Workers Comp Medical Provider Shortage = Losing Control of Claim
The Workers Comp medical provider shortage can easily cause the loss of medical control that many states afford their employers and their insurance carriers or third party administrators (TPAs).
Earlier this month when I attended (and posted live) the 2024 WCRI Workers Comp Conference, one of the sessions brought up an important point. The process had begun before the pandemic. The pandemic and post-pandemic effect on the workers comp medical provider shortage could lead to losing control of claims – see later in this article.
Business Insurance’s Jon Campisi authored a great article that you can find here on the shortage. By the way, you should sign up for a few of the Business Insurance newsletters including the weekly editions – worth it. One of the passages from the article on a panel on the employer outlook for 2024 and beyond –
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For example, nursing turnover rose in the pandemic and is beginning to normalize to pre-pandemic levels, but it’s “still too high,” said Charles Kyles, director of workers’ compensation for Duke University & Health System in Durham, North Carolina.
Workers comp claimants have been affected by provider shortages during the past few years, as fewer health practitioners meant limited care, Mr. Kyles said, adding the issue is still prevalent.
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Who better to experience and identify workers comp medical provider shortages than Duke University Medical Systems?
Workers Comp Medical Provider Shortage = Losing Claim Control
Many articles on this website cover medical control of the claims as a key to cutting workers comp costs. The most important part of having medical control is most workers comp systems see the treating physician as an impartial party to the claim.
Cutting costs while providing the highest level of medical care for a gainful return to work can be obtained if there are enough medical providers in a certain area who accept Workers Comp patients.
Most states allow for the employer to choose the initial treating physician. Even in states where the employee chooses the medical providers, the injured employee will often go to the medical provider suggested by the employer.
Medical treatment networks have become even more critical with the workers comp medical provider shortage.
Bottom Line – What to Do
- Check to make sure that the initial medical treatment (physician or clinic) still accepts worker comp patients.
- If you are using a recommended provider network that your carrier or TPA provides – obtain an updated medical provider listing from your carrier or TPA.
- Do not wait until an accident to find out that the injured workers cannot be seen by the usual medical providers that have seen your injured workers before now.
- Contact your workers comp claims office or adjuster by email and ask them if they know of any changes to your list of medical providers. Adjusters usually find out first when changes are made to the medical networks.
Keep your medical treatment network up to date. Providing the best care remains the goal even if you may experience workers comp medical treatment network shortages.
