Reviewing 194,000 claims, the report found that claims with degenerative comorbid conditions are 58% more likely to become a high-cost claim.
Reviewing 194,000 claims, the report found that claims with degenerative comorbid conditions are 58% more likely to become a high-cost claim.
While overall medical inflation remains low, certain tariffs are still pending, which could impact long-term costs.
Medical costs went up 8% in 2024, driven by increased utilization, fee schedule inflation, and growth in medical-legal services.
Initial treatment from nurse practitioners saw a 2.3% shorter time from injury to the first non-emergency service.
The report covers trends from 2003 to 2023, looking at claim frequency and costs, vocational rehab, dispute resolutions, and more.
An 8.7% increase will take effect on September 1, 2025, slightly below the WCIRB’s suggested 11.2% increase.
The meeting covered 2024 healthcare costs and utilization, along with incoming regulatory changes.
From 2021 to 2024, medical payments per claim increased by about 5% per year in most states, rebounding from earlier pandemic-related declines.
Pharmacy service costs fell 40% - or $28 million dollars – from 2018 through 2023.
Long COVID cases made up 4.7% of COVID claims, totaling 6,000 claims, yet medical payments for long COVID claims was $105 million.
The study compares prices paid for medical services across 36 states from 2008 to 2024, representing 88% of workers’ comp benefits in the U.S.
A total of 14 reports capture workers’ comp data from 2018-2023 for 18 states, with information on medical payments and other metrics.
Approximately 38.8% of claims had one or more comorbidities, based on an analysis of 930,000 claims with at least 7 days lost time across 32 states.
While pharmacy payments are dropping, physician dispensing remains high.
Mega claims – with losses over $2 million – represent less than 0.1% of claims, but over 2% of total loss dollars.
