Why do some patients need more PT than others?

Why does a therapist’s treatment duration vary for patients with the same diagnosis?

What conditions have the most impact on patient recovery?

Thanks to WCRI’s Vennela Thumula PharmD; Randall Lea MD; and Te-Chun Liu there are answers.

WCRI’s latest research based on FOTO data digs into just how big an impact mental and physical health co-morbidities – and other factors – have on improvements in functional status.

The methodology is robust indeed, the data solid as it gets, and the insights provided by the researchers quite valuable.

Using FOTO’s 100 point scale, their research indicates patients with both physical health and mental health comorbidities see about 20% less improvement in functional status than patients with no comorbidities.

courtesy WCRI

Co-morbidities – aka health conditions a patient has in addition to the one you’re focused on – may be physical – think obesity, hypertension, arthritis – or mental – depression, anxiety/panic attacks, sleep dysfunction.

Quick takeaways…

About two-thirds of patients have a physical or mental health comorbidity, and these comorbidities definitely affect the patient’s ability to recover.

The more comorbidities a patient has, the greater the impact on recovery.

More troubling still, the more likely these patient would have “very limited” function at the end of therapy.

The researchers also looked at the same metrics for non-work comp patients…and found comorbidities had similar if not more impact on recovery.

And…it isn’t just comorbidities.

Quicker access to PT had an even greater impact on recovery than physical or mental health complications. The details are on page 43 of the study. If you’re not a WCRI member, become one to get access to all their great work at no charge.

Non members will have to pony up a few bucks to learn more.

What does this mean for you?

Great research is really useful…use this to help injured workers get better faster. 

 

 

The brainiacs at NCCI have a must-read post detailing physician services’ costs and utilization in most states.

Gotta say this is one of the most useful and insightful analyses I’ve seen from anyone. Kudos to NCCI.

Couple highlights…

• VERY wide range of physician costs – on a service year basis, state costs range from $800 to almost 4 times that.
•  Using NCCI’s utilization metric (units), utilization varied almost as much – from fewer than 1000 to more than 2500 units.
• one of the most insightful learnings is about the factors contributing to variations in utilization…

• “service intensity” is the most important driver of variation; NCCI’s definition is the “collection and type of physician services rendered on average for a claim given its diagnosis and whether there was a major surgery.”

What does this mean for you?

Your medical management strategy MUST be state-specific. 

It’s that time of year…when the brilliant minds at WCRI release the latest CompScope report.

The top finding…is likely to surprise many…

Couple observations:

• yes, this was during COVID….medical costs during COVID were LOWER, not higher than previous in previous years. Those who understand medical care delivery anticipated this, alas that is a very small group.
• no, medical costs in comp are NOT increasing significantly. Haven’t been for years.
• That’s because we’re still benefiting from the opioid hangover effect.

Warning – Medicaid disenrollment aka “screw the poor folks” will push facilities and healthcare systems in many states to look for revenue replacements.

And, because work comp is pathetically awful at controlling facility costs, we can expect facility costs to increase – which will increase medical costs.

You can register for WCRI’s  webinar highlighting findings from this year’s report here….tune in November 16, 2023 @ 2 pm eastern.

What does this mean for you?

It is long past time to start preparing for higher medical spend.

Over the last two decades work comp bill review has A) changed a lot and B) remained stagnant.

Both things are true…

Here’s the top takeaways from our just-released Survey of Workers’ Comp Bill Review (public version is available here; respondents received a much more detailed version).

Is the subject of a WCRI webinar at 2 pm eastern TODAY. No charge, but there’s a limit of 500 registrants.  Register here.

The webinar follows publication of WCRI’s Dr. Bogdan Savych’s study of Long COVID’s impact on workers’ comp (Study is free to WCRI members; non-members incur a fee).

A very brief summary from WCRI CEO Ramona Tanabe:

“Among all workers with COVID-19 claims, 6 percent received treatment for long COVID conditions, some more than a year after the initial infection. At an average of 18 months of post-infection experience, these workers received more than 20 weeks of temporary disability benefits and received about $29,000 in medical care.”

Note the relatively low medical cost…$29,000.

Other studies have examined Covid costs for patients covered by commercial health and Medicare Advantage. (note some are NOT Long Covid)

Long Covid – a study published in May of 2022 (note that was a while ago…) indicated the average annual medical costs of LC was $9,000.

CDC – costs average around $9,000 for care in the first 6 months after confirmed infection.

• Using a large electronic administrative discharge database, Shrestha et al estimated a per-patient cost of $24,826 for inpatient care for adult patients with COVID-19.
• Tsai et al examined claims data and found that the mean cost per outpatient visit of a Medicare beneficiary with a COVID-19–related diagnosis was $164.
• Bartsch et al used simulation modeling and estimated median direct medical costs of a COVID-19 diagnosis ranging from $57 to $15,943, depending on the patient’s age and the severity of the case.
• Another study found that COVID-19–related hospital costs per adult hospitalization varied from $8,400 in a general ward to more than $50,000 in an intensive care unit with a ventilator (7).

A useful synopsis of Long Covid issues, treatment, and symptoms is here.

What does this mean for you?

To date, Long Covid is not expensive. Regular readers would have anticipated this.