Treating Injured Workers Like Athletes: Why Early PT Is Key to Claims Success

Apr 25, 2024 | Insights

Early PT can be the key to improved injured worker outcomes and lower claims costs. How can workers’ comp promote quicker access to care?

Any sports fan can probably recall a moment when they saw a professional athlete get injured on the field. A wide receiver limps off the field grabbing his hamstring. A basketball player sprains his ankle. An outfielder nurses his shoulder on the way to the dugout.

For common musculoskeletal sprains, strains and similar injuries, athletes will be in PT almost as soon as they’re off the court — getting them back to full health and function will be top priority for their teams.

That immediate access to PT has proven results, and it’s caused some in the workers’ compensation industry to wonder what would happen if injured workers got that kind of care. After all, a professional athlete is also just a worker doing a job.

“What’s the difference for an industrial athlete that is working in a coal mine and a professional athlete that’s on a football field?” said Greg Nichols, PT, president of SPNet, a division of MedRisk. “They’re still trying to make a living for their family.”

A growing body of evidence suggests that fast and direct access to PT improves outcomes for injured workers and can reduce claims costs. Now, new technologies are helping payers and their PT partners catch potential claims hurdles earlier and improving communication throughout the workers’ comp process.

A Growing Emphasis on Early Access to PT

Greg Nichols, President of SPNet, A MedRisk company.

The broader U.S. health care system has long known the benefits of early PT. A study from the U.S. Department of Defense found that seeing a physical therapist resulted in $3.6 million in reduced medical spending and improved patient outcomes.

“There’s this accumulation of evidence that points towards the benefits of starting the rehab process early,” said Brian Peers, DPT, MBA, vice president of provider management and clinical services at MedRisk.

“It seems to be independent of the body part, the age, the job type, the type of injury, the severity. Across the board, earlier access to rehabilitation is translating to better outcomes — not just clinically but also as far as the claim outcome goes.”

Other studies have found that PT can reduce costs and improve outcomes for a variety of common workers’ compensation injuries. MedRisk’s 2024 trend report found that when PT is used over alternative treatments, payers can see $39,533 in net economic savings for carpal tunnel and $4,160 for low back pain.

The key here: direct patient access. Rather than seeing a primary care physician or a chiropractor first, patients went directly to a PT, as many patients in the Department of Defense study had immediate access to a PT, much like a professional athlete. They didn’t spend time seeing other providers or working through the workers’ compensation system.

Simply put: “If someone needs physical rehabilitation, let’s get them in physical rehabilitation as soon as we can,” Peers said.

Access to quick and conservative medical care like physical therapy is obviously important to improving claims outcomes. Workers’ comp payers and providers need to work together to get injured workers the care they need. Yet speed-to-care in workers’ comp has only increased by about 2% over the past 10 years, per MedRisk’s 2024 injury trends report.

“If the injured worker is struggling to enter into the medical ecosystem, we’ve got to create another entry point somewhere,” Nichols said. “If we don’t have clear channels of communication with these injured workers, then we’re dropping the ball.”

How Does Early PT Drive Improved Patient Outcomes?

Brian Peers, DPT, MBA, Vice President of Provider Management and Clinical Services, MedRisk

In order to get the workers’ compensation industry to embrace early access to PT, it needs to understand the benefits. The studies are clear. “We’re seeing people getting back to work faster. We’re seeing lower expense for the claim overall,” Peers said — but it’s important to know why that’s the case.

So, why is early PT so critical to driving positive claims outcomes?

One component is physical. Early access to care can prevent injuries from getting worse and requiring surgery or other costly treatments down the road. “We want to get these folks started as early as we can because we know that the outcomes will be better,” Peers said.

But the benefits of early PT go beyond physical health improvements. Physical therapists spend significant amounts of time with injured workers. They can detect changes in mood, like depression or anxiety, or flag other biopsychosocial factors that could influence a claim before it derails recovery and drives up costs.

“What we’re starting to learn about is the value of the interaction between the PT provider and the claimant to pick up on barriers that might exist but are buried underneath the surface,” Peers said.

New technologies are helping PTs share these insights with adjusters and other stakeholders; data-driven models are helping to process the information and create recovery models to help predict claim progress. All these factors contribute to quicker return-to-work timelines and lower claims costs.

“TPAs had a bunch of information regarding a claimant, and it would have been great if we were passing that information on to the PT provider early,” said Skip Brechtel, executive vice president of strategic partnerships, CCMSI.

“Clinicians were gleaning all of this information, literally talking to the claimant significantly more in the early stages than an adjuster does. Having that information enhances what we can do to better move along in that claim.”

A Collaborative, Data-Driven Approach

Skip Brechtel, Executive Vice President of Strategic Partnerships, CCMSI

The benefits of early PT — for patient outcomes, for claims costs — are unambiguous. Injured workers get the treatment they need sooner and claims costs are reduced.

MedRisk has long been a leader in providing workers’ compensation PT services. Last year, the company treated over half a million injured workers, and 90% of workers’ comp payers choose MedRisk for managed PT services.

The company has invested in a number of innovative tools to help capture and process claims data so providers and adjusters can effectively use it to drive recovery. Its tools can help process unstructured claims data, like the data gleaned from interviews, so it can be processed and used to drive better recovery outcomes.

“It takes all these things and it scores the claim,” Brechtel said. “You’re capturing significantly more information on that claimant.”

Most important of all, MedRisk understands that workers’ comp is a collaborative business with many stakeholders. It understands the importance of working with health care providers, insurers and other stakeholders to ensure the best possible care for injured workers.

“One party can’t do it alone,” Brechtel said. “It’s got to be all three working in unison.

All in all, MedRisk helps injured workers get the physical therapy they need, when they need it.

“We have a lot of musculoskeletal injuries,” Peers said. “We have this mounting data that’s getting better at predicting who needs what and when, and what’s effective and what’s not working. But we still, as an industry, have to get better at delivering the right care to the right person at the right time to get these outcomes.”