The MedRisk Blog
Every facet of healthcare has been touched by the COVID-19 pandemic and workers’ compensation has been no exception. In its annual industry trends report, MedRisk examined new patterns in managed physical therapy for injured workers, including shifts in the duration of claims, patient challenges physical therapists (PTs) have to contend with, as well as what lies ahead.
The deferral of hospital treatments and physical therapy due to COVID-19 impacted injured workers and providers especially last spring. A key finding from MedRisk’s data tracking was the correlation between the postponement of non-emergency surgeries and the volume of post-surgical PT.
“Some researchers predicted it would take about 45 weeks to catch up with a backlog of surgeries and other medical procedures postponed because of COVID,” said COO Mary O’Donoghue. “Our data reflected this with significant fluctuations in post-surgical PT referrals as states closed and reopened.
Fortunately, significant treatment delays for new injuries did not continue beyond the second quarter of 2020, according to a recent National Council of Compensation Insurance report.
MedRisk anticipates a higher number of referrals for post-surgical PT, as well as pre-surgical PT for deconditioned patients preparing for postponed surgery. PTs will likely see patients recovering from serious COVID-19 cases as well. Those who spent time in intensive care units and developed post-intensive care syndrome or PICs need rehabilitation to restore their functionality and strength and occupational therapy to regain the ability to perform activities of daily living.
The last year drove a steep increase in symptoms of mental and emotional strain in the general public—a trend that is impacting the needs of PT patients as supported by MedRisk’s claims data.
Approximately 40% of US adults reported struggling with mental and behavioral health issues in 2020 (up from 11% in early 2019), and the numbers are holding steady. In a US Census Bureau survey from January 2021, 41.1% reported symptoms of anxiety and/or depression.
MedRisk’s data indicates injured workers, who already experience heightened levels of fear and emotional challenges, are also experiencing a pandemic-related rise in depression and anxiety.
These types of psychosocial factors can be significant barriers to recovery and have been linked to longer duration of PT care, so this rise in mental and behavioral health conditions has reinforced the importance of addressing mental and emotional recovery as part of the physical recovery process. As a continued focus of its managed care program, MedRisk identifies these barriers prior to care, so treatment can be modified by the provider as needed.
And as the healthcare system gets back into full swing, managed physical medicine is expected to play a critical role in the effort to curtail the proliferation of opioids, which saw a surge in recent months.
More than 40 states reported a significant increase in opioid-related deaths in 2020 compared to 2019 with an increase of 123% in opioid overdoses nationwide. This acceleration in the opioid crisis during the COVID-19 pandemic turns the spotlight on the critical importance of effective alternative treatment paths such as PT and other conservative care approaches.
Recent research has shown that PT can reduce the number of opioid prescriptions written in LBP cases and MedRisk’s data mirrors these implications. MedRisk’s proactive interventions have been associated with significantly less opioid involvement in lost time claims—opioids were prescribed in 34% of standard care cases but in only 18% of cases that included MedRisk’s proactive interventions.
What’s on the horizon for patients, providers, and employers as we usher in 2021? Read more on recent legislative changes, a biomechanics-based approach to preventing remote work injuries, the role of PT in managing long-term musculoskeletal pain, and a renewed focus on patient education as we prepare to take on managed physical medicine “post pandemic.” Click here to read MedRisk’s 2021 Outlook: Industry Trends Report.
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