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WCRI 2022 Conference Morning Day 1 – No Masks – Great Speakers


WCRI Conference Morning Day 1 –

Dr. Bob Hartwig – Inflation

Impact of Disruptions Caused by COVID-19 on Workers’ Compensation

The 1980s were much worse – Inflation 2022 13.5%

2022 -7.5% Inflation

Misery Index –

Two years on, the disruptive impacts of the COVID-19 pandemic continue to reverberate throughout the economy. What began as a public health crisis has morphed into a hydra of economic turmoil and public policy uncertainty on a global scale, with no easy or quick solutions in sight. This presentation will explore the myriad challenges facing the economy today—including enduring labor market dislocations, inflation, concerns over economic growth, and financial market volatility—and their impacts on the workers’ compensation line in 2022 and beyond.

The following are among the questions that will be addressed in this session:

  1. How has COVID-19 disrupted and changed U.S. labor markets?
  2. What is the impact of these disruptions on the workers’ compensation line?
  3. Where is the economy headed and what will be the impacts on workers’ compensation?
WCRI 2022 Conference Day 1 Morning Chart
(c) Dr. Bob Hartwig, USC

COVID-19 Disruptions and Workers Comp: Outline

Inflation Overview & Outlook
Drivers of Inflation: Goods, Services, Wages and Medical Care
Russian Invasion of Ukraine:
Potential Impacts for Insurers—Inflation, Recession & Beyond
Labor Markets: A Post-Pandemic Paradox
Economic Outlook & WC: Turbulent Times
P/C Industry Financial Performance and Growth
Does inflation impact industry profitability and growth?
Investment Market Issues
– Inflation-driven volatility
– Rising interest rates and a newly hawkish Fed
COVID and Workers Comp

The unemployment rate has recovered back to where we were previous to the COVID 19 outbreak.

17 – 25 old age group fastest to return to work after COVID 19.

The average Wage increased from $28.56 to $31.58 during the pandemic

2021 – 10% growth rate in wages

Great Resignation

The sharpest increase in COVID-era retirements is among 65  to 74-year-olds

Pandemic retirees are more likely to be older white college-educated from the Midwest

WCRI 2022 Conference Day 1 Morning Dr Hartwig Combined Ratio
(C)) Dr. Bob Hartwig USC- NCCI

The Combined Ratio for Workers Comp showed this line of insurance was one of the most stable during the pandemic.


  • The P/C Insurance Industry Remains Strong, Stable, Sound and Secure
  • The WC Line Remains Among the Best Performing of All P/C Lines
  • Payroll exposure base already exceeds pre-Covid levels
  • Labor Markets Remain Tight (3.8% unemployment rate in Feb. 2022)
  • Rising WagesRising Indemnity Severities
  • Millions of workers remain out of the labor force…Will they return?
  • Surging Inflation Is Now the Greatest Threat Facing the Economy
  • Inflationary pressures led by energy, commodities, goods; Services lag
  • Geopolitical turmoil (Russia/Ukraine war) will add to pressure—oil leading the way
  • Probability of a “Hard Landing” Growing (e.g., Recession)
  • Higher Interest Rates Will Benefit Long-Tail Lines (e.g., WC)

Download this presentation at www.uscriskcenter.com 

Effect of Provider Consolidation on Payments for Medical Care Provided to Workers with Injuries

Wed. Mar 16, 2022
10:35 AM – 11:15 AM

Consolidation of medical providers has been a steady trend in the United States. Hospitals often merge to create a health system, while physicians are increasingly more likely to be working at practices that are owned by hospitals and health systems. While the forces shaping consolidation of medical providers are external to workers’ compensation, they can affect prices of medical services, quality of care, access to providers, treatment patterns, costs of care, as well as worker outcomes.

In the session, Dr. Bogdan Savych, WCRI author and policy analyst, will share preliminary findings from the study Effect of Provider Consolidation on Payments for Medical Care Provided to Workers with Injuries while addressing the following questions:

  • What are the trends in the consolidation of medical providers who provide care to workers with injuries, and how do these trends differ across states?
  • What are the implications of increasing consolidation for access to medical providers?
  • What is the impact of increasing consolidation of medical providers on payments for workers’ compensation medical care?

In 2012 44% of Primary Physicians were operating in a clinic

In 2018 45% of Primary Physicians were operating as part of a health system

Gradual switch from clinical operations to operating in a health system between 2012 – 2018

Orthopedics  switched from 41%  at a clinic to 33% as part of a hospital system

More than 50% of Primary Care physicians see less than 3 Workers Comp patients in a 3 year period

More than 1/3 of Orthopedic physicians have seen more than 30 Workers Comp patients in a 3 year period

Vertical  integration increased payments per group of similar services by 14%

Vertical  integration increased payment for the day of care by 12%

Non-fee schedule states had higher payments than states with fee schedules during physician vertical integration

–Still a work-in-progress study by WCRI

Patterns and Outcomes of Chiropractic Care

Wed. Mar 16, 2022
11:15 AM – 12:00 PM

Chiropractors often participate in the delivery of physical medicine services to workers with low back pain in many states. It is important to know how they are involved and the outcomes of the care they provide. This is one of several preliminary studies we will be sharing at our annual conference, giving attendees a first look. Join WCRI Economist Dongchun Wang as she shares preliminary findings from her 28-state study Patterns and Outcomes of Chiropractic Care, which will address the following questions:

  • How often do workers with low back pain receive chiropractic care across states?
  • What are some reasons for the substantial interstate variation in the use of chiropractic care?
  • How are chiropractors involved in delivering care?
  • How do costs and temporary disability duration compare between low back pain claims with exclusive chiropractic care and those with non-chiropractic physical medicine care?

Minnesota uses chiropractic care more than any other state in Workers’ Comp – Minnesota allows employee choice of physician.

Chiropractic care is considered part of physical medicine treatment

Difference between physical therapists and chiropractors – physical therapists formulate a treatment plan, using a diagnosis from a physician.   Chiropractors formulate their own diagnosis and treatment plan.

States that have employer-controlled medical treatment had a lower amount of chiropractic care. 

Minnesota ad almost 35% of workers comp injuries treated by chiropractors.  7% was the 28 state median.

Thirteen states had less than 5% of workers comp injuries with chiropractic care.

Overall provider patterns

71% did not involve chiropractors

17% mix between chiropractors and non-chiropractors

12% exclusively chiropractic treatment

Comparing Costs and TTD Duration

Chiropractic care is associated with a shorter length of TTD and lower medical costs than claims with other types of physical medicine – an interesting finding (preliminary only)

Question – Are Doctors’ costs and pharmacy fees figured into the physical medicine cost when compared to chiropractic care?  Yes

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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