industry and marked by a refusal to listen to contrary opinions with an open mind.

Why?

There is a cultural issue in comp, a risk avoidance at all costs mentality that is blocking needed change.

Joseph Paduda is the principal of Health Strategy Associates, a consulting firm focused on improving medical management programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.