Solutions for Workers' Compensation Insurance Pools and MGAs
your path to success
Welcome to your dedicated resource hub, built for insurance pools and MGAs tackling today’s toughest workers’ comp challenges. Here, you’ll find practical strategies and expert insights to help reduce delayed recovery, simplify claim oversight, and deliver measurable results for your members and clients.
Throughout this year, we will dive deep into key themes designed to ignite recovery, conquer claims chaos, and tackle costs with precision and purpose.
- Ignite Recovery. Get ready to activate powerful strategies that prevent delayed recovery and accelerate successful outcomes.
- Conquer Claims Chaos. As you strive to balance stretched resources against growing demands, we will explore how advancements in automation and AI can modernize your adjusters’ desktops and unlock new opportunities for efficiencies throughout your program.
- Tackle Costs and Awaken Results. Get an inside look at how a holistic approach across the claims continuum unleashes new opportunities to realize better outcomes while capturing every savings opportunity.
recovery
Delayed recovery impacts claim duration, costs, and member outcomes. That’s why early action and whole-person support are critical. Discover how pools and MGAs are using proactive models to prevent setbacks and drive return-to-work success.
Early Behavioral Coaching That Drives Better Outcomes
See how telephonic case management and cognitive coaching helped a worker overcome complex barriers, resulting in a full return to work and meaningful savings.
From Setback to Comeback: Effective Solutions for Delayed Recovery
Explore strategies to address mental health, social risk factors, and delayed intervention—all tailored for pooled risk environments.
Resilience Redefines Results
Presented by Tammy Bradly and Dr. Michael Lacroix (The Hartford)
Learn how resilience-based strategies can shorten claim duration and improve return-to-work outcomes across diverse member populations.
Expert Interview series How Top Claims Teams Catch Risk Before Costs Escalate
Hear from Enlyte leaders on how data can predict recovery challenges early and support stronger claim oversight for pools and MGAs.
Additional Resources to Ignite Recovery
The key to preventing delayed recovery lies in using holistic information to identify risk factors throughout the claim's lifecycle. The following insights demonstrate how resource integration addresses claims risk and promotes swift recovery.
Why Discharge Planning Matters for Getting Back to Work
Discover how solid discharge plans help injured employees recover and return to work faster and with better results.
Lower Claim Costs with Smarter Discharge Decisions
See how clinical insights helped reduce unnecessary therapy and boosted return-to-work success by over 20%.
Don’t Overlook the Mental Health Side of Workplace Injuries
A physical injury may be just the beginning—understand why mental health screening should be part of every recovery plan.
How Health Coaching Keeps Injured Workers Motivated
Learn how one-on-one coaching drives better outcomes by helping employees stay engaged in their recovery.
Early Intervention Leads to Greater Clarity
See how a large self-insured employer created a customized early intervention program and achieved 91% return-to-work.
Making the Most of Managed Care Plans
Take advantage of state-certified programs with expert oversight and a trusted provider network to support faster recovery.
Getting Better Results with Outcomes-Based Networks
Find out how choosing providers based on data can lead to faster recovery, fewer delays, and lower costs.
Smarter Approaches to Managing Opioid Use
Uncover ways to reduce high-risk opioid use in complex claims while keeping patient care front and center.
Best Practices for treating PTSD in Workers' Comp Claims
Get up to speed on clinical and medication guidelines that support better outcomes for workers facing psychological injuries.
How to Bill Accurately for Functional Restoration Programs
Avoid billing issues and ensure proper reimbursement by understanding how these programs should be reported.
Bringing Mental Health Into the Workers’ Comp Conversation
See why mental health is essential to full recovery and how it fits into a comprehensive care strategy.
claims chaos
MGAs and pool administrators face mounting complexity—more data, higher caseloads, and tighter resources. The solution? Smarter oversight powered by automation, analytics, and integrated tools that streamline workflows and improve performance.
How One Referral Simplified Coordination
Learn how fragmented care coordination was turned into a streamlined, clinically guided solution. This case study shows how one referral can reduce adjuster workload by 100+ hours, cut claim costs by thousands, and improved care delivery for a multi-employer pool.
Expert Interview Series with Rebecca Morgan and Jim Harris
Tame the Chaos: How to Use Data to Bring Structure to Claims
Discover how real-time analytics, dashboards, and system integration give you clearer oversight and stronger decision-making power.
Automate the Chaos: AI, Dashboards, and the Future of Claims
Get a deep dive into how automation, AI, and dynamic dashboards are shaping the future of claims management. Learn how these advanced technologies are accelerating insights, enhancing productivity, uncovering key trends, and empowering teams to deliver stronger outcomes.
Additional Resources to Conquer Claims Chaos
To stay competitive in a high-pressure environment, casualty payers must move beyond incremental fixes and tackle inefficiencies head-on. These resources will unlock strategies you can implement to reduce complexity and tame claim chaos.
Bringing Data and Clinical Expertise Together for Better Outcomes
Discover how aligning clinical insights with data analytics can eliminate inefficiencies and enhance return-to-work results.
Mental Health Screening Tools to Improve Claim Planning
Understand why addressing mental health challenges is essential for a comprehensive recovery strategy.
Aligning Clinical Insights With Predictive Modeling
Learn how predictive analytics can help identify key data signals and deploy clinical resources more effectively.
Taking Control of Medical Expenses with Real-Time Insights
Explore how the Medical Spend Dashboard transforms complex billing data into actionable visuals for better decision-making.
Managing Workers' Compensation Costs with Direction of Care
Understand how direction of care can help payers negotiate better network rates, eliminate bad actors, and implement clinical controls to manage pharmacy costs.
ePay: A Simple Solution to Improve Claims Efficiency
Discover how transitioning from outdated paper-based processes to modern electronic payment solutions can significantly enhance claims efficiency.
