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Trends in Physical Medicine: Why PT is Bigger Than You Think

January 7, 2019 - WorkCompWire

Occupational injury rates and workers’ comp claim frequency continue to decline, but is your medical spend on physical therapy following suit? Here is a closer look at key trends impacting your workers’ comp costs and why the management of physical medicine services continues to be a critical investment for employers:

For almost a decade the news of fewer occupational injury rates1 and the declining frequency of workers’ compensation claims2 have been making headlines. Experts credit the downward trend to a wide range of contributing factors, including advances in safety, automation, better management and more.

However, some employers may be surprised that their workers’ comp costs–especially those related to the treatment of musculoskeletal injuries–are not necessarily mimicking this descending slope.

This post explores some of the reasons why, despite positive claim trends, managed physical medicine is still a critical component of a strong workers’ compensation program.

One in two Americans has a musculoskeletal condition.
According to a recent report3 by the United States Bone and Joint Initiative (USBJI), half of American adults are affected by a musculoskeletal condition. This amounts to 126.6 million Americans – comparable to the number suffering a chronic lung or heart condition. In fact, musculoskeletal injuries are the leading cause of healthcare visits4 and account for 77 percent of injury-related healthcare visits. That’s approximately $213 billion in annual treatment, care and lost wages. But what about workers compensation?

31% of all workplace injuries are musculoskeletal.
According to the Bureau of Labor Statistics (BLS), musculoskeletal disorders, including injuries resulting from overexertion such as sprains and strains, made up 31 percent of the total cases for all workers5 in 2015.

31_percent_of_injuries_are_musculoskeletal

While claims rates are falling due in large part to workplace safety programs, the numbers show that accidents will always be a risk. And if you’re a growing company, more employees mean more risk and more injuries. Falls, slips, and trips accounted for 27 percent of the total occupational injuries and illnesses, and the incidence rate of workers being struck by an object or equipment increased year over year. Professions at a high risk for musculoskeletal disorders include laborers and freight, stock and material movers; nursing assistants; and heavy and tractor-trailer truck drivers – each accounting for five percent of the private sector’s musculoskeletal cases in 2015.

Workers with musculoskeletal injuries are out of work 44% longer.
Musculoskeletal disorder cases can often be more challenging to treat and manage than other workplace injury or illness. In fact, according to BLS data6, in 2017, the median number of days away from work for musculoskeletal injuries was 13 days compared with only 9 days for all other workplace injuries. Unless properly managed, the road to recovery for patients with musculoskeletal injuries can be unnecessarily complicated. Following diagnosis, a referral to a physical therapist or other specialist is typically needed to formulate and execute a treatment plan. If not managed properly, workers with musculoskeletal injuries often get lost in a labyrinth of unnecessary MRIs, injections, opioid prescriptions and even surgery.

13% Increase in Claims with Physical Medicine involvement
While injury rates and frequency has been declining, data from the Workers’ Compensation Research Institute (WCRI) shows that the percent of claims with physical medicine involvement has been increasing. In 2011, 56 percent of lost time claims included outpatient physical medicine services7 (physical therapy, occupational therapy or chiropractic care). By 2017 the 18-state median was up to 63 percent8 with some states like California and New Jersey even higher at 72 and 71 percent. This consistent, year-over-year increase can be attributed in part to a better understanding of the value physical medicine brings to the workers’ compensation community and the benefit it plays in supporting return to work goals. Physical medicine not only helps address musculoskeletal issues, it also promotes patient participation in recovery and self-management, and reduces the risk of re-injury. Today, mounting evidence now shows that early physical therapy also reduces the risk of opioid addiction9 and can reduce downstream healthcare costs10 suggesting that this trend of increased PT involvement will continue and even escalate.

Workplace safety programs are a big part of keeping workers’ comp claims in check, but for the injuries that cannot be prevented, employers must set their workers up for success. Considering the prevalence of musculoskeletal injuries in the workplace and the current trends pointing to a continued increase in physical medicine involvement, a patient-focused managed care program for physical rehabilitation is a must-have for employers.

Click here for more information on the current trends and research in physical medicine that is impacting your workers’ comp costs.

Partner Post:
This is a sponsored post from WorkCompWire marketing partner MedRisk.

Notes
1https://www.bls.gov/news.release/pdf/osh.pdf
2https://www.ncci.com/Articles/Pages/II_Insights-Frequency-Severity.aspx
3https://www.sciencedaily.com/releases/2016/03/160301114116.htm
4http://www.boneandjointburden.org/docs/By%20The%20Numbers%20-%20MSK%20Injuries.pdf
5https://www.bls.gov/news.release/pdf/osh2.pdf
6https://data.bls.gov/gqt/RequestData#download.f.1
7https://www.wcrinet.org/images/uploads/files/wcri_med_benchmarks14_CA.pdf
8https://www.wcrinet.org/images/uploads/files/wcri8422.pdf
9http://www.apta.org/PTinMotion/News/2018/12/14/JAMAEarlyPTOpioids/
10https://www.ncbi.nlm.nih.gov/pubmed/29669080

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