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Addressing the True Cost of Injuries and Illness

By Robert Mortensen, President, Anthem Workers' Compensation

Robert Mortensen, President, Anthem Workers' Compensation

Many factors impact the bottom line. As we enter a new decade, workplace injuries and illness could be an increasing cost driver if strategies are not put in place to optimize workers’ compensation programs. 

According to the latest research from the U.S. Bureau of Labor Statistics, in 2018, there were 2.8 million nonfatal workplace injuries and illnesses reported by private industry employers. More than 900,000 of those injuries and illnesses caused a worker to miss at least one day of work, and many of them required multiple days. 

Meanwhile, the U.S. Bureau of Labor Statistics notes that the number of people in the workforce who are aged 65 and above is expected to increase through 2024 rapidly. The number of missed workdays due to injuries and illnesses also increases with age, so an aging workforce means an increase in the number of employees who will miss workdays due to injuries or illnesses.

"A growing trend among insurers that have integrated benefits data is automating their workers’ compensation processes to reduce the processing of claims and connect patients with the right providers much more quickly than previously possible"

Now, couple both of these statistics with financial figures: nonfatal workplace injuries amount to nearly $60 billion—more than $1 billion per week—in direct U.S. workers’ compensation costs per year; and in 2017 workplace injuries cost U.S. businesses over $165 billion, including more than $50 billion in lost productivity.

For businesses of all sizes, these converging trends need to be addressed. In order to reduce these mammoth expenses and restore employees to full health and productivity more quickly, businesses must examine and optimize their workers’ compensation offerings. To operate optimally, employees need the right support to recover and return to their jobs as soon as they are able. But with so many potential workers’ compensation insurance partners and rapidly evolving technologies to choose from, how do businesses identify the best possible partners?

How data optimizes workers’ compensation programs

One of the most important things to look for in a workers’ compensation insurer is their use of data. Data and analytics are transforming all aspects of business, and while workers’ compensation is no exception, not all insurers can maximize the value of this information. Ideally, workers’ compensation insurers use claims and billing data from physicians to quickly connect patients with physicians that will help them fully recover and return to work as soon as possible at the most efficient cost.

Some workers’ compensation insurers have access to data from their in-network providers that allows them to identify trends and determine expected outcomes. The more a provider deals with a particular population, the more effective they are at adapting their patient care. For example, one orthopedic surgeon may have better outcomes and patient satisfaction scores for knee replacements, while another is better at treating carpal tunnel.

In addition to performance data, insurers also have access to claims data. With this insight, they can identify financial trends and determine the average total cost of specific injuries, from treatment and duration to litigation and settlement. From this, insurers can direct patients to the providers that will give them the most efficient treatment possible, both in terms of quality of care and cost.

A growing trend among insurers that have integrated benefits data is automating their workers’ compensation processes to reduce the processing of claims and connect patients with the right providers much more quickly than previously possible. The sooner treatment starts, the sooner patients can recover, and the sooner these individuals return to work. Not only does this make the process faster, but by reducing administration, insurers can cut costs and pass those savings onto employers.

Using this wealth of data and automation, insurers can factor inpatient experience and billing trends to recommend the best possible provider: the one that helps the patient heal and return to work as quickly as possible for the most efficient cost. Rather than just picking a physician because they practice in a specific geographic or medical area, these insurers tailor recommendations to each patient and each injury.

The bottom line

As America’s workforce gets older, the recovery time associated with workplace injuries is likely to increase, as well. On top of the billions of dollars these instances cost U.S. businesses collectively, they require time—company time, employee time—and, more importantly, employee well-being.

When it comes to patient recovery and employee productivity, every day counts, so employers are well served to ensure they have the tools in place to give themselves and their employees the best chances for positive outcomes. That starts with implementing workers’ compensation programs that provide employees with the most efficient care if they need it. Your employees (and your bottom line) will thank you.

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