State of the States July 15, 2022

National - NCCI released its mid-year highlights report demonstrating that overall workers’ compensation results for 2021 were “strong and consistent with the recent past.”

• Rate adequacy: Workers’ comp industry remains resilient with robust results in 2021 as it approaches the eighth consecutive year of underwriting profitability and a combined ratio of 87%. Although covid may have slightly impacted claim frequency and severity results, data continues to show long term frequency declines and subtle changes in severity. Overall reserves remain a source of strength for the industry.
• Covid: Compared to 2020, covid claims declined and most claims comprised of relatively low costs with more than two thirds accounting for losses of $1500 or less. The estimated average cost per covid-19 claim is approximately $7,800.
• Workforce Dynamics: With a shifting workforce, experts believe that injury frequency could decline or uptick depending on future circumstances. While the emergence of remote work could put downward pressure on claim frequency, the job-hopping effect of the market could potentially increase injury frequency as new employees are at greater risk of injury than more experienced workers. Industry leaders say if an uptick in injury frequency occurs it will be more likely in sectors such as leisure and hospitality, who saw the most turnover over the last two years.
• Medical Costs: Despite inflationary pressures, medical cost increases were mild when compared to other sectors. Analytics predict that medical costs are expected to remain moderately contained with certain exceptions.

National – With a number of jobs in a variety of sectors remaining unfilled, industries such as healthcare are set to bear the brunt of staffing issues, which could impact injured workers’ care. A 2019 study from The Association of American Medical College (AAMC) predicts the U.S. to have 20,000 fewer doctors than required to meet the nation’s healthcare needs and anticipates a labor deficit of 134,00 by 2034. Because of the pandemic’s effects, healthcare leaders are worried that covid may have exacerbated these numbers, further limiting access to care. A more recent study from McKinsey & Co. estimates that by 2025 the U.S. could face a deficit of 200,000 to 450,000 nurses available for direct patient care, approximately equating to a 10-20% gap. To make up for these unfilled jobs, the healthcare industry would require double the number of graduates for the next three years. With burnout still high amongst medical staff, the issue may be even more difficult to mitigate than anticipated.

National – Among mid-year renewals for workers’ compensation rates were flat as the sector remains one of the least volatile for insurers, according to Business Insurance. Although claim cost severity is experiencing small changes with an aging workforce, declining claim frequency is likely to offset this as workplace safety continues to improve and modernize. Industry leaders say that inflation has not hurt them as much as other sectors giving them an advantage. However, despite resilient and fortified numbers, hesitations exist regarding increased wages, payroll, and the handling long covid claims.

National – Enlyte published part III of Mitchell Pharmacy Solutions Drug Trends Series Report which takes focus on opioids in workers’ compensation. Overall scripts (-1.3%) and cost for opioids (-3.2%) continue to experience declines. Morphine equivalent dose (MED) and duration of use also decreased. In 2021 scripts per claim dropped 10.2%, cost per claim saw a 13.8% drop and cost per script went down 4%. The number of injured workers using opioids witnessed a 3% drop in a years’ time from 33.3% to 30.3%. More than half of the top 20 states by opioid volume saw declines in high MED with the greatest reduction coming from AZ (1.8%), IL (1.7%) & SC (1.6%). Other findings include a near double increase in naloxone for opioid claims with MED>50.

Missouri – Last year, state leaders gave their stamp of approval for the creation of a statewide PDMP (SB63), making MO the last state to establish such a program. The process of creating the program, although slower than initially expected is experiencing some incremental progress. The task force selected to set up the PDMP is currently outlining its expectations for dispensing operations and monitoring procedures. Member of the task force then hope to select a vendor that is the most compatible with electronic record systems utilized within the state of Missouri. A fully implemented PDMP is anticipated to be completed by March of 2023, giving the state time to select a proper vendor and make any rules necessary.  

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