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Workers' Compensation Board

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The BPR Program Foundation


The BPR Program is built upon a foundation of analysis and stakeholder input. The following page describes the phases of the BPR Program, as well as where it is going.

Discovery and Design Phases (January 2012-September 2014)

The approach to the prospective system design is represented in the diagram below. Each component is described in the section that follows.

Inputs of Stategic Vision, As-Is Documentation and Leading Practices goes to Acitvites with Working Teams and Focus groups providing output to Board systems
  1. Strategic Vision – As a key project both for the Board and for the state as a whole, it is critical to understand the justification and motivation of the executives for undertaking this project now. To this end, the Board conducted interviews with Board executives to develop themes for future visioning sessions and to identify the measures of the Board's success as well as anticipated obstacles to achieving this vision. These visions for the project and the proposals coming from it, fell into two categories — those overarching visions that the executives believe all system participants share, such as transparency, simplicity and communication, and those that are more tailored to particular groups of participants such as timely payment of appropriate benefits, dignity and self-respect for claimants, and effective system performance and cost control for employers.
  2. An assessment of the current system (a.k.a. "As-Is Assessment") – This assessment was based on input from both internal and external sources. In addition to the working teams' review of the current state of the system, multiple sessions were held with system participants around the state. These sessions were both in person and by video and teleconference calls, and webinars. We used surveys to reach injured workers — who responded in the thousands — and also invited comment by email to a dedicated email address.
  3. Leading practices – The workers' compensation system in New York is nearly 100 years old. All states have some form of workers' compensation system. As changes were considered, the experience of other states was considered to validate proposals, identify potential challenges and solutions that other states had experienced, and to discard proposals that other states had found not to work.
  4. Workers' Compensation Board Working Teams – These teams were created by the Board to focus on each of four functional areas. These areas are:
    1. Claims Management
    2. Compliance and Monitoring – Oversight
    3. Medical Provider Management
    4. Adjudication and Appeals

    While the teams focused on specific areas of activity within the system as a whole, and the Board in particular, the members of the teams were drawn from all areas and levels of the organization. In this way, a variety of perspectives and experience were brought to bear on each issue, to fully understand the impact of each change and identify the potential for unplanned results.
  5. Focus groups – Focus groups were created to ensure continuous feedback and input from all the participants in the system. As suggestions came from the Workers' Compensation Board working groups, these were formed into propositions which were shared with and discussed by the focus groups. This approach provided several invaluable perspectives. First, the approach quickly identified perceived benefits and potential issues with each of the suggestions. Second, the ensuing discussions helped identify where the participant groups were aligned and where their perspectives diverged. Third, the discussions and contributions by the focus group members helped deepen the Board's understanding of the issues underlying the propositions and understand the importance of the transition plan or "road-map" in determining the success of this project.

Implementation Phase 1(Initiated September 2014)

Please view the February 2014 Webinars for an overview of the recommendations.

The first phase of implementation is focused on building the high priority solutions in the following areas:

  1. Medical Authorizations. Establish a faster, streamlined approach using the Internet, to make medical authorizations (and denials) faster.
  2. Virtual Hearings. Pilot a series of hearing sites equipped with online meeting capabilities to support virtual hearings.
  3. Medical Fee Schedule. Implement an updated Medical Fee Schedule that increases payments and equalizes the payment structures across medical disciplines.
  4. Payor Compliance. Implement better performance reporting in order to ensure timely payments to injured workers.
  5. Improved Resolution Processes. Implement several faster resolution processes for claimants including an improved Section 32 process and a new Voluntary Binding Review process.
  6. Customer Experience. Improve the customer experience across the call center, hearing sites and website with faster, more consistent information and improved customer service. Improve the hearing site furniture. Overhaul the website. This effort will span phases.