Jan
14

This is why media gets a bad name.

The LA Times’ Patrick McGreevy penned a piece on California’s State Fund – one that I contend is highly misleading.

McGreevy – and his editors – did their readers a disservice when “reporting” on executive compensation at the State Compensation Insurance Fund of California, focusing only on complaints about compensation and unsubstantiated claims of nepotism. Fact is, under CEO Vern Steiner, the State Fund has made a remarkable turnaround, one that has literally and figuratively paid dividends for businesses and taxpayers throughout the state.

McGreevy failed to mention anything about the Fund’s 2019 performance ($160 million in dividends paid to policyholders while significantly strengthening reserves) – performance he knew about before he wrote his piece.

Here’s an example of McGreevy’s reporting; an uniformed – at best – comment from one so-called “former industry executive”:

“It’s a very cushy gig…They don’t do much of anything and they get paid a ton.”

[Oh, and the guy who said that worked for a not-for-profit insurer – USAA – that paid it’s CEO 5 times what State Fund CEO Vern Steiner made. And the State Fund had a MUCH better year.]

But about that comment; specifically “they don’t do much of anything”.

I called Steiner to ask how the State Fund has delivered those results. Here’s what he said.

MCM – Talk about the Fund’s financial performance.
VS – ” [We] went into this year knowing that the Fund’s financial strength was exactly where California needed it to be to handle the market no matter what comes. Reserves are very strong; surplus is what we need to withstand any catastrophe; biggest risk is significant negative reserve development from unexpected system changes – we can handle this.”

“For 2019, we planned to break even, instead, investment performance was so strong that we realized $100mm in capital gains due to equity investment performance.”

MCM – What are the factors that drove this?
VS – There have been several transformative initiatives at the Fund, largely driven by claim performance and investment performance.

This could not have happened several years ago. A few years ago the State Legislature authorized additional executive positions at the Fund and allowed the Fund to invest in equity. We hired a Chief Investment Officer, and the equity investments have generated much more in unrealized cap gains. Our state insurance code only allows us to invest 20% of unrestricted surplus in equity; as our equity portfolio increased in value, it exceeded that 20%, so we had to sell off equity to get under 20%. This happened several times in 2019, creating a large capital gain. We didn’t need this money for surplus or reserves and we are not for profit, so we are giving them to our policyholders.

Since we were given the authority to invest in equities we have generated $433.8M in capital gains.

MCM – Has the Fund’s medical management of claims affected results?
VS – “The Chief Medical Officer position was also created by the Legislature. After Dinesh Govindarao came on board we created a comprehensive approach to the opioid epidemic; the work that was started in 2013 is impacting reserves for claims going back to 2008.  About $60 million dividend is from claims improvement…[there] may be as much as several hundred million more in dividends from our opioid initiatives alone.”

“After the Palm Medical case, we had not removed any physicians from our previous network, so we closed it down, rolled out a new network in 2016, and did not include physician offices in our pharmacy network.  That had a massive impact on lowering claim costs and reducing inappropriate compound medicine and opiate prescriptions.”

MCM – Any significant changes to claims handling?

VS – “When the Chief Claims Officer joined at the end of 2015 we redesigned the claim model to move the 1/3 of open claims that were from early 2000s to a dedicated group of adjusters specializing in resolution. We had (received) a million claims over a 5 year period [this happened back when the California work comp system was in crisis and the State Fund had over 50% market share]

In 2015 a third of our open claims inventory was from that period, managing these claims was taking a lot of attention away from focusing on the 20,000 new claims we get every year. We separated the old and new claims, have different people working those and as a result we are closing claims at faster rate than ever and this continues to improve.”

The result of all these people in “cushy jobs not doing much” is a State Fund that’s:

  • never been stronger financially,
  • returned $160 million to policyholders, and
  • one of Forbes’ 500 best mid-sized employers to work for.
    [btw USAA – where that “former exec” worked, the one where the CEO makes five times what Steiner does – didn’t make Forbes’ list.]

What does this mean for you?

Kudos to the State Fund for delivering remarkable results for patients, policyholders, and taxpayers. 

Note – I emailed Mr McGreevy early today asking for an explanation as to his article didn’t include information re the improvements in financial and claim outcomes. If he responds I will keep you posted.


Jan
10

Failure isn’t.

