Rising Medical Solutions Publishes 12th Annual Workers' Compensation Benchmarking Study

Wednesday, August 6, 2025 | 275 | 0

Focus Group Research Reveals How Industry Leaders Are Balancing Digital Transformation with Human-Centered Claims Management

August 6, 2025 -- Chicago, IL -- Rising Medical Solutions today announced the release of its 12th annual Workers' Compensation Benchmarking Study Report. The newly published study examines how claims organizations are successfully navigating the challenge of implementing digital transformation while maintaining the human elements essential to optimal outcomes.

Based on comprehensive, first-person focus group research conducted with claims and medical management executives, the latest annual report provides real-world strategies that high-performing organizations are using to deploy artificial intelligence (AI) to enhance human performance and strategic productivity while simultaneously investing in human judgment and emotional intelligence that technology cannot replicate.

"The workers' compensation industry faces a pivotal challenge: how to harness AI's potential without sacrificing empathy or outcomes," said Rachel Fikes, Chief Experience Officer and Study Program Director at Rising Medical Solutions. "Our research reveals that successful organizations aren't choosing between technology and human connection they're strategically combining both to create better experiences for injured workers while improving operational efficiency and job satisfaction."

Key Research Focus Areas
Conducted late last year, the 2024 study concentrates on three industry challenges identified by executive participants as most critical to investigate during the focus group research exercise:

1. Administrative & Regulatory Compliance Burden: With 46% of claims professionals spending 30-40% or more of their time on routine tasks, the research identifies how AI and automation can reduce this burden while freeing professionals to focus on higher-value, human-centered work.
2. Industry Transformation through Technology & Customer Engagement: The study reveals strategies organizations are using to leverage customer-facing technologies from other industries such as banking, retail, and auto insurance to rapidly advance technology ecosystems and create personalized digital experiences for injured workers.
3. Talent Skills Gap & Attracting New Workforce Entrants: With demand for claims professionals at a 13-year high, the research explores how organizations are expanding recruitment pools, enhancing training programs that upskill claims staff in both emotional intelligence and the use of AI, and creating cultures that embrace innovation instead of resisting it.

Real-World Solutions for the Future
The resulting 2024 Report identifies practical use cases and actionable strategies that organizations should consider prioritizing in the next one to three years to drive competitive advantage. The report cites that organizations fully embracing AI see twice the measurable benefits compared to others, including increased productivity and profitability. However, the study emphasizes that successful digital transformation must start with understanding customer and frontline user needs rather than leading with technology.

"Claims professionals bring irreplaceable expertise and compassion that technology should work to strengthen, not eliminate," noted Fikes. "Our research shows that organizations achieving the best outcomes are those that use AI to handle repetitive tasks while empowering their people to build stronger relationships with injured workers."

Continuing its tradition of industry contribution, the 2024 Study Report is available to all stakeholders at no cost. Interested parties can request the 2024 Report here.

About the Workers' Compensation Benchmarking Study
The Workers' Compensation Benchmarking Study is a national research program examining the complex forces impacting claims management in workers' compensation today. The study's mission is to advance claims management in the industry by providing both quantitative and qualitative data. Through survey research with claims leaders and practitioners nationwide, the program generates actionable intelligence for claims organizations to evaluate priorities, challenges, and strategies amongst their peers. Conceived and directed by Rising Medical Solutions, the ongoing program is a collaboration of industry executives representing diverse organizational perspectives, including the Study's Principal Researcher and Advisory Council:

• Denise Zoe Algire, Director of Health | Albertsons Companies
• Marcos Iglesias MD, VP, Chief Medical Director | AF Group
• Paul Kearney, Chief Claims Officer | AF Group
• Robert Biltz, Vice President, Claims | AmTrust Financial Services
• Tyrone Spears, Chief, Workers' Compensation Division | City of Los Angeles
• Kelli Chapman, Vice President, Claims | Eastern Alliance Insurance Group
• Thomas Stark, Regional Vice President, Commercial Lines | Encova Insurance
• Daniel Conley, Partner, Senior Vice President, Director of Claims | FutureComp
• Helen Weber, Assistant Vice President, Head of Medical Strategy | The Hanover Insurance Group
• Adam Seidner, MD, Chief Medical Officer | The Hartford
• Victoria Kennedy, Vice President, Workers' Compensation | Linea Solutions
• Jaclyn Tiger, Senior Director, Claims, Workers' Compensation | Markel
• Jennifer Barth, Vice President, Chief Legal & Claims Officer | MEM
• Stacy Foote, Vice President, Claims | The MEMIC Group
• Michele Lewis, Medical Services Director | Montana State Fund
• Molly Flanagan, Assistant Vice President, Workers' Compensation Claims | Nationwide
• Shannon DelGuercio, Director, Workers' Compensation | Publix Super Markets
• Brigitte Hamilton, Vice President of Claims | SAIF
• Sarah Grace, RN, Managing Director, Workers' Compensation Product Medical Innovation & Strategy | Travelers
• Brian Trick, Senior Director, Employee Health & Claim Services | Wegmans Food Markets

About Rising Medical Solutions | We Make Lives Better.
Rising Medical Solutions is a national managed care firm that provides medical cost containment and medical care management services to the workers' compensation, auto, liability, and group health markets. Rising's mission is to "make lives better," by taking the pain out of the healthcare experience for those providing, receiving, and paying for medical care.