By Healthesystems
For 2023, workers’ comp stakeholders are most concerned about healthcare provider and service shortages. This is one of many statistics revealed in the fifth annual Workers’ Comp Industry Insights Survey, conducted by Healthesystems in collaboration with Risk & Insurance® magazine through the end of 2022. Over 500 stakeholders from across the workers’ comp industry responded to the survey, which continues to reveal insights about the challenges, successes, innovations, and evolving needs in workers’ comp medical care.
Here are the top five major findings from this year’s survey:
#1. Strong Focus on Healthcare Industry Dynamics
Survey participants cite healthcare provider/service shortages and medical price inflation as their top two challenges this year. The pandemic greatly accelerated an already looming shortage of healthcare workers, while lingering supply chain shortages and rising wages put pressure on prices. This combination is causing both access to care issues and higher costs for some medical services and products. The number three challenge – increasingly complex claims – exacerbates concern over healthcare service shortages and costs because mental health conditions and comorbidities are top contributors to claim complexity.
#2. Comorbidities a Chronic Condition for Workers’ Comp
Comorbidities continues to be a growing priority for workers’ comp healthcare. This is likely due to the aging workforce; chronic conditions such as diabetes, obesity, and hypertension; and rising rates of mental health conditions, including depression and anxiety. Chronic conditions are increasingly common among the general population and good health outcomes for injured workers require treating the whole patient. Identifying at-risk patients early on to ensure appropriate treatment is key to managing comorbidities and keeping injured workers on a path to recovery.
#3. Industry Banks on Technology
The healthcare worker shortage may be the industry’s most pressing challenge in the coming year, but a shortage of insurance industry professionals is also a concern for roughly 50% of survey participants. In response, workers’ comp leaders have made technological initiatives a priority. Organizations are turning to solutions such as claims process automation, virtual and mobile technologies, system integration and data sharing, and analytics to improve operational efficiency and enhance services.
#4. Diverse Pharmacy Management Concerns
Unlike in years past when the industry was contending with the ubiquitous use of opioids, pharmacy program priorities have shifted to more subtle and diverse concerns. Medical-related concerns are top of mind this year and several of them – price inflation, comorbidities, and increasing claim complexity – are linked to pharmacy management strategies. Private label topicals (PLTs), specialty drugs, and physician dispensing are growing contributors to pharmacy costs. Comorbidities, including mental health conditions, are now common factors that must be considered when treating injured worker patients, and often contribute to claim complexity.
#5. Improving Injured Worker Patient Experience a Growing Priority
Survey participants have identified the injured worker’s unfamiliarity with the workers’ comp system as the #1 barrier to recovery for the past three years. As awareness of the difficulties faced by injured workers grows, so does the desire to improve their experience. The easier it is for injured workers to receive appropriate and effective treatment, the more likely it is that they will recover and return to work in a timely manner. Industry stakeholders are betting on technology to facilitate a smoother experience for injured workers.
For more findings and insights from this year’s survey, check out the complete 2023 Workers’ Comp Industry Insights Survey Report.