If the insurance industry – and your organization – is going to a) make real progress and b) survive the next hard market its/your leaders must reward those who take risks – not fire them. (this is a follow-up to my last post)

In order to do that, our “leaders” must understand the value of failing.

A C suite exec with decades of success in work comp claims and executive leadership sent me this:

the lack of innovation is as much about penalizing those with ideas as it is anything else.  Whether my own direct experience as an individual contributor or member of a team, or watching others, I’ve seen way too many ideas be dismissed out of hand, ignored, or simply not advanced because of a culture that is just too harsh when it comes to ‘failure’.  The industry has, generally speaking, failed to realize that great innovation often comes from failed innovation.  I can think of multiple executives I’ve worked for where I simply gave up on advancing ideas because of their reaction to suggestions from me and others.

An example.

One of our daughters works for a huge tech firm that does data storage, backup, and a lot of other stuff I don’t pretend to understand. Molly (daughter 2) and her team are responsible for some really big accounts, one a huge business application company. Long story short, the team is always looking for ways to provide increased value, deliver more services, and help the client grow. Her company was working on a new tech platform/capability/service, one which might help Molly’s client speed up its development cycle and improve service delivery.

This was new, not-tested, bleeding-edge stuff. The team debated if they should pitch it to their client, as there was a better than 50/50 chance it would not meet the objectives.

Throwing caution to the winds, they pitched the $15 million+ project to the buyer, telling the buyer that it would likely “fail”.

The client bought it.

She asked why, given it might well fail to deliver, which would mean her client blew $15 million, which might be pretty awkward for the decision maker.

Nope – the client said there was every reason to go forward.

First, it might actually work, which would dramatically improve a couple key metrics;

Second even if the project “failed”, it would be well worth it because the client would:

  • gain really valuable experience and insight into new technology;
  • improve the client’s ability to implement new and unique technology; and
  • help Molly’s company get better faster, increasing her company’s value as a partner.

Yeah, I can hear all the reasons this is fine for tech but not for workers’ comp. But those aren’t reasons – they are excuses – and lame ones at that.

Tech can do this because they have a lot more money than we do.

BS.  The work comp industry is making more money now than it ever has – there’s never been more dollars available for innovation.

We are doing great now, so no need to do anything different (if it ain’t broke…)

BS. The time to prepare for the storm is when the sun is shining, because sure as hell you won’t be able to patch that roof during the inevitable hail storm.

We don’t have the ability/expertise/employees we need to innovate.

And…whose fault is that?

You need to build a culture that rewards smart failure, that values innovation – which by definition includes failure, that is excited about doing stuff better, faster, and more efficiently, that recognizes risk-taking as critically important to growth in revenues and margins.

That’s the single most important change we need to make – and those who do will win.


Jan
7

A wake-up call for the insurance industry

We are stuck in a self-destructive cycle, namely an industry-wide culture that rejects true innovation that leads to a huge talent deficit that prevents innovation.

With few exceptions, there is little in the way of innovation, effective marketing, risk-taking, creativity and substantive investment in systems and technology in the insurance industry. That will be the death of many insurers and healthplans.

As a result, we can’t get enough brilliant, impactful people to work in our business because our culture is anathema to most of them.

So, there’s no innovation.

The most important part of any organization is its people. Yet our industry’s talent deficit is as wide and deep as the Marianas Trench. Sure, there are some very smart folks doing great work – in healthplans, State Funds, private insurers, TPAs, and service companies.

They are the exception, not the rule.

Don’t agree?

How many of your brilliant college classmates chose a career in insurance? In your career, you were blown away by someone’s acumen, insight, brilliance, thinking how many times? How many execs in this business came out of top business or other schools?

Why is this?

I’d suggest it is the very nature of our industry; it isn’t dynamic, doesn’t reward innovation, hates self-reflection, abhors risk-taking, and doesn’t invest near enough in people or technology.

Proof statements, courtesy of The Economist 

  • No insurer ranks among the world’s top 1,000 public companies for R&D investment – yet dozens of insurers are in that top 1000.
  • On average insurers allocate 3.6% of revenue to IT —about half as much as banks.
  • In a study of 500 innovation topics across 250 firms, many insurers are working on the same narrow set of ideas.
  • Many property insurers, whose fortunes rely on forecasting climate-induced losses, are still learning how to use weather information.

