Survey Reveals Top Challenges of Workers’ Comp Stakeholders in 2022
Health care provider and medical service shortages were the No. 1 challenge workers’ compensation stakeholders faced in 2022, according to a recent survey of workers’ compensation professionals, with 58% of survey participants naming it a top-five concern for their organizations.
Injured workers often struggle to find available care as a number of medical practices and related services refuse to accept workers’ compensation insurance payments due to low fee schedules.
Medical price inflation and increasingly complex claims were the second and third most often cited challenges identified by the survey. The survey was conducted by Risk & Insurance magazine, which covers risk management and commercial insurance. Survey data was garnered from attendees at National Comp, a national workers’ compensation and disability conference, held in Las Vegas from Oct. 18 through Oct. 20, 2022.
Medical price inflation was listed by more than 57% of respondents as a top concern. Although medical costs per claim increased 2% in 2021 and a projected 3.7% in 2022, health care inflation typically lags behind price inflation. According to Risk & Insurance, workers’ compensation payers are already seeing price inflation for some medical services and products.
Increasingly complex claims were cited by more than 56% of respondents. According to the survey, mental health issues were the primary concern for respondents worried over claim complexity, with 61% naming them as problematic. Comorbidities were cited by 61% of respondents as a key driver of claim complexity.
Other concerns include:
- Workers’ compensation litigation.
- New workplace safety challenges, such as telecommuting, communicable diseases and workplace marijuana use.
- Comorbidities and poor worker health.
- Insurance industry labor shortage.
- Increasing regulation and expanding coverage requirements.
More information about the survey is available here.
Musculoskeletal Disorders Injuries Are Top Concern and Cost of WC Programs
Work-related musculoskeletal disorders (MSDs) cost employers $20 billion in annual direct costs and comprise 30% of workers’ compensation claims, according to the U.S. Bureau of Labor Statistics (BLS). Recovery from MSDs takes longer than from other injuries and illnesses too — accounting for 38% more lost time.
MSDs affect the muscles, nerves, blood vessels, ligaments and tendons. Workers in many different industries and occupations can be exposed to risk factors at work, such as lifting heavy items, bending, reaching overhead, pushing and pulling heavy loads, working in awkward body postures, and performing the same or similar tasks repetitively.
According to BLS, the private sector experienced 247,620 MSD injuries or illnesses involving days away from work in 2020, the most recent year for which statistics are provided. The median time away from work for an MSD injury was 14 days, compared to 12 days away from work for all other types of workplace injuries.
Ergonomics helps lessen muscle fatigue, increases productivity, and reduces the number and severity of work-related MSDs, according to the U.S. Occupational Safety and Health Administration.
According to AmTrust Financial Services, an insurance provider with an emphasis on workers’ compensation, a workplace ergonomics program can reduce stress and eliminate injuries associated with the overuse of muscles, bad posture and repetitive tasks. The insurer suggests that components of an ergonomics process include:
- Providing management support by defining clear goals and objectives for the program.
- Involving workers in assessment, solutions and implementation of the ergonomics updates.
- Offering training to ensure employees understand the importance of ergonomics in the workplace.
- Identifying ergonomics issues before they result in MSDs.
- Encouraging early reporting of MSD symptoms to help reduce the progression of injuries.
- Evaluating the progress of the program and updating procedures as needed.
Employee Engagement Declines
Only about 1 in 3 U.S. workers are engaged in their job, the lowest level since 2015, and 18% of workers are actively disengaged, according to survey results from Gallup.
Gallup asks random samples of the working population about workplace elements that affect organizational outcomes such as profitability, productivity, customer service, retention, safety and well-being. Gallup conducted quarterly surveys of the working population during 2022 — random samples of approximately 15,000 U.S. full- and part-time employees each quarter. The latest results are an average across those four quarters.
The survey measures several workplace elements, including employees’ level of agreement about clarity of expectations, opportunities for development, and their opinions counting at work. Gallup describes engaged employees as involved in and enthusiastic about their work and workplace. Actively disengaged employees are described as disgruntled and disloyal because most of their workplace needs are unmet.
Gallup says employee engagement has dropped steadily since 2019, the year before the pandemic began. The engagement elements that declined the most from 2019 are the following:
- Clarity of expectations.
- Connection to the mission or purpose of the company.
- Opportunities to learn and grow.
- Opportunities to do what employees do best.
- Feeling cared about at work.
Younger workers’ engagement was impacted more than that of older workers. Engagement for those under age 35 (young millennials and Gen Zers) decreased by 4 points, and active disengagement in this same group increased by 4 points, compared with before the pandemic. Engagement among older workers (those 35 years and older) decreased by 2 points, and the percentage actively disengaged in this group increased by 1 point. Younger workers experienced more decline in the following:
- Feeling cared about.
- Having someone who encourages their development.
- Opportunities to learn and grow.
- Their opinions counting.
- Having a best friend at work.
Workers Show Loyalty to Companies That Prioritize Safety
Of workers surveyed, 3 out of 4 (76%) said they are more likely to join or stay with an employer that prioritizes their physical safety. That percentage jumps to 82% among workers who have previously been injured on the job.
The survey was conducted by Centiment for Ansell, a leader in safety solutions. More than 500 workers and decision-makers in the warehousing and manufacturing industries were surveyed.
