Richard Victor retires this month as president and chief executive officer of the Workers’ Compensation Research Institute, bringing to a close 32 years of honest and clear leadership on how to think about work injuries.  

Richard Victor

Victor led industry practitioners and regulators to making injury response more transparent and intelligible.  His most important legacy is, I think, to induce industry participants to act in a more accountable way among themselves and to society at large. The workers’ comp system’s treatment of injured workers is under the most severe scrutiny since the early 1970s. In large part due to the WCRI, the industry is less insular than in the past and ready to respond to the challenge.

With an economics PhD and law degree, Victor is a public policy expert turned analysis entrepreneur for an industry with millions of legal and managerial decisions a month.  He saw in every work injury a natural experiment in the efficacy of the state-based benefit system. 

In 1983, when he become WCRI’s founding president, the industry had little capacity or appetite to analyze itself.  Claims databases were primitive. In his application for the position at the WCRI, he said he wanted to locate the organization in Cambridge in order to draw upon the area’s research talent.

Patiently, persistently, he nurtured among claims payers, employers and state agencies financial support for quantitative analysis. It took until the 2000s for the Institute to produce regular multi-state reports through its CompScope program. Some states are in their 16th edition of CompScope this year.

Before he had his own immense database, he often relied on the analysis of others.  CNA released at the 1996 annual conference a devastating critique of the cost-effectiveness of telephonic case management, drawn from a comparative analysis of six simultaneous trials.  I recall the consternation on the face of one sales executive in the audience.

Up through the mid 1990s, many insurers and pure claims operations had limited information technology, capacity for data storage, analysis and reporting. But with 1990s came large database systems, a host of analytic tools, and a large supply of PhDs with training in modeling.

The WCRI’s standard approach is observing variances in cost, utilization and other measures. In the 1990s, it reported an almost 50% difference between the total cost per paid claim in the Austin/San Antonio area and the El Paso area.  In mid-2015, it reported how rates of back and knee surgery in 13 states differed, and why.

These kinds of variances, the WCRI has said often, cannot be plausibly explained by differences in state workers’ compensation law. Economic and social factors and dynamics within the medical and communities were the drivers.  Delivering with this kind of documentation, the Institute inspired thousands to think more imaginatively. 

There is a causal connection from the Institute’s work and the emergence of an analytical community within for-profit ventures.  Jeffrey Austin White, director of innovation at Accident Fund Holdings, told me that Victor “is able to see beyond work comp and able to find talented researchers that help us understand future opportunities in the context of economic change and state/federal legislation. We have adapted our own business strategies in response to WCRI research on opioid utilization, physician dispensing, medical treatment cost shifting, and work comp market dynamics.”

The Institute has not danced at every industry wedding. It did not, for instance, devote much time to predicting injury outcomes, which others have studied in depth.  I sense that Victor has tried to do as much as he could with limited resources. One investment that may have required some coaching of his advisory board was interviewing injured workers.

At its fall 2003 research conference, a groundbreaking survey of claimant satisfaction with medical care was unveiled.  The results were both reassuring and disturbing, a typical Victor cocktail. The WCRI reported how 3,000 lost-time injured workers in four states not only graded their medical care, but also reported how they recovered physically and vocationally.  A more recent worker survey led to a widely cited report that the injured worker’s trust in the employer plays an important role in injury outcomes.

Well-done research on work injuries thrives when skilled researchers apply themselves within an ecology of similar research.   Much of this good research is hidden from the view of practitioners because it appears in research journals.  Much of it is visible, published by the WCRI, the California Workers’ Compensation Institute, NCCI, and other centers. More and more of it come from for-profit ventures.  Among the now many and varied individuals and organizations part of this research ecology, Rick’s WCRI has been the most energetic and effective.