Tough to recruit talent to an industry that – for Pete’s sake, invests half what banks do in IT…

  • Or for a property insurer that hasn’t figured out weather is kinda important?
  • Where all your competitors define “innovation” as doing the same stuff you do?
  • That probably spends more on janitorial services than R&D? (Ok, that may be a bit of an exaggeration.)

Many of the big primary insurers in today’s market will be overtaken by the Apples, Amazons, Googles, Beazleys, Trupos, and Slices tomorrow. The names you know are brilliant innovators and have billions upon billions of cash to invest. The names you don’t know have figured out and are diving into markets that the traditional, stodgy, glacially-fast insurers can’t even conceive of – reputational risk, very short-term insurance for specific items, disability coverage for gig workers, and a host of other opportunities.

Oh, and they are doing it without all the paperwork, hassle and nonsense that keeps insurance admin expenses at 20% of premiums while frustrating the bejezus out of potential customers. (having just spent hours on the phone fixing a problem with flood insurance, count me as one)

And no, with rare exceptions health insurers aren’t any better. With structural inflation that guarantees annual growth of 5-8% and an employer customer that has to provide workers with health insurance, plus governmental contracts that pay on a percentage of paid medical, and record profits across the entire industry, there’s every reason to NOT control costs.

Those record profits may well continue till a Cat 5 storm hits the Jersey shore and/or a deep recession hits and/or investment portfolios are crunched by macro factors.

In the meantime, Jeff Bezos will be looking for places to plow some of his hundreds of billions.

Tomorrow – what to do about this.

What does this mean for you?

Critical self-reflection is really hard, and really necessary. This industry is ripe for disruption and it will happen. The question is, what will you – and your company – do?

 

 


Jan
2

Predictions for workers’ comp in 2020, Part 2

My last post covered the first five of my annual prognostications; today we look a bit deeper into the crystal ball…

6. California’s crooked docs will be outed.

With SB 537 signed into law, it looks like we’ll know which docs are the bad actors later this year. Kudos to the behind-the-scenes folks who made this happen; thanks to them we’ll know the name of the PM&R doc in northern California who filed IMR requests resulting in 2,800 IMR letters and 4,441 Medical Decisions.

(while the law doesn’t require this outing to happen before 2024, I’d expect we’ll know the names of the worst offenders in 2020.)

Word of warning – network providers would be well advised to do their own research to identify and remove problematic providers before the list becomes public. Failing to do so will show you’re just a box of contracts.

7.  More effective approaches to chronic pain and opioid abuse disorder are here – and will gain a lot of traction in 2020.

Behaviorally-focused treatment, medication-assisted therapies, long-term clinical support and individual-specific treatment plans are all essential to solving the biggest problem in workers’ comp – chronic opioid use disorder [OUD]. Payers are recognizing that discounted-network approaches to pain and OUD are nothing more than revenue-generators for vendors. Carisk’s Pathways 2 Recovery is getting significant traction; Paradigm is shifting to more of a behavioral approach as well. (Carisk is an HSA consulting client).

8.  Don’t expect any meaningful state legislation/regulatory changes.

Significant change doesn’t happen unless there is a lot of pressure to make that change. And there isn’t – With workers’ comp anything but a problem for employers and insurers, constituents aren’t pressuring legislators to take action and regulatory activity will be mostly clean-up stuff.

Word of warning – beware of folks hyping relatively minor stuff like medical marijuana. Compared to the California crisis and Illinois’ past work comp disaster these issues are pretty insignificant.

9. Benefit adequacy will gain some traction.

I’ll admit this is much more of a hope than an actual prediction.

As reported by NASI, worker benefits have declined dramatically over the last two decades. Sure, some of this is due to the drop in frequency, but workers are getting less in benefits than they have in the past – and that’s bad by any measure.  It’s great that employers’ costs are declining, but that shouldn’t be at the expense of injured workers and their families.

With employers’ work comp costs at an all-time low, it’s long past time we focused on making injured workers whole.

This does NOT mean I support the self-described “worker advocates” who make their living off injured workers. If anything these leeches do more harm than good.

10. Conferences will continue to struggle

look familiar?

The work comp conference industry is suffering from over-supply; as a result many conferences are seeing drops in attendance, revenues, and exhibitors.

For some conference planners, the fix is pay-to-play.

While a possibly-useful short-term fix [pay-to-play generates much-needed revenue and profit] the long-term impact will be to further reduce the value of conferences.

