Posts Tagged ‘workers compensation costs’

Controlling the high cost of prescription drugs

Tuesday, August 24th, 2004

Industry trends point to a consistent decline in claims frequency, but a disturbing trend towards increased severity. In other words, the number of claims is trending down, but the cost of claims is trending up. Part of this is due to skyrocketing medical costs. Claims costs include both wage replacement and medical benefits. Historically, wage replacement has represented the larger share of the claims dollar, but recently, medical benefits has edged ahead as the leading cost. No surprise – health care has been rising at or near double-digit rates for a few years now.

Prescription drugs are an increasingly larger piece of the medical pie for workers compensation costs. According to Joseph Paduda of Health Strategy Associates, the costs for prescription drugs associated with workers compensation claims total approximately $2.5 billion a year, and are increasing at an annual rate of 13 to 17 percent. Despite this hefty price tag, it is interesting to note that workers comp expenditures represent less than 2% of the nation’s total drug costs, a fact that has significance in terms of the potential arsenal of cost-control strategies.

Joe discusses some of the reasons for this trend in an essay, Why Can’t We Control Drug Expenses?

Earlier this year, he also released the findings of a Comprehensive Prescription Drug Management Survey that Health Strategy Associates conducted among decision-makers at 21 of the largest workers compensation payer organizations to assess their perceptions, opinions, and attitudes about prescription drug cost management in workers compensation. Respondents cited Pharmacy Benefit Management (PBM) programs as a key tool for controlling costs. Next to PBMS, the most frequent cost control strategy cited was the treating physician:

Five respondents cited a desire to influence the treating physician, and four others specifically cited the ability of a “payer-side” pharmacist or physician to intervene with a treating physician, thereby influencing a specific prescription or the treating physician

Workers’ Compensation Industry Results For 2003

Tuesday, May 11th, 2004

The National Council on Compensation Insurance today announced 2003 workers’ compensation results. In “The State of the Line: Analysis of Workers Compensation Results,” the NCCI struck a cautionary note.

Frankly, we find the data are both interesting and confounding. For the sixth straight year, claim frequency, the total number of claims, has declined. Many industry people take great comfort in this. Safety efforts seem to be bearing real fruit. However, the declines in the past few years have mostly been in the less severe injury types. Moreover, BLS data show that frequency has declined in 6 of the last 7 recessions. Perhaps there’s more going on here than successful safety. Maybe more workers than usual who suffer minor injuries are choosing to tough it out in the workplace, rather than go out on workers’ compensation and risk being replaced. Something to think about.

But we think that the real story lies in the industry’s indemnity and medical costs, the claim severity. Consider these facts. First, in 2003 the average total cost of a claim increased to $34,600, up from $32,400 in 2002. Second, the average indemnity cost of a claim, the wage replacement portion, at $16,800, rose for the tenth straight year, this year by 4.5%. Third, the medical portion of the average claim, at $17,800, rose 9% and, for the second year in a row, exceeded the cost of indemnity.
At $42 billion, workers’ compensation is big money in America. It’s a lot to comprehend. Every 1% is $420 million. In 2003, the industry scored a combined ratio of 108%. Seventy percent of that went to losses, alone. The rest, to various expenses. That 70% is what employers can impact by their actions, their behaviors. In future posts we’ll discuss how.