The Coventry VIP Program
Learn how the Coventry VIP Program drives efficiencies and reduces administrative burden through proactive provider support.
Smart Provider Channeling to Reduce Administrative Friction
Learn how channeling tools simplify provider selection, reduce administrative burden, boost operational efficiency, and keep claims on track.
Pharmacy Strategies That Cut Costs Without Compromising Care
Dig deeper into proactive opportunities to address pharmacy utilization and cost challenges through identification, regulation, analytics, and continuous outcome evaluation.
Manual UR Application Is Costing You – Here’s the Smarter Way
Learn how breaking down silos between bill review and utilization review can help you eliminate manual errors, save valuable time, and accelerate payments.
costs and awaken results
MGA and pool administrator's costs are accelerating—and the drivers are no mystery. Escalating medical expenses, staffing shortages across clinical and claims roles, and delays that stretch out disability durations are straining pools and sidelining recovery. But here’s the opportunity: by confronting these issues head-on, pools can tackle costs while taking a more human-centered path forward. When care is fragmented, outcomes suffer. It’s time to realign your strategy to support recovery—not just process claims.
Expert Interview Series From Reactive to Proactive: How to Leverage Data to Capture Savings
Utilize data beyond basic decision-making support to drive measurable savings and prevent claims escalation. In this video you’ll learn strategies for early intervention, cost control, and proactive management using integrated data sources, predictive analytics, and AI-powered insights. Transform both structured and unstructured information into actionable intelligence across the entire claim's lifecycle.
How to Go from High-Dollar to High-Value: Five Strategies for Claims Cost Control
Rising medical costs, prolonged disability, and increasing litigation are straining MGA and pool programs nationwide. Leading organizations are reversing these trends with these proven strategies. Through real-world case studies, you’ll see how data-driven approaches can deliver measurable savings and faster claim resolution.
Taking Charge of Pharmacy with Proven Cost Containment Strategies
Are hidden pharmacy costs inflating your claim spend? This white paper uncovers leakage from unmanaged out-of-network prescriptions to costly high-impact drugs, and how a fully integrated approach can capture every dollar. Proven strategies combine real-time management, early intervention, and targeted drug identification to cut your pharmacy costs while improving patient recovery. If controlling total claim costs is your priority, this is your blueprint for eliminating waste, closing cost leaks, and maximizing savings.
From Fragmentation to Integration: Awaken Results in Claims Cost Management
Presented by Anne Levins, Rebecca Morgan and Kim Radcliffe
Medical costs are climbing—but the real budget drain often hides in plain sight: fragmented processes, delayed referrals, and duplicated treatments. In this on-demand session, Enlyte experts will walk you through the entire claims lifecycle to reveal where inefficiencies drive up spend and how integration can reverse the trend. You’ll see how proven strategies like network optimization, automated evidence-based reviews, and predictive analytics can lower medical costs, speed recovery, and improve outcomes without adding work to your team’s plate.
Additional Resources to Tackle Costs
Reclaim Control Over Specialty Costs
Learn how enhanced network access, clinical oversight, and utilization controls help payers reduce specialty costs by up to 30% and gain better visibility into spend.
Specialty Solutions Deliver Brighter Outcomes for Both Injured Employee and Employer
Find out how coordinated specialty services delivered 31% savings on home health care and a $172,000 reduction in costs for a paraplegic employee.
Catch High-Cost Claims Before They Spiral with Field Case Management
Learn how timely case management spots risk early and keeps treatment in the right setting.
Real Claim, Real Savings with Field Case Management
This case shows how proactive field case management can turn a claim with a high-cost trajectory into a lower-cost claim with a quality outcome.
Unlocking Millions in Savings Through Optimized Medical Bill Processing
Learn how Enlyte's medical bill review service helped a client reduce staffing from 12 to 1.5 FTEs, shrink turnaround times from 6.5 to 4.5 days, and achieve a staggering $117.3 million in total labor and medical cost savings over four years.
AuditPro Resolved Overcharge Medical Services
The case study shows how AuditPro identified and corrected an overcharge resulting in a 27% cost reduction.
Inside Texas Workers’ Comp: How Certified Health Care Networks Shape Outcomes
In Texas, unique workers’ compensation rules and open provider choice present both opportunities and challenges for managing medical costs and recovery outcomes.
Driving Results Through Cost Strategies in California’s MPNs
Explore how California’s Medical Provider Networks (MPNs) are helping organizations manage rising medical expenses without sacrificing care quality. In this podcast, Enlyte’s Stephanie Leras breaks down the regulatory landscape, strategic network considerations, and trends shaping cost containment.
Integrated Pharmacy Benefit Management Results in Double-Digit Savings
Learn how comprehensive analysis revealed increased savings through better clinical controls and visibility into all claims.
Gauging the Impact of High-Impact Drugs in Workers’ Comp
Topicals, compound kits, combo packs, and specialty medications represent proportionately low utilization but often at significant costs. This podcast discusses the related trends and cost drivers to promote clinically appropriate savings.
Turning Regulatory Obstacles into Strategy Advantages Using Informed Decision-Making in Workers’ Comp & Auto Casualty
As policy changes create new complexities, the integration of advanced analytics, artificial intelligence and regulatory expertise offers a powerful framework for optimizing costs.
Enlyte’s Medical Price Index—Q1 2025 Report
This report analyzes medical bill review professional service charge data for P&C claims. The information is based on our own observations of these trends.
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Explore new insights and innovations designed to support smarter claims handling, faster recovery, and measurable savings for pools and MGAs.
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