Another “solution” is to require each session include an employer, ostensibly to provide real-world examples that other employers can use to improve their programs. The problem with this is obvious; while it will drive more attendance from brokers, TPAs and insurers, it doesn’t deliver much value for other employers. Here’s what I said back in August..

I can’t count the number of times I’ve heard “well, if I had a thousand workers in XYZ city I could negotiate with an occ clinic too”, or “how do I apply that to my interstate trucking company” or “yeah that’s not going to fly with my unionized workforce”.

That said, conferences put on by CWCI, NCCI, WCRI and those focused on self-insureds are content-rich and well worth your time.

That’s it for this year – may you do well by doing good.


Dec
30

Predictions for workers’ comp in 2020

Well, proving once again that I can’t/won’t learn from past mistakes, here are five of my predictions for 2020.

  1.  The work comp insurance market will stay soft.


    As in mushy, pillowy, baby rabbit fur soft.
    Multiple factors make a strong argument for a continued soft market. (that’s a market where prices decline and it’s very easy to get insurance)
    First, insurance rates and prices continue to drop in pretty much every state. Second, outside of California self-insureds I haven’t seen any significant uptick in – or even leveling off of – claim frequency.
    Third, see prediction #2.
  2. Work comp medical trend will remain flat.

    Trend has been flat for several years now; as a result, medical severity (that’s a financial term, not a clinical one) remains well under control as well.
    The biggest factor may well be the industry’s ongoing success in reducing inappropriate opioid usage.  Also, frequency declines will likely continue, helping drive down medical costs.
    But…
  3. Facility costs will gain a lot more attention.

    This is the biggest cost problem payers are facing; hospitals and health systems have figured out work comp payers are a very soft target, and are hoovering dollars out of payers’ pockets.
    We’ll see more payers take specific actions to address facility costs; payment integrity will gain significant traction among payers and service providers. (PI firm Equian is an HSA consulting client)
  4. Consolidation in the work comp services industry will continue, with more of the big players merging/acquiring each other.
    A few years ago there were ten or a dozen PBMs, now there are 4 with any measurable share. Paradigm and Genex have consolidated the case management sector. There are now a handful of bill review application vendors; that could decrease if Conduent’s Stratacare/ware goes up for sale early in 2020. Same thing has happened in the TPA space driven primarily by Sedgwick.
    The consolidation has been both horizontal, that is across different sectors (e.g. Paradigm buying CM and network companies) and vertical (TPAs buying other TPAs); as there are fewer assets for sale
    Sure there is a proliferation of start-ups and smaller players but it is going to take a while for these to break thru and gain major share in one of the verticals.
  5. OneCall will be sold. 

    And possibly broken up by the buyer. After KKR and GSO’s takeover of the near-bankrupt company two months ago, not much has been heard from Jacksonville HQ.  After the balance sheet clean-up and Polaris review are completed, expect the new owners to put it up for sale. KKR and GSO will turn a handsome and quick profit, prior debtholders won’t have to write off their entire portfolio.
    No word on whether employees will get something back as well; that would require action by the current owners as “old” stock is essentially worthless.Next time – the next five.


Dec
10

in which I cover newsworthy stuff that happened this week…

Uh…that’s why you buy insurance

From Politico we hear CMS Administrator Seema Verna asked us taxpayers to pay for $47,000 worth of jewelry and other stuff stolen “during a work-related trip.” Among the valuables gone missing – that she wanted us to pay for were a $325 moisturizer (!!!) and $349 for noice-canceling headphones – plus a $5,900 Ivanka Trump pendant.

Yep, the person who runs the biggest insurance entities in the world wants the government to bail her out because she decided to NOT buy insurance. (update – good news, we aren’t paying for Ms Verma’s bling)

Physical therapy in workers comp

MedRisk released its third annual report on PT in WC earlier this week.  560,000 work comp patients were served by MedRisk so far this year; the average duration of care has shrunk to 11.2 visits over 48 days.  Better news – 98.1% patient satisfaction rate and 97.7% of providers agree with MedRisk’s clinical recommendations.

There’s an old business meme that comes to mind – “stick to your knitting.”

At a time when other service companies were seeking to become everything to everyone, Shelley Boyce, Mike Ryan and their colleagues at MedRisk went the other direction, focusing narrowly on work comp physical medicine. Along with the best management team in the business, they executed the plan to perfection. (While MedRisk is an HSA consulting client, all the credit goes to those folks).

