Day One Keynote: Prof. David Cutler, Harvard University
A very disturbing chart – people with college degrees or with more money tend to live much longer.
Presnter’s Outlook
Medical Payments in Workers’ Compensation During the Recent Inflationary Period
From WCRI –
The steep growth in consumer prices for energy, food, and housing over the last few years created concerns about potential rising inflation in medical care. This session examines to what extent the recent sizable price growth for all goods and services spread to the healthcare sector in general and to workers’ compensation in particular.
A picture is worth 1,000 words so I thought it was best to add in a few slides from the presentation. As with the NCCI studies, medical price inflation was lower than CPI.
- Inflation – check the chart above, as many states use the Medicare Fee Schedules as a basis for setting their WC fee schedules
- Hospital Payments – the main driver of medical cost growth in Workers Comp and other markets
- Utilization – Workers Comp medical growth will occur after recovering from the pandemic
- WC Fee Schedules – see the first point – Medicare price inflation = Workers Comp medical treatment inflation that will take time to register in the fee schedule changes over time.
The consolidation of medical care facilities and practices –
- Increased 8% in fee schedule states
- Increased 10 – 14% in non-fee schedule states
2024 WCRI Conference – Psychological Risk Factors and Functional Recovery
2024 WCRI Conference – Day One Afternoon
Labor Shortages
Sharon – all-time low turnover now, stabilized
Michele – a large number of part-time employees, increase in minimum wage, ESOP program successful, stabilized workforce
Charles – massive nurse burnou, post-offer testing program was eliminated due to barriers in hiring
Drug Testing
Sharon – no drug testing
Michele – no drug testing
Charles – limited drug testing
Claims Model
Michele – advocacy-based workers comp claims program
Sharon – 100 people in their claims department, team up with the safety department,
Access to Care Issues – Behavioral Health
Charles – access to care issues, recent providers declining to see workers comp patients
Sharon/Michele – had issues with the number of behavioral health providers
Return to Work
Michele – very strong return to work program, will return anyone to work, even amputees
Charles – strong return to work program that has been very successful
Sharon – robust return-to-work program, transitional-duty return-to-work program, 400 positions for transitional duty
Primary Focus
Charles – employee-centered program, workplace violence, rising concern patient or visitor violence, physical assault, workplace violence taskforce, hard security screening program, 300 weapons were found in the first year. High level of low-severity violence in hospitals and urgent care clinics
Sharon – not a huge concern with violence
Legislation Affecting Their Programs
Michele- physician dispensing
Charles – 500-week TTD soft cap being challenged in court
Trends in Claims
Complex Claims and Recessionary Issues?
Michele/Charles/Sharon – Claim frequency is down, and claim severity is up due to claim complexity
Questions
- Return to work – no matter the restrictions return them to work or list of jobs to see if any fit the restrictions Charles – Duke does both, Sharon – tell us what they can do
- Access to care issues – Michele – workers comp claims can be complex, so providers will not want to see people due to the paperwork. Sharon – Florida has paper overhead, much more complicated than group health, and will pay extra for Workers Comp medical care, Charles – medical providers do not want to enter into a legal system
Impact of Vertical Integration on the Utilization of Care
In this session, we will examine how the growing consolidation of medical providers affects care delivered to workers with injuries.
The large percentage of vertically integrated physicians increased from 37% to 48%. That level of growth is amazing. This growth has had quite an effect on medical pricing.
The vertically integrated medical providers increased the number of providers significantly. The percentage of providers per claim grew by 19%.
