Medical utilization remains down in comp post-pandemic: WCRI

Studies released Thursday by the Workers Compensation Research Institute found that utilization of medical services by injured workers has not rebounded to pre-pandemic levels in the majority of the 17 study states studied.

The 17 individual studies, addressing the percentage of claims receiving a particular medical service and the number of services provided, show that the industry “continues to see effects of the pandemic on 2022 claims with experience through March 2023,” said Sebastian Negrusa, vice president of research for WCRI, in a statement.

“Besides strained hospital capacity and avoided medical care by many people out of fear of COVID-19 in the early months of the pandemic, waves of increased COVID-19 cases and medical provider shortages may have also affected the delivery of medical care,” he said. “Even in the few cases where utilization in certain states has begun to rebound, we do not see it reaching pre-pandemic levels yet.”

Some key finding of the studies include:

  • In California, utilization of medical services decreased in 2022, particularly in the percentage of claims with inpatient care and facility services for both hospital outpatient departments and ambulatory surgery centers.
  • In Indiana, utilization declined in 2022, particularly for major surgery and facility services.
  • In Minnesota, unlike most study states, utilization of most services either remained stable or began to increase in 2022.
  • In North Carolina, decreasing utilization was a driver of the state’s decline in medical payments per claim in 2022, in contrast to many study states that experienced growth.

This article was first published in Business Insurance.

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