The 2024 Workers Compensation Industry Insights Survey Reveals Priorities and Challenges – Duncan Financial Group
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The 2024 Workers Compensation Industry Insights Survey Reveals Priorities and Challenges

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The 2024 Workers Compensation Industry Insights Survey Reveals Priorities and Challenges

The sixth annual 2024 Workers Comp Industry Insights Survey Report sponsored by Healthesystems and Risk & Insurance Magazine, alerts employers to the challenges in work comp perceived by industry stakeholders. For the second consecutive year, a shortage of healthcare workers was the top challenge cited by survey participants. Compounding the nationwide shortage of healthcare workers, some providers who previously treated workers comp patients have left the system, deterred by medical fee schedules.

Almost 75 percent of claim professionals cited difficulty obtaining information from medical providers as an obstacle to facilitating care. The shortage makes medical treatment networks even more critical. Stay abreast of what’s happening in your network – don’t wait until an accident to find out that the injured workers cannot be seen by the usual medical providers.

The worker shortage in the insurance industry is also a top challenge. Technology, including chatbots, virtual assistants, AI, data analytics, and claim processing automation are expected to be part of the solution. While most experts agree that technology can be a valuable tool in detecting fraud, reducing litigation, identifying and mitigating risks, and controlling loss-time claims, they also caution that the industry moves slowly and rollout will take time and must dovetail with the “human touch,” required in comp. Only 29 percent of survey respondents think that AI will be an important technology for the industry in the next 3-5 years.

While telemedicine still holds promise to alleviate problems associated with the shortage, respondents feel expansion of these services has been stalled. When insurers are understaffed, proactive employers can expedite claims by providing high-quality data, facilitating information sharing about claims, and advocating for injured employees.

Reflecting the realities in the work world, medical inflation, which was the #2 challenge last year dropped to #8, replaced by other workplace safety challenges, including communicable disease, remote work, marijuana, and workplace violence. Mental health came in at #3. Although most stakeholders support addressing mental health conditions that could delay recovery, they are careful about what is and is not compensable. Comorbidities are the top barrier to injured worker recovery and sixty-five percent of respondents said that mental health conditions are a concerning claim complexity.

Containing costs is the top pharmacy program goal, although pharmacy costs, as a percentage of total medical costs, have steadily decreased driven by the decline in opioid prescriptions. Managing opioids and substance abuse prevention remain top priorities. Managing other drugs (i.e. benzodiazepines,gabapentin) is an emerging concern as are the use and high cost of private-label topicals (PLTs).

The report also identified the top ten barriers to recovery of injured workers:

    1. Comorbidities/poor worker health
    2. Injured worker engagement
    3. Limited availability of transitional duty/return to work options
    4. Psychosocial/mental/behavioral health concerns
    5. Care coordination/communication challenges
    6. Access to timely/quality care
    7. Negative interactions with claims staff and/or treating providers
    8. Medical history and/or other relevant information unavailable to payers or providers
    9. Worker fear of re-injury
    10. Language/cultural barriers

For more information about what current industry insights mean for your wallet, schedule an appointment with one of our financial professionals.