Between the Affordable Care Act, new treatments, and an older workforce, workers' compensation faces several ongoing challenges. Read the trends below to better prepare for the future of workplace injury care and costs.
Medical care
Technology continues to spread across states, cities and towns, and medical advancements are becoming more effective. Communication and flexibility have improved considerably: injuries and illnesses are more likely now to be treated via a video visit than an in-person consultation.
Telemedicine gives people who might avoid visiting a doctor more control over how they obtain information and treatment recommendations, and it can improve long-term care. At the same time, newer tests and treatments tend to raise overall costs for the system.
For insight into how healthcare settings and staffing affect claims, see Hospices and Health Care Workers Compensation.
Risks today
Different doctors often disagree about the "right" treatment, and some recommendations may be influenced by factors other than patient benefit. Workers' compensation systems are grappling with the fact that money is being lost when care is inconsistent or poorly overseen.
States are reviewing guidelines to improve consistency and considering fee schedules that increase visibility into who pays for what. Greater oversight is needed when deciding on addictive prescriptions, surgeries, or extensive testing so choices benefit the employee, employer, provider, and insurer.
For discussion of cost pressures, workforce shortages, and emerging trends in claims, see Workers' Compensation: Costs, Seasonal Workers, Workforce Shortages and Emerging Trends.
Forecasts
States are likely to continue efforts to reduce the amounts paid on claims by tightening care guidelines and increasing post-injury investigations to confirm improvements and limit unnecessary costs. However, some experts warn these steps may not fully offset systemic cost inflation driven by newer, pricier treatments.
Another area to watch is mental health: employers and insurers are beginning to see more claims tied to mental health conditions, which are often linked to serious physical illnesses and can affect recovery and return-to-work outcomes.
If you want help applying these trends to your business, talk to an agent.
Frequently Asked Questions
How is telemedicine affecting workers' compensation?
Telemedicine increases access to care and can improve early treatment, but it may also change cost patterns and require updated policies for evaluation and follow-up.
Why are workers' compensation costs rising?
Costs rise due to more advanced—and often more expensive—medical treatments, greater use of diagnostic testing, and inconsistent treatment practices across providers.
How are states trying to control medical costs in claims?
States are updating treatment guidelines, exploring fee schedules, and increasing oversight to improve consistency and reduce unnecessary spending.
Will mental health be covered under workers' compensation?
Mental health claims are increasingly recognized, and coverage depends on the jurisdiction and whether the condition is demonstrated to be work-related.