Workers Compensation Game Changers. Timothy C. Mosler John E. Wade

Transcription

1 Workers Compensation Game Changers Timothy C. Mosler John E. Wade October 20, 2016

2 About Presenters Timothy C. Mosler, FCAS, MAAA Senior Consulting Actuary Atlanta, Georgia Pinnacle Actuarial Resources, Inc. 20 Years of WC experience John E. Wade, ACAS, MAAA Senior Consulting Actuary Indianapolis, Indiana Pinnacle Actuarial Resources, Inc. 1

3 Agenda Elements of the Workers Compensation System Worker Characteristics Injury Prevention Doctors Medical Treatment Economic Factors Alternatives/Constitutionality Challenges 2

4 Worker Characteristics Longevity Risk Obesity and Other Medical Conditions Part-Time Employees Return to Work 3

5 Age Increasing Longevity Life Expectancy at Birth (US) Year Do workers compensation rates reflect how long claimants will live or how long they used to live? 4

6 Percent of Obese in the US Year Adult Youth 5

7 Percent of Full-Time and Part-Time 83.5% 83.0% 82.5% 82.0% 81.5% 81.0% 80.5% 80.0% 79.5% 79.0% Year 20.0% 19.5% 19.0% 18.5% 18.0% 17.5% 17.0% 16.5% 16.0% 15.5% Full Time % Part Time % 6

8 Percent of Multi-Job Holders 5.30% 1.40% 5.20% 1.35% 5.10% 1.30% 5.00% 1.25% 4.90% 1.20% 4.80% 1.15% 4.70% 1.10% 4.60% Year 1.05% Multi-Jobholders% Multiple Part-Time Jobs% 7

9 Injury Prevention Drones Insurance Fraud Risky Tasks Additional Exposure created for others Loss Control A Good Idea Never Gets Old Wearables Warning Tracking HIPAA Autonomous Vehicles Less Human Exposure Corporate Fleets 8

10 Drones Insurance Fraud Drones can provide quicker, cheaper and safer surveillance and documentation. They eliminate the risks involving physical trespass, reduce investigator visibility in rural settings and provide access to otherwise inaccessible areas of interest. Risky Tasks Drones Replace humans for Bridge inspection in Duluth Additional Exposure created for others New Technologies and Novice Users Wild Fire Fighters and Commercial Pilots 9

11 Loss Control A Good Idea Never Gets Old Chubb s Website Workers Compensation Services Ergonomic Services Identification Teamwork Implementation Training Ergonomic Risk Assessment and Mitigation Medical management Office Ergonomics Industrial Ergonomics Industrial Hygiene Services Noise Monitoring Air Contaminant Monitoring Indoor Air Quality Assessment General Worker Safety (with seven subcategories) 10

12 Which best describes your use of a Fitbit or other health tracker? A B C D Don t wear one ever Wear one occasionally, when expecting to be active Wear one most of the time Wear one always, even for sleep Polling Question #1 11

13 Wearables Growth In May, the Tata Group announced it had doubled its number of published patents over two years, from about 3,500 at the end of 2013 to 7,000 at the end of Hazardous Tasks Wearables in hazardous environments are actually quite real today. The desire to monitor field service staff working in remote and possibly dangerous locations is seen by many as a key driver in the creation of the elusive killer app that wearables will require for industries to adopt them. 12

14 Wearables HIPAA and Tracking As this article from SearchHealthIT explains, Non-covered entities can often do whatever they want with someone's data as long as those potential actions are included in the terms and conditions which are rarely ever read by users including sharing and selling data. And sell your data, they will. A recent review in Science Translational Medicine offers some scary statistics for wearable technology consumers: The U.S. Federal Trade Commission recently tested 12 health and fitness apps and found that consumer data from these apps were being sent to 76 different third-party companies. 13

15 (Semi) Autonomous Vehicles Less Human Exposure The number of vehicle-related workers compensation claims, now responsible for a large but decreasing portion of claim costs according to the National Council on Compensation Insurance, should continue to drop as will the share of healthcare and disability insurance costs related to auto accidents. Blame Shifting Corporate Fleets Other 14

16 Doctors Supply of Doctors Millennials Regional Issue 850, , ,000 Count of Patient Care Physicians 700, , , Big Data on Doctors Driving the WC Costs 15

17 Medical Treatment Opioids Drug Testing Medical Marijuana Wearables 16

18 Opioids Prescribed in 65-80% of claims involving pain medication based on WCRI research Effectiveness generally plateaus after 60 days Injured worker frequently continues taking them National Institute of Health study: 2/3 of those taking opioids for more than 90 days will still be on them 5 years later Delays return to work Generally, lack of obstacles in the system to prevent it Efforts at better safeguards/education in several states 17

19 Opioid Deaths Increase 18

20 Drug Testing After the Injury Can result in denial of benefits During the Claim Ensures the correct dosage Ensures the drug is not being mixed with another drug producing a bad side effect Ensures the drug is actually being taken How much is appropriate? 19

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22 Within the next five years, marijuana s impact on workers compensation will be A B C D Talked about a lot but with no real impact Small, applying to only a limited set of states and injuries Significant, providing a valid alternative to opioids in many cases Somewhere between B and C Polling Question #2 21

23 Medical Marijuana Legal for recreational use in 4 states (WA, OR, CO, AK) and DC California was the first state to legalize for medicinal use in 1996 Now 21 states allow for medicinal use 15 others allow CBD use only Found effective in treating Epilepsy PTSD Alzheimer s disease Parkinson s disease Cancer pain 22

24 Medical Marijuana Issues Less evidence on effectiveness for acute and chronic pain associated with workplace injuries Workplace safety Possibility of fraudulent claims Interaction with federal law Class 1 substance Reimbursement issues New Mexico rulings 23

25 Wearables in Treatment Plans Activity Trackers Location Trackers Exoskeletons 24

26 Economic Factors Medical Inflation General Inflation 25

27 Medical Price Index for Workers Compensation 26

28 US Public Debt $25, % $20, % $15,000 80% 60% $10,000 40% $5,000 20% $ Year 0% US Public Debt (in Millions) Debt as Percent of GDP 27

29 Based on your observations, workers compensation laws are A B C D Great for business but bad for injured workers Not generous but still reasonable Generally good for workers, with only a few exceptions Too generous, almost to the point of being wasteful Polling Question #3 28

30 WC Alternatives/Constitutionality Challenges Florida Supreme Court Decisions Castellanos vs. Next Door Company Westphal vs. City of St. Petersburg Stahl vs. Hialeah Hospital Oklahoma Opt-Out System Federal Regulation ProPublica Labor Department Report 29

31 Questions 30

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33 Final notes We d like your feedback and suggestions Please complete our survey For copies of this APEX presentation Visit the Resource Knowledge Center at Pinnacleactuaries.com 32

34 Thank You for Your Time and Attention Tim Mosler John Wade Commitment Beyond Numbers 33