Still recovering from the impacts of the pandemic, the workers’ comp industry must seek new approaches to optimize patient care, reduce duration and increase return-to-work rates in 2022. This requires a fresh look at best practices – especially in light of new findings on the treatment of injured workers. To effectively guide the industry (and workers) towards recovery, MedRisk has analyzed important trends seen over the past year and, in response, offers changes that may be made in the years to come.
Researchers have long agreed there are significant benefits to starting physical therapy early – that is, within 14 days post-injury, according to a 2020 Workers Compensation Research Institute study. To further reap these benefits, especially given the challenges the industry is facing in light of the pandemic, practitioners are shifting focus to one very specific type: manual therapy (MT).
decrease in temporary disability with early PT vs late post-injury PT
PT is understood to be the first-line treatment for musculoskeletal injuries before considering addictive opioid prescriptions and invasive procedures. Further, the 2020 study from WCRI says that for workers with low back pain, early initiation of PT (as defined by WCRI) is associated with lower utilization, lower costs and shorter duration of temporary disability.
more likely to experience a worsening disability without MT
A 2020 systematic review of randomized controlled trials updated a 2013 review exploring the value of MT (among other interventions) over the past several years. The 2020 review concludes by strongly recommending MT be integrated as an additional therapy. This supports earlier study results, which observed that patients who received only exercise (without MT) were 8 times more likely to experience a worsening disability compared to patients receiving exercise and MT treatment.
lower average medical cost per claim with early MT
In September 2021, WCRI released an initial study on MT for LBP claims. Researchers found that the temporary disability per claim was 22 percent shorter and the average indemnity payment per claim was 28 percent lower when workers received early MT compared with those receiving it later; a positive step towards more effective WC outcomes.
We’re seeing an increased focus on early MT in the industry and we’re delivering on it in our business. MedRisk data highlights patient age, surgical status and case complexity as three key factors that impact case duration and have been traditionally difficult to tackle. Our data – which has shown consistent results over the past five years – reveals the difference with and without early MT.
PT utilization and visit duration usually increase with age – a concern for the WC industry as the workforce continues to age. The good news: the value of early MT also increases with age. MedRisk data shows that patients between the age of 51 and 60 are discharged 7 days sooner and those 61+, 9 days sooner when they’ve received early MT. As the industry navigates an aging workforce, a shift to more MT sooner will get employees back to work faster.
DAYS TO DISCHARGE
early mt
late mt
AGE
Following surgery, patients receiving MT later in their episode require more treatment over a longer period of time than those who receive MT early in the episode.
Early MT
Late MT
Early MT is especially valuable for complex cases involving more than one ailment. In such cases, early MT leads to fewer visits over a shorter duration.
Early MT
Late MT
The mental health challenge of the pandemic persisted throughout 2021 and has continued to impact recovery time. Looking forward, we expect anxiety and depression rates to align with COVID-19 recovery as underemployment, high hospitalization rates and other negative pandemic-related stressors remain.
With uncertain times, mental health concerns and rising PT costs comes a renewed focus on structure and guidelines to lean back on.