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By NCCI InsightsMay 13, 2021


Latest Trends in Time to Treatment

Barry Lipton, FCAS, MAAA, Practice Leader and Senior Actuary, NCCI

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NCCI Senior Actuary Barry Lipton explored how the pandemic has affected time to treatment for injured workers. In short, the pandemic caused treatment times to slow during the first surge of the virus. However, time to treatment quickly recovered to prepandemic levels.

Lipton and his team dug deeper into the data to share insights on an issue with wide impact: understanding the nuances of time to treatment.

In this presentation, NCCI explained that longer time to treatment is not always bad and that it requires a more nuanced approach. A longer time to surgery does not affect outcomes for some injuries, such as cruciate ligament tears. And for certain injuries, such as herniated discs, longer time to surgery may be associated with better outcomes.

Key Takeaways:

  • COVID-19 has had limited impact on time to treatment in workers compensation.
  • This deeper dive was a reminder that longer time to invasive treatment may be appropriate for the specific injury and may lead to better outcomes in some cases.
  • Medical directors and claim adjusters found it helpful to focus on injuries where time to treatment is impactful. In addition, workers and employers saw more return-to-work opportunities—including new telecommuting options—as the economy improved.

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A Story of Escalating Claims

Raji Chadarevian, Director, Medical Regulation & Informatics, NCCI

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Raji Chadarevian from NCCI’s Medical Regulation and Informatics Team took an in-depth look at what drove runaway claims to understand how COVID-19 claims might escalate.

A mere 4% of claims opened three years after injury contributed more than 75% of the observed medical escalation.

Chadarevian and his team explored the trajectory of complex escalating claims, such as low back pain injuries, to examine attributes critical to deteriorating injured worker conditions. Multiple medical conditions—notably anxiety and depression—and surgical complexities, such as adverse reactions to implants, are claim characteristics that historically contributed to cost escalation.

COVID-19 claims did not overwhelm the workers compensation industry. However, the potential for escalated medical conditions remained uncertain. Early data showed a readmission rate six months after initial hospital discharge in the 10% to 15% range for workers who contracted COVID-19.

Key Takeaways:

  • We have just begun the COVID-19 journey in the workers compensation system. Treatments are evolving. The uncertain long-run consequences have yet to be understood.
  • The long-term medical costs associated with needed treatments such as rehabilitation and home healthcare might contribute to escalated treatment costs.
  • We shed some light on potential long-term complexities for injured workers who contracted COVID-19 by understanding the trajectories of other types of claims that escalated.

Bonus Content

A Conversation With Alan Mulally on Leadership Session Highlights

Alan Mulally, Former President and Chief Executive Officer, Boeing Commercial Airplanes, Boeing Information, Space and Defense Systems, and the Ford Motor Company

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Alan Mulally took the AIS audience inside his “Working Together” approach to leadership, culture, and profitable growth. The former CEO of Ford and Boeing Commercial Airplanes told NCCI’s Bill Donnell that “being humble is the essence of working together.”

From 2006 to 2014, Mulally set a clear vision and drove relentless implementation to focus and reinvigorate Ford, the only American carmaker to refuse to accept government bailout funds during the Great Recession. He’s also credited with leading Boeing’s competitive success against Airbus from the 1990s to 2006.

His “Working Together” principles emphasize leaders showing respect, listening, setting clear priorities, and being honest about business realities.

He said, “People want to know, who are you? What are you about? Where are we going with your leadership? Do you see me?”

It’s critical, he said, to “seek to understand your team in order to be understood.”

Mulally highlighted additional ideas in his interview with Donnell:

  • Effective business leaders focus on creating profitable growth by delivering valuable products and services while improving productivity and margins. Good companies are growing their revenue and margins.
  • Great leaders must be clear with themselves and their teams on priorities. Write down your priorities and then match them to your calendar. Put time and energy into the issues that really matter.
  • Care about your people and care about their opinions. But be relentless in understanding the facts about the business.

The Future Is Now Session Highlights

Amy Webb, Quantitative Futurist & Founder and CEO of Future Today Institute

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Quantitative futurist Amy Webb shared a framework for attendees to think about the future and develop business strategies in a disciplined way. She challenged traditional thinking about the future that is too narrowly focused on current realities and noted that chief risk officers tend to focus on the familiar and measurable.

She outlined 11 factors driving change that included the economy, public health, demographics, the environment, and technology. Through her research, she identified three clusters of trends that may impact the workplace and workers compensation:

  • The You of Things. The rapid, expanded use of wearable technology may anticipate accidents and help workers avoid injuries.
  • Mixed Reality. Tools that might change work and workplaces and create increased risk include spatial computing, augmented reality, assistive risk, and diminished reality.
  • Workplace Environments. Working from home that expanded during the pandemic may become permanent. Reimagined and redefined work and social safety nets may result.

Webb emphasized that “the future is now.” She challenged attendees to “confront deep uncertainty with difficult questions” and explored ways to take advantage of emerging trends and technologies. She encouraged leaders in workers comp to set a vision for the long-term future and take actions now to create it.