Washington – Workers’ compensation medical expense costs are growing at a rate far exceeding the increases in group health costs, and this will be a critical issue for property/casualty insurers and actuaries, attendees at the
Peter Rauner, FCAS and president,
“Over the last eight years, workers’ compensation medical costs have nearly doubled, from about $13.5 billion in 1999 to more than $25 billion in 2007—that’s staggering,” Rauner said.
Rauner outlined some of the factors driving medical costs on a macro level, such as inflation, economic growth, provider consolidation and lifestyle factors—increasing obesity and diabetes.
William Miller, FCAS, SVP and actuary,
“While group health includes disincentives for overutilization, workers compensation has no coinsurance payment by the injured worker,” explained Miller. “Utilization is one of the primary reasons that workers compensation costs are rising so dramatically.”
Miller used an NCCI study to drive home his point. The study looked directly at utilization for 12 injuries and compared services provided within three months of injury. It was found that workers’ compensation costs were 71% more than group health costs across the 12 injuries, driven primarily by increased office visits and physical therapy.
“Workers compensation injuries result in more intense and costly treatments earlier on than under group health,” said Miller.
Miller encouraged the actuaries in attendance to use their analytical skills to help design efficient workers’ compensation medical coverages. “Use predictive modeling to find which doctors are providing the best outcomes for getting workers back to work and staying at work,” urged Miller, as he outlined the keys to containing utilization.
Source: The Casualty Actuarial Society