Occupational injury rates and workers’ comp claim frequency continue to decline. Is your total spend for musculoskeletal treatment following suit?
In this article, Medrisk explores some of the reasons why, despite positive overall claim trends, the percentage of claims with physical therapy (PT) involvement is on the rise – and why a managed physical medicine program continues to be a necessary component of workers’ comp care.
“For almost a decade the news of fewer occupational injury rates and the declining frequency of workers’ compensation claims have been making headlines. Experts credit the downward trend to a wide range of contributing factors, including advances in safety, automation, better management and more.
However, some employers may be surprised that their workers’ comp costs, especially those related to musculoskeletal treatment, are not necessarily mimicking this descending slope.
While injury rates and frequency have been declining, data from the Workers’ Compensation Research Institute (WCRI) show that the percent of claims with physical medicine involvement has been increasing. In 2011, 56 percent of lost time claims included outpatient physical medicine services (i.e., physical therapy, occupational therapy or chiropractic care). By 2017, the 18-state median was up to 63 percent with some states like California and New Jersey even higher at 72 and 71 percent, respectively.
This consistent, year-over-year increase can be attributed in part to a better understanding of the value physical medicine brings to the workers’ compensation community and the benefit it plays in supporting return to work goals. Physical medicine not only helps address musculoskeletal issues; it also promotes patient participation in recovery and self-management, improves patient compliance with treatment strategies and reduces the risk of re-injury.
Today, mounting evidence shows that early physical therapy also reduces the risk of opioid addiction and can reduce downstream healthcare costs, suggesting that this trend of increased PT involvement will continue and even escalate. With multiple visits to coordinate, continued authorization requests to manage and a variety of return-to-work treatment strategies to implement, employers must ensure they are equipped to effectively manage physical medicine today and in years to come.
THE PREVALENCE OF WORK-RELATED MUSCULOSKELETAL INJURY
According to the Bureau of Labor Statistics (BLS), musculoskeletal disorders alone, including injuries resulting from overexertion such as sprains and strains, made up 31 percent of the total cases for all workers in 2015. While claims rates are falling due in large part to workplace safety programs, the numbers show that accidents are still a risk. And if you’re a growing company with a growing number of employees, that often means assuming higher risk. Falls, slips, and trips accounted for 27 percent of the total occupational injuries and illnesses, and the incidence rate of workers being struck by an object or equipment increased year over year. Professions at a high risk include laborers and freight, stock and material movers; nursing assistants; and heavy and tractor-trailer truck drivers – each accounting for almost 5 percent of the private sector’s musculoskeletal cases in 2015.
EXTENDED LOST TIME
The prevalence of musculoskeletal injuries becomes even more concerning when you consider that musculoskeletal disorder cases typically have more days away from work than the average nonfatal workplace injury or illness. In fact, according to BLS data, in 2017, the median number of days away from work for musculoskeletal injuries was 13 compared with 9 for all other workplace injuries. Unless well-coordinated, recuperation for patients with musculoskeletal injuries can be unnecessarily complicated and drawn out. One way to counteract these effects is for employers to ensure injured workers are matched with the right physical therapist as quickly as possible and feel supported during the scheduling process so treatment can begin promptly. Physical therapy as a first-line of treatment has been shown to be a cost-effective contributor to positive patient outcomes.
Workplace safety programs are a big part of keeping workers’ comp claims in check, but for the injuries that cannot be prevented, employers must set their workers up for success. A managed physical medicine program is a must-have for employers as the increase in claims with physical medicine involvement continues to climb. Ensure your company has the necessary partners and resources in place so that no matter how much your company grows or healthcare policies change, your injured workers can rely on a supported and streamlined road to recovery.”
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