Meanwhile all the caterwauling about drug prices turns out to be much ado about nothing (I’m looking at you, AARP) . This from the estimable Adam Fein PhD’s discussion of CMS’ review of healthcare costs:

    • For 2018, spending on outpatient prescription drugs grew by 2.5%—below the spending growth rate on hospitals, physician services, and overall national healthcare costs.
    • CMS significantly lowered its previously reported drug spending figures by billions after incorporating new data on manufacturers’ rebates.

More news showing hospital consolidation raises your healthcare costs.

From NIHCM comes a terrific slideshow – my favorite is this one – key takeaway is prices ALWAYS GO UP after mergers.

 

 


Dec
2

Time for an effective workers’ comp opioid solution for Louisiana

Today’s WorkCompCentral arrived with William Rabb’s report on the use of opioids by workers’ comp patients in Louisiana. [subscription required]

A few notable findings:

  • Louisiana work comp patients get more opioids, and they get them for longer periods of time than any other state studied
  • Employers and taxpayers pay significantly higher prices for drugs than in other states
  • 7 out of 10 claims included an opioid prescription
  • Louisiana patients get twice as many opioid scripts than the average state.

For some reason, some “claimant attorneys” don’t see the wisdom of formularies/guidelines intended to reduce inappropriate opioid use, citing spurious claims from the pain industry in attempt to validate their complaints.

Louisiana has had treatment guidelines in place for several years, however they have not been revised or updated in memory and are very difficult to enforce. Compared to other states, the Pelican State has made little progress reducing inappropriate opioid use by work comp patients.

Back in 2017 I cited Sheral Kellar, Director of Louisiana’s Office of Workers’ Compensation Administration discussing the opioid issue in her state.

Ms Kellar knows a formulary is NOT a panacea, rather a critical tool in the armamentarium which includes:

  • Prescription drug monitoring programs that require and facilitate pharmacist and physician participation,
  • Strong and well-designed utilization review programs,
  • Flexibility for PBMs and payers to customize medication therapy to ensure patients get ready access to appropriate drugs and reduce risks from inappropriate medications,
  • Carefully-planned implementation,
  • Drug testing, opioid agreements, and addiction/dependency treatment

Over the last decade I have spoken with many individuals heavily involved in Louisiana workers’ comp; each frustrated and saddened by the lack of meaningful progress in attacking the overuse of opioids by workers’ comp patients. 

What does this mean for you?

Here’s hoping Louisiana is able to make real progress on reducing opioid usage. Families, communities, employers, and providers have all waited long enough.

 

 


Nov
25

What’s up with Paradigm?

Paradigm is evolving rapidly – and none too soon.  A data-driven firm known for taking risk on catastrophic claims, Paradigm has strengthened its behavioral health offerings, and added case management, specialty and network services, all intended to make the company one of the major players in workers’ comp medical management.

I’ve tracked Paradigm for more than two decades, watching the company evolve from one stubbornly stuck in a business model that precluded growth to a diversified provider with a broad array of service offerings. In conversations with Paradigm execs several years ago, I wondered why the company wasn’t solving client’s problems, instead focusing narrowly on a highly-selected group of catastrophic claims.

While this made sense from Paradigm’s perspective – it wanted to focus its expertise on a very select type of claim – there was a big problem with this approach.

Namely, Paradigm wasn’t thinking about this from its customers’ perspective. Customers gave Paradigm a big list of claims which Paradigm winnowed down; typically relatively few were actually “accepted” by Paradigm.  The customer had a bunch of problematic claims, but Paradigm wasn’t interested in solving the customer’s problem, it just wanted to cherry-pick claims.

That’s changed.

I caught up with Paradigm Catastrophic Care Management CEO Kevin Turner a couple weeks back to get updated on the company.  Here are my takeaways (Paradigm Outcomes is one of three divisions).

Paradigm is moving down the severity scale, applying the expertise and experience it has gained handling big cat claims to less-complex claims. In so doing, the company is embedding itself deeper and broader into its clients – and growing revenues.

Turner spoke at length about Paradigm’s core asset – the wealth of data the company has amassed over the last three decades – and how that informs the company’s approach to managing cat – and “near-cat” claims (my words, not his).

We also dove into bio-psycho-social issues, including the patient’s “whole family situation” (again, my words) and the critical importance of the family in the recovery process. Marital status and satisfaction, financial stability, relations with children are all key considerations that can impact the recovery process. That just makes sense; if a patient has a difficult home life and kids with issues, it is going to be that much harder to get better.

