New Rate-Fast Data-Driven Rating Method Will Save Stakeholders Millions of Dollars and Years of Litigation
ST. PAUL, Minn., April 3, 2024 /PRNewswire-PRWeb/ -- Hamline University, in collaboration with impairment rating calculations company Rate-Fast, today announced groundbreaking research that revolutionizes the assessment of impairment in workers' compensation cases. The study validates a novel algorithm-based Functional Loss Rating (FLR) method, which offers a more objective, efficient, and cost-effective approach for calculating a whole-person impairment (WPI) score, upon which compensation for work-related injuries is based. The study demonstrates that the computational FLR method is consistently more accurate than the traditional, manual Four Corners Rating (FCR) system, the current industry standard for WPI measurement.
The new FLR method solves a major problem in the workers' compensation system: It takes too long to agree on WPI ratings, delaying claim settlements by months or years. In California alone, it takes 11 years on average to resolve 95 percent of indemnity claims[i]. The current FCR process relies on extensive manual exams conducted by doctors, making it highly variable and often resulting in years of wrangling over the veracity of WPI scores among injured employees, employers, doctors, insurance companies, and lawyers.
In sharp contrast, the advanced analytics–based FLR approach uses simplified patented computations to produce an accurate rating in mere minutes, according to a thorough investigation by Hamline University. This objective, data-driven methodology can potentially save all parties significant time and money by helping them come to a resolution more quickly and get workers reimbursed for the treatment they need.
FLR Uses Data Science to Bring Speed and Consistency to Impairment Ratings
FLR is a mathematical impairment evaluation method that uses advanced data analytics to calculate an objective, accurate WPI rating. The algorithm at the heart of FLR was built on more than a decade of research comprised of nearly 70,000 impairment case rating experiences. It introduces the concept of an "impairment signature," an interpolated number between 0 and 10, that represents both the decline in activities of daily living (ADLs) and reported patient pain and/or symptoms. Its singular focus is on determining the functional loss of the injured worker.
To arrive at this impairment signature, FLR replaces over 250,000 manual calculations detailed in the FCR method. With FCR, a physician must use the American Medical Association's Guide to Permanent Impairment (AMA Guides), 5th Edition, to come up with an evaluation of a patient's overall health, including their perceived pain, the percentage by which their ability to conduct ADLs has declined, and their broader medical history, among many other variables. The doctor must examine and rate multiple subsections of each body part, attempting to follow and interpret an exhaustive 600 pages' worth of AMA Guides guidelines, charts, and tables.
Instead of poring through the AMA Guides, FLR merely requires a physician to provide a tiny fraction of this information delineated into three elemental, focused data points—1) pain/symptom score on a scale of 0 to 10, 2) pain/symptom frequency, 3) and ADL loss—the most important variables for determining WPI ratings. The resulting FLR impairment signature provides a WPI score that objectively measures what the findings of an FCR report hopes to estimate. In a head-to-head comparison, the FLR method and traditionally prepared FCR cases produced similar results 100 percent of the time for shoulder injuries and 98.2 percent for lumbar spine cases, according to the university's rigorous analysis. Knee ratings were found to demonstrate that the traditional FCR method would at times erroneously assign a WPI rating that was not accurately supported by actual loss of ADL function.
"FLR reliably produced accurate WPI ratings that would satisfy all stakeholders within the workers' compensation system in no time," said Bruce Bolon, PhD, associate professor of physics at Hamline University. "FLR would spare all parties years of time, money, and headache, and help get aid in the form of financial payouts into the hands of injured employees significantly quicker."
"In my years of service within the workers' compensation industry, I have witnessed firsthand the challenges in achieving accurate and equitable injury assessments," wrote Don Hurter, senior advisor at Carisk Partners. "By providing a direct measurement of functional loss, this new method appears to enhance accuracy and integrates internal validation of workers' comp settlement reports, specifically in the California market."
"With Rate-Fast, we've been able to give both our new and existing medical providers basic instructions on how to complete a report request for their exams. Now, instead of three or four providers, we have 62 providers who can do this regularly," said Scott Prysi, MD, medical director of Doctors on Duty Medical Clinics. "Cases are being resolved promptly, which is appreciated by the patients and the adjusters."
A true breakthrough solution, the FLR method pares down a years-long workers' compensation evaluation process into a few simple mouse clicks. The dramatic increase in efficiency that FLR brings to the impairment evaluation process can reduce litigation and streamline claim negotiations, benefiting all stakeholders, including injured workers, employers, doctors, insurance companies, and lawyers.
"Using a data-based lens, we isolated the truly pertinent variables that produce reliable WPI ratings," said Dr. John Alchemy, MD, QME, DWC Educator, founder and CEO of Rate-Fast. "By applying the discipline, rigor, and data-driven analysis common in other parts of the insurance and healthcare industries, FLR delivers the methodology needed for transparent, fair, and cost-effective workers' compensation settlements."
"By focusing on functional loss, FLR provides a more direct and precise measure of impairment that can be used to standardize, correct, and normalize WPI ratings across all body parts," said Bolon.
To view Hamline University's report, please visit www.rate-fast.com.
About Hamline University's Department of Physics
The Department of Physics at Hamline University, located in St. Paul, Minn., is a hub of scientific exploration and discovery. With a commitment to excellence in education and research, we offer a dynamic curriculum and hands-on research opportunities, guided by our expert faculty. Our state-of-the-art facilities support a learning environment where theoretical knowledge meets practical application, preparing students for successful careers and advanced studies. At Hamline, we're dedicated to shaping the future of physics through innovation, collaboration, and community engagement, contributing to our global understanding of the physical world.
About Rate-Fast
Rate-Fast's mission is to resolve workers' compensation claims quickly, accurately, and transparently by standardizing impairment ratings. The company seeks to remove the subjectivity in the workers' compensation impairment assessment process that leads to unresolved claims and causes significant financial burdens to clinicians, payers, nurse case managers, and employers. Developed by Qualified Medical Examiners (QMEs), Rate-Fast implements California's AMA Guides, 5th Edition standards to score pain levels, assess loss of function, and discern apportionment accurately. With over 80,000 claims complete, Rate-Fast's proprietary technology leverages predictive analytics for claims with missing data so all stakeholders can make informed decisions throughout the workers' compensation process.
Founded in 2013, Rate-Fast is a privately-held company based in Santa Rosa, Calif. For more information, please visit www.Rate-Fast.com.
[i] California Medical Payment Development Up to 30 Years Post-Injury, July 2015, G. Johnson, Workers' Compensation Insurance Rating Bureau of California (WCIRB)
Media Contact
Jon Lavietes, Rate-Fast, 1 415-572-4408, [email protected], www.rate-fast.com
SOURCE Rate-Fast
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