According to the survey, 53% of workers see something in the workplace that poses a hazard between one and two times a week, 25% see risks between three and five times a week, and 11% see risks six or more times a week. Respondents said employers could improve workplace safety by quickly responding to safety hazards like damaged equipment or spills (47%); increasing real-time communication with team members about safety hazards (39%); alerting employees where, when and what PPE to wear (37%); and providing more visibility to how quickly safety issues are resolved (31%).
Other key findings include:
- Of employees with two or more years of experience, 54% said their employer could improve how they coach employees on proper form, compared to 43% of workers employed one year or less.
- Nine out of 10 manufacturing, warehousing and distribution workers are interested in wearing connected technology that identifies unsafe physical movements and makes customized recommendations to reduce workplace risks.
- Three-quarters of respondents receive less than 30 minutes of safety training per week. Another 20% don’t receive any weekly training.
More information is available here.
Collaborating With Your WC Pharmacy Benefit Manager Yields Better Outcomes for Employees and the Company
by Ron Carter, RxBridge
Pharmacy Benefit Managers (PBMs) serve as the middlemen between drug companies and insurers, creating customized formularies, developing pharmacy networks, processing claims, providing critical clinical oversight, providing access to prescription needs for injured employees, offering discounted medications, and much more.
Isn’t it time for a new perspective? … Your perspective matters!
Risk managers across many industries sat around a whiteboard and collaborated on the shared problems they had experienced for decades. They lamented on the industry –unchanged for decades.
They lamented the vendors and the vendor perspective. But what about their perspective? Their needs? The needs of the injured employee?
Prescription medications comprise a significant share of workers’ compensation costs, accounting for approximately 14% of a workers’ compensation claim. So how do you get what you need? How do you get the right prescriptions in the hands of the right injured employee at the right time for the right cost? And how do you ensure this is accomplished every time?
In technology, when measuring uptime, anything below 99.7% is considered unstable. In manufacturing, error rates are measured for every million products coming off the line. How great would it be if 99.7% of each script filled met your objectives?
Who is your PBM?
The first question to ask yourself is, “Who is my PBM?” For bundled programs, we know who the TPA’s or the managed care provider’s PBM is. But who is your PBM? Do you have clear and unfettered access to your PBM team? What is your escalation path? When you have partners that report directly to you, then you have a PBM that lives solely for the purpose of serving your perspective and your interest, and not the interest of the bundler.
Are we focused on the right things?
Another consideration is focus. The street hustler of New York asks you to keep your eyes on the card in order to keep you from noticing what the hustler is doing with his other hand. Similarly, we all intuitively know that any “savings” number not compared to a fee schedule is more theater than a key performance indicator. Your overall spend is what is important, and that spend includes much, much more than “savings.” It includes the $10 bill review fee for each prescription, the out-of-network leakage, the rogue biller cost, the efficacy of clinical oversight (and clinical should be free), utilization efficiency, and much more.
My injured employee matters most!
The injured employee experience also empowers or enrages your injured employees. Daily, we use DoorDash, Uber and Amazon in seconds with little effort. The injured worker expects that degree of ease and service when it comes to the orchestration of services in their claim. Many workers’ compensation service providers like us deploy sentiment AI algorithms to understand the frustration levels of the injured employee, because we know a discouraged injured employee can lead to a litigated case unnecessarily. And we all know an unnecessarily litigated claim leads to unnecessary expense and inefficient operations.
So how do you get 99.7% of all your pharmacy spend to meet your financial and clinical standards? In a nutshell, sometimes we must ignore the theater and engage in much more substantive and authentic collaborations to achieve the outcomes we want.
Costly Workplace Driving Accidents Can Be Reduced
Accidents involving fleet vehicles can become an expensive liability for a business.
According to the Bureau of Transportation Statistics, there were 8.1 million fleet vehicles in service in 2020, including 3.4 million automobiles and 4.7 million trucks. These numbers don’t include personal vehicles used for company business.
The annual accident rate for fleet vehicles is about 20%. The repair and injury cost of these accidents averages about $70,000, almost double that of other workplace injuries. Add to that higher insurance premiums, legal fees, lost business, lost employee time, administrative costs, exposure to third-party liability, and bad publicity that can stem from a wreck.
Regardless of the type of fleet your company has, there are measures you can take to improve safety, reduce accidents, and limit financial exposure. Start by identifying all company drivers. This includes occasional drivers who use personal or rented vehicles for company business, as they may be a liability risk.
The top cause of wrecks is distracted driving, primarily from cell phone use. With employees expected to work the entire time they are on the road, there is a strong incentive to multitask while driving — making sales calls, texting the office, checking routes on GPS, etc.
Some ways to reduce wrecks caused by distracted driving include:
- Consider placing strict limits on cell phone use while driving.
- Schedule conference calls well ahead of time so drivers can be parked during meetings.
- Have drivers set specific times when they can safely take calls.
Travelers Insurance recommends these additional steps to promote safe driving habits:
- Periodically review each driver’s motor vehicle record.
- Monitor driver performance by reviewing all accident reports and checking vehicle performance data for signs of aggressive driving, hard braking, etc.
- Adjust work schedules to limit driver fatigue.
- Promote healthy practices for drivers who spend long hours on the road.
- Follow a regular vehicle maintenance schedule.
- Institute a formal training program for company drivers, including road tests to check driving skills.
- Strictly enforce company policies, particularly for distracted driving violations, and reward drivers who follow the rules and maintain a clean driving record.
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NH Business Review
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Risk & Insurance
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The United States Attorney’s Office
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Safety + Health
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