Rising recently released their 13th Annual Workers' Compensation Benchmarking Study.
Rising Medical Solutions 13th Annual WC Benchmarking Study – Next-Gen Claims Differentiators
How High Performers Operationalize Strategy – Execution and Strategy
The annual Rising Medical Solutions Workers’ Compensation Benchmarking Study is a national research program examining the complex issues impacting claims management. Rising Medical Solutions (an MSIA member) has been behind the study since its’ inception 13 issues ago. Each year, the study highlights the differences between higher performing organizations and the run-of-the-mill organizations.
Given the consistency of the study, there is a high credibility level with the study.
What makes a difference?
How do they achieve it?
What are the key take-aways to make your organization one of the higher performers?
These and other questions are answered every year.
Higher performers are defined by a claim closure ration of 101% or higher; lower performers are below 100%. Merely closing claims is not a true differentiator – they must be closed with a high level of quality, so they do not generate regulatory action, litigation, or re-openings. “Organizations are not differentiated by priorities alone. Stronger outcomes emerge when people, processes, technology and culture are aligned to execute them effectively.” It is execution as well as strategy.
Higher performing organizations are not necessarily managing less complex claim inventories – quite the opposite, according to the study. They are more likely to report higher concentrations of active indemnity claims. It’s one thing to talk a good game – or to have the right plans in place – and it is quite another to execute properly. This years’ findings emphasize that it is a good strategy combined with execution that makes a difference.
For example, A.I. is important – no questions about that. Higher performing operations invest in implementation plans that rely heavily on engaging front line staff in the design, pilot programs and create feedback loops that must be closed, before program launch. Their programs and changes are made with a level of consistency and end-user input and support. That’s where culture comes in to play. The expectation at the front line level is that their input would be pursued and valued. And, organizational leadership demonstrates their dedication to listening to what the people who do the work are telling them by removing or designing alternative solutions when work performance roadblocks are identified.
Based on the study High Performers:
They Choose Better: Higher performers rely more heavily on frontline insight and operational data to identify improvement opportunities, prioritize investments, and select high-value initiatives.
They Reduce Friction: Higher performers are more effective at identifying operational pain points and designing solutions that reduce administrative burden, simplify workflows, and improve day-to-day claims execution, contributing to stronger gains in staff efficiency.
They Drive Adoption: Higher performers actively engage frontline staff throughout implementation, using pilot programs and feedback loops to test, refine, and improve solutions before scaling them across the organization.They are also significantly more likely to foster innovation and change adoption through leadership behavior modeling.
They Build Strength: Higher performers invest more heavily in workforce development, knowledge transfer, leadership readiness, and organizational capabilities that support ongoing improvement and future performance.
A more in depth discussion of the study and the findings can be obtained through this link to the recorded Webinar held in August, 2025 Benchmarking Study Webinar. As well, you can request a copy of the full study here: Rising Medical – WC Benchmarking Study.
*Originally published in the MSIA UPDATE, a publication of the Montana Self Insurers Association.