icare launches open market tender for claims and injury management services

This tender is for the procurement of claims and injury management services for the NSW Nominal Insurer workers compensation scheme.

Minister for Finance and Employee Relations Damien Tudehope said the announcement follows extensive consultation on a new claims model, which included a market study on potential service providers, a survey on the NSW Government Have Your Say website, and interviews and focus groups with injured workers, businesses, unions, industry groups, service providers and the community.

"The aim is to improve the way claims are managed, providing simpler, better care for injured workers and support for employers," Mr Tudehope said.

"icare has listened to the needs and concerns of stakeholders and is taking action to evolve and improve the way NSW workers compensation claims are managed. This consultation will continue through the tender process and as the new claims model takes shape."

"The intention is to include more roles for service providers, encouraging different providers and specialised skills, increasing transparency of performance of providers and providing greater choice for employers over time. This will drive improved outcomes for injured workers and businesses through competition," he said.

"This new approach aligns with the McDougall Review, which found that icare had previously sought to introduce changes to the claims model too quickly without sufficient testing. This time, icare is adopting a measured, staged implementation."

This tender process follows the final 12-month extension to icare's existing provider contracts ensuring stability as the tender process gets underway. Service providers who are successful will begin on 1 January 2023.

icare CEO and Managing Director Richard Harding said delivering better outcomes for the more than 326,000 employers and 3.6 million workers in the NSW private sector that the icare Nominal Insurer serves was paramount.

“The new model aims to create a competitive marketplace, enabling choice, innovation and continuous improvement to support injured workers and employers.”

"We're looking for enhanced performance of case managers, specialised claims service providers and we're targeting performance incentives to drive better outcomes," he said.

In addition, icare has already taken the following actions to improve the NSW workers compensation scheme:

• Accepted in full the 49 recommendations of the McDougall Review
• Allocation of dedicated case managers for those injured workers, who have had or were expected to have ongoing time loss for more than a week
• Supported the hiring of an additional 80 case managers and 15 mobile claims managers throughout 2021 to enable lower case loads and to help drive improvement
• Piloted an early intervention program, which has increased the targeted use of vocational rehabilitation providers – with a 44 per cent increase since May 2021
• Launched a Professional Standards Framework late last year across the Nominal Insurer and Treasury Managed Fund that provides case managers with learning and career pathways in order to rebuild industry-wide capability, expertise and capacity
• Initiated monthly governance and performance meetings with all claims service providers, focused on return to work and other performance indicators.

Providers intending to bid for a contract will receive procurement details under a Confidentiality Deed Poll. Notification has been made available on the NSW Government eTender website, with submissions due 14 April 2022.