Arbicare March 2024

IAIABC: Please provide a description of your organization. 

Alex O'Neal, CEO, Arbicare: Arbicare got started in August of 2019 and is headquartered in Atlanta, GA. Arbicare is a URAC accredited and nationwide utilization review and peer review organization. We specifically serve property and casualty payer organizations including employers, carriers, and third party administrators. Through the first 4.5 years in business, we’ve been able to meet and surpass many of the internal goals we set for ourselves.  

Arbicare’s specific mission is to promote evidence-based medicine that will improve clinical care and accelerate patient recovery. Service excellence is the core value on which Arbicare was founded. Arbicare has succeeded as the result of the client service first approach we bring to partnership. Every decision about corporate strategy, operational execution, and service development has been made to enable a peerless customer experience in the managed healthcare space.

Arbicare Logo

IAIABC: What do you see as the most important role you play in the workers' compensation industry?

AO: Utilization management is a medical management service designed to inject evidence based medicine into the treatment of patients. Researchers have concluded that compliance with the Official Disability Guidelines has been shown to reduce claim duration by 13% and reduce medical costs by 38%. 

As the industry’s first advocacy-based UR organization, we believe that employees who are valued during difficult times are employees who recover. We do that through creating the industry's highest levels of communication with the provider to help facilitate evidence-based care.

Human interaction isn’t transactional, it’s a relationship. We lean into that. The value of each relationship we form by creating more interactions informs better care and injured worker recovery.

IAIABC: What do you see as some of the major challenges the industry is facing, and how can we as a community address them?

AO: There’s no doubt that mental health is one of the most important and complex challenges we face as an industry. The biopsychosocial health model has become frequently used over the recent years and for good reason. Our number one job as an industry is to help people recover from workplace injury. Historically we’ve treated musculoskeletal injury primarily through the bio (physical health) component of the model while largely ignoring ⅔ of the recovery model.

Unemployment, precarious employment, and employment conditions continue to be routinely linked to increased psychological distress. Family relationships and past trauma can be major barriers to recovery and need proper treatment, otherwise recovery and claim resolution become substantially more difficult. The NEJM Catalyst Insights Council (comprised of healthcare executives, clinical leaders, and clinicians) were surveyed and the results show that family / friends support is the number one motivator for realizing health goals - even surpassing financial rewards. Support from all those who interact with the injured employee increases the chance of recovery. Medical professionals, examiners, case managers, social workers, and managed care providers can all have an impact on patient recovery. 

The whole person health model is appropriately becoming more well understood. It’s time to both continue learning but more importantly, start helping.

IAIABC: Are there any projects/programs/initiatives going on at your organization that you are particularly excited or enthusiastic about?

AO: We’ve spent the past couple of years building and iterating our UR management technology to help ourselves and our clients better manage quality and timeliness of UR cases. The complaints that we’ve heard from clients is that current industry software they license is old, data is difficult to obtain, custom changes are rare, and information security is a problem.

Knowing these challenges up front, we’ve been able to directly solve these problems with the primary focus being customization. We’ve been able to:
●    Create a custom platform from the first meeting. The client uses what they need, not what we’ve decided they need
●    Live data dashboards created for each user to manage their daily activities
●    Instant data exports by pressing a single button
●     Automatic treatment approvals based on custom treatment scenarios and treatment guidelines to expedite proven care plans and patient recovery
●    SOC 2, Type 2 security

Evolving technology is always a focus in our industry.  We’re extremely excited about a platform that solves pain points now and in the future.

IAIABC: What's an interesting fact about your organization that most people don't know?

AO: Hard to narrow it down to just one - so here are a few!

●    Arbicare was recently selected as a finalist for the Comp Laude "Best Customer Service Award" 
●    The idea for Arbicare was first discussed by Alex and Hal over gyros. 
●    Arbicare's color scheme is inspired by the colors of Hal’s beloved Golden State Warriors. 
●    The name Arbicare comes by combining 2 words - arbitrate and care. Arbicare sits between the injured worker, provider, and payer and is tasked with making objective clinical care decisions. Combining the words was a natural fit.   
●    60% of the Arbicare team is female. 
●    We have an internal chat used solely for sharing pictures of our pets.
●    Our VP of Clinical Operations is still an active practice provider, staying current with evidence-based medicine, healthcare trends, and patient care.

IAIABC: Why is your organization a member of the IAIABC? What would you tell others about the benefits of membership?

AO: Workers’ compensation sits at the intersection of property & casualty insurance, healthcare, and a state run regulatory environment. The regulatory aspect of our industry and the unique rules and requirements inside each jurisdiction are both complex and critical for doing our job correctly.

The IAIABC allows us to learn and connect with individuals inside these regulatory environments. Those relationships allow us to understand the details well beyond any statute or written rule set. The better we can perform our services as intended gives us a better opportunity to provide a valuable service that has a positive impact on all stakeholders involved in workplace injury.  Better care and faster recovery - that’s our goal.

For us, membership in the IAIABC is a no brainer.