2022 Outlook

Industry Trends Report



Guiding the Industry
(and Injured Workers)
to Recovery

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.

Timing And Type Of Therapy Matters

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).

42 %

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.

8 x

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.

27 %

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.

Trending at MedRisk

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.

Age of Patient

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.


  • 45 days
  • 40 days
  • 35 days
  • 30 days
  • early mt

  • late mt

  • 41-50
  • 51-60
  • 61+


Surgical Status

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.

Treatment Duration

  • 44 Days
  • 56 Days
  • Early MT

  • Late MT

Complexity of Case

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.

Treatment Duration

  • 38 Days
  • 44 Days
  • Early MT

  • Late MT

MedRisk By the Numbers

MedRisk is the market leader in managing PT with an extensive national network of physical therapists, occupational therapists and chiropractors, and multiple solutions to help deliver the outcomes you need and with the care patients deserve.


90 %

of Top Wc Payers Trust Medrisk’s Managed PT

88 %

of MedRisk's Peer-Reviewed Cases Result in a Modified and Agreed-Upon Treatment Plan


Days To Initial Evaluation

148 , 391

Total Network Providers

428 , 483

Injured Workers Treated

Responding to Evolving Needs

Addressing Mental Health

Addressing Mental Health

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.

What You Need to Know

  • High anxiety and depression rates continue to dampen return to work rates for injured workers. Read more about the connection of psychosocial factors and patient outcomes in LBP here.
  • The key to overcoming psychosocial barriers will be getting injured workers identified and treated early.
  • Significant correlations have been found in research between depressive symptoms, fear of movement, pain catastrophizing and perceived injustice.

What You Can Do

  • The Orebro-OMPQ tool is a 10-question questionnaire that, when used in conjunction with other data, identifies the presence of psychosocial risk factors and assigns a level of risk of poor outcomes. This helps practitioners take the best course of action before factors become barriers to recovery.
  • Read more about psychologically informed PT practice in this Risk & Insurance article, highlighting MedRisk’s webinar “Psychosocial Barriers of Returning to Work”

Early PT & Patient Education

Early PT & Patient Education

What You Need to Know

  • To drive more positive patient outcomes, early access to PT and patient education go hand in hand. It’s important to engage the patient from the beginning to ensure that they hear and understand the diagnosis and treatment. Read more.
  • Studies show that an initial consultation with a PT provider may reduce overall healthcare utilization (i.e., opioid use) for patients seeking care for neck pain. Read more.

What You Can Do

  • MedRisk’s PTConsult program identifies barriers to recovery – including psychosocial barriers – and recommends the best course of action to mitigate before they become true barriers to recovery.
  • MedRisk’s consulting therapists can facilitate early PT to ensure optimal outcomes for workers.

Identifying the Right Treatment

Identifying the Right Treatment

With uncertain times, mental health concerns and rising PT costs comes a renewed focus on structure and guidelines to lean back on.

What You Need to Know

  • By identifying factors early – flagging comorbid conditions, psychosocial barriers and other factors that impact care – providers can structure care within necessary guidelines to prevent interference with recovery. This accounts for the complexity of a given case and situations that cause delays in care (associated with the pandemic and rising mental health issues).

What You Can Do

  • MedRisk’s International Scientific Advisory Board is the industry leader in the development and maintenance of evidence-based treatment guidelines specific to physical rehabilitation and utilization management protocols. Read more about the critical role of evidence-based guidelines in injured worker treatment here.
  • These evidence-based treatment guidelines differ from most guidelines in a number of ways, most notably by providing recommendations for treatment choice, timing and sequence of interventions – effectively helping people get the right kind of therapy at the right time.

Legislative Recap

MedRisk gathers the latest legislative and regulatory developments and challenges each quarter. Here is a full summary of significant movements in 2021 and the implications for 2022.

Research & Insights

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