Co-Morbidities and the Cost of Claims
Monday, December 10, 2012 | 0
The National Council on Compensation Insurance has issued a report on the impact of co-morbidities on workers' comp claims. While there are few surprises, the research is able to point toward a handful of specific conditions that are most likely to drive up the cost of a claim: hypertension, drug abuse, chronic pulmonary problems and diabetes. The research also confirms a particular red flag that has frequently been the focus of this blog: the impact of the aging workforce on the costs of workers' comp.
The overall scale of the co-morbidity problem is relatively modest: only 6.6% of claims involve workers with co-morbid conditions that directly impact their treatment; however, this reflects a nearly a three-fold increase between 2000 and 2009. In those claims where co-morbidities are a factor, the cost of medical treatment is double that of less complicated claims. Co-morbidities begin to show up in workers in their mid-30s and rise with age. Workers with co-morbidities are more likely to work in contracting or manufacturing
The majority of claimants with co-morbidity diagnoses are male: 65% of all claimants, 73% of claims involving drug abuse, 68% of claims involving diabetes and 67% of claims involving hypertension. This may also correlate to the fact that men are more likely to be involved in physically demanding jobs, where co-morbidities would have more of an impact on recovery.
American Health
The study notes that illness rates in the general population are increasing, especially in the areas of hypertension, obesity and diabetes. As the incidence rates increase in the general population, the workforce will mirror this growth. While workers with co-morbidities currently comprise only 6.6% of injured workers, we should expect to see a steady climb in that percentage over time.. American workers reflect American health.
It will be fascinating to track the impact of (virtually) universal healthcare −
AKA Obamacare −
on workers' compensation. For starters, we can hope for earlier diagnosis and treatment of serious health problems. Where workers without health insurance were highly unlikely to undergo treatment for their non-work-related conditions, insured workers may receive treatment. Where uninsured workers were only covered by workers' comp − and then only for work-related injury and illness − insured workers will have access to preventive care all along. This might help to contain the growth of workers' comp costs.
As always, medical treatment under workers' comp represents just a miniscule portion (about 3%) of total medical costs in America. There is an elephant in the room and it isn't us. But what happens to that elephant will impact the unique, 100-year-old public policy experiment that is workers' comp. In this era of data mining, there will be much data to be mined.
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