There are almost 900 people attending the second annual national Rx abuse summit, and many are workers comp stakeholders. There are PBMs, UR firms, testing companies, drug companies, a few clinicians from large payers: but no executives no C-suite residents, no actuaries.
That is precisely why opioids are the single biggest problem in workers comp.
Executives don’t grasp this. With a very few exceptions (Aig’s Benmosche is one, SCIF’s Tom Rowe another), the leadership the workers comp is not paying attention. I suppose this is understandable as they have yet to see the real impact of opioids on their financials. Sure they are aware of the growing influence of opioids and are sorta/kinda focused on drug costs, but most are much more cognizant of other more traditional issues: settlement rates, TRIA, admin expense ratios, market cycles. All important and significant, but I’d suggest nowhere near as important as opioids.
The reality is claimants on opioids for more than six months are at high risk for addiction, are not going back to work, and run up high medical costs. Many of these claimants have nothing more serious than back sprains and strains, conditions that should rarely – if ever – merit opioid treatment.
Until and unless those execs start paying attention, focusing their staffs and resources and government affairs people, the problem is going to get worse.
And until and unless actuaries tell them how much more costly these claims are that’s not going to happen.
Frankly, I wish a few WC regulators had attended it also. Particularly those who don’t see this as a significant issue worthy of immediate intervention.
A risk manager friend of mine is attending at my recommendation, and he reports the content is very enlightening….and tragic.
The AIGs of the world write loss sensitive WC policies. Premium and collateral funding are based on loss trending. Claims histories rise, so do premiums and deductible funding all if which generate investment income. Where is the incentive to reduce losses? The key to underwriting profit is picking the right risks not claims reduction strategies. It is possible as very large losses pierce deductibles that the carriers will take a more active role. But I think not; they will just refine underwriting standards and raise deductibles