The company recently launched a home-grown IT application – EDDG – designed to help care managers use the company’s historical data and lessons learned along with bio-psycho-social indicators to manage claims.

Of note, Paradigm is no longer the only company in the cat claims risk taking business. Carisk Partners has gained traction with its Pathways 2 Recovery program, leveraging the company’s deep expertise in behavioral healthcare and workers’ comp experience. Carisk takes risk both on individual claims and for entire portfolios of claims. (disclosure; I work with Carisk)


Nov
20

Workers comp is A) doing great, or B) a big problem

Where you sit determines what you see; this adage applies to the work comp industry.

For payers, employers, and taxpayers, all is great.  Rates are low and dropping, insurers are enjoying record profits, frequency continues to trend down, medical costs are flat.

The very things that make payers happy have the opposite effect on service companies. For most entities involved in medical management, pharmacy management, investigations, technology, claims systems, Medicare Set-Asides, and litigation defense the drop in frequency and flat medical costs are unwelcome news.

The trickle-down effects of this dichotomy are many and varied.

  • There is little-to-no pressure to revise state workers’ comp laws and regulations.
  • Insurers are looking to increase their work comp business as it is a big profit maker.
  • Claims execs are trying to balance hiring and training new claims adjusters while planning for long-term decreases in claim volume.
  • Execs are also extremely careful about investments in new IT projects, as the long-term payoff is also challenged by structural declines in claims.
  • The consolidation of service companies continues unabated; IMEs, bill review, specialty networks, PBMs, investigations, case management, cat case management services are all subject to this consolidation.
  • Selling services to payers is getting increasingly difficult.  Payers aren’t seeking solutions to major problems; they are reluctant to switch vendors unless there are serious service problems.
  • Work comp conferences are struggling due to the structural issues above; the lack of big problems driving intense interest in solutions and an arguably-over-saturated conference market is hurting attendance.

So, what to do?

If you are a service entity, you’ve got to differentiate. You must also deeply understand what individual buyers want, why they want that, what their decision process is, and who else is involved.

Unfortunately many service entities are cutting marketing budgets and pressuring sales staff to deliver deals. While sales targets are important indeed, they must also be realistic.

If you are a payer, I’d echo the last sentence above. Many payers are planning to write more workers’ comp, an obvious impossibility.

 


Nov
18

Work comp rates are still too high – and will continue to drop

Today, I’m going to convince you that despite years of continued decreases, work comp premiums are still too high.  And will likely remain too high for the next few years.

That’s how long it will take the impact of reduced opioid consumption to work its way through comp financials. Sure, continued declines in frequency and high employment along with declining worker benefits are also factors – but I’ll argue what’s way more important is the drop in opioid prescriptions.

A decade into this, the dramatic drop in work comp opioid prescriptions is continuing unabated.

  • CompPharma’s 16th Annual Survey of Prescription Drug Management in Workers’ Comp [free to download] shows payers have slashed opioid spend by 40% over the last two years.

  • myMatrixx [HSA consulting client] reported a 15% drop in opioid spend in 2018.
  • Optum Workers’ Comp reported a 2.9% reduction in opioid spend for the first half of 2019 compared to the first half of 2018.
  • CWCI’s just-released report analyzes data from lost time claims incurred between 2008 and 2017:
    • the percentage of claimants receiving opioids dropped 51% over that time period
    • chronic opioid use dropped by 77 percent, from 13% of claimants to 3%
    • acute use declined by 40 percent

My key takeaway from CWCI’s report isn’t the drop in opioid usage, it is that claims without opioids are much less costly, therefore the drop in opioid prescriptions is driving lower claims costs.

Those reductions have yet to be fully factored into work comp rates – so rates will continue to drop.

Key data points:

  • Average benefits for claims without opioids were 30% less than for claims with opioids (at 12 months).
  • Claims without opioids had 25% fewer TD days than claims with opioids.

The net – “Cumulative savings from the decline in opioids are projected at $6.5 billion for 2010 – 2017 claims.”

Report authors Steve Hayes, Kate Smith, and Alex Swedlow provide suggestions for actuaries on page 15 and in Appendix 4.

What does this mean for you?

Rate reductions haven’t caught up with the reality on the ground. 

Barring major unforeseen events, work comp rates will continue to drop for several more years. 

For those so inclined, an extensive discussion of rate-making is here.