PHOENIX – Inflation, labor shortages in the health care industry and unknown costs related to long COVID-19 are some of the prime concerns in the workers compensation sector in 2023, according to experts.
States that have controls in place to limit injured worker claims costs will likely fare better on medical claims than states without controls such as fee schedules, they said.
But much remains unknown about how long COVID claims will develop, they said last week at the Workers Compensation Research Institute’s annual Issues & Research conference.
Hospital payments were a major contributor to medical inflation in the general health care system in the past few years and states with comp medical fee schedules were more likely to keep physician expenses at or below the levels in the general health care system, they said.
During a panel discussion on medical inflation, WCRI economist Olesya Fomenko said factors that could lead to higher medical inflation include health care labor shortages, changes in pricing contracts and network discounts, a rise in medical facility fees and enhanced negotiation power from hospital systems, and medical provider consolidation.
A developing concern is the issue of long COVID, she said.
A wave of retirements during the pandemic meant that more experienced workers left the workforce and were replaced by younger and less experienced workers.
The change led to an increase in work-related injuries, which contributed to increased treatment and costs. Policymakers and comp professionals should be aware of the trend, said Rebecca Yang, senior public policy analyst with WCRI.
It remains unclear what effect long COVID will have on comp
Early in the pandemic, many workers infected with COVID-19 only received indemnity benefits, because, although they could not go to work, they did not require much medical care, panelists said.
During a study period from March 2020 to September 2021, WCRI researchers determined that 68% of claims were indemnity-only, while medical constituted 17% of COVID comp claims.
About 3% to 5% of workers with little medical care early after infection were treated for long COVID, but half of workers hospitalized after contracting COVID-19 received treatment for long COVID, according to WCRI senior policy analyst Bogdan Savych.
“The main takeaway here is that the prevalence of long COVID varies widely based on your experience,” Mr. Savych said.
Mr. Savych said 18 months after the acute infection period, 20% of workers who were admitted to intensive care units continued to receive medical care for long COVID.
Long COVID comp claims are often expensive and symptomatic workers received more than five months of temporary disability benefits, Mr. Savych said. Claims that did not include a long COVID component had about three weeks in benefits, he said.
Steve Wurzelbacher, manager of the Center for Workers’ Compensation Studies at the National Institute for Occupational Safety and Health, said compensability for long COVID varies by state because comp presumptions vary by state. The definition of long COVID also varies by state, he said.
Since comp systems are designed to track outcomes over several years, workers comp is a great way to evaluate the long-term effect of COVID-19, he said.