Drug overdose is the leading cause of accidental death in the United States, with more than 47,000 lethal drug overdoses in 2014.¹ Opioids, including prescription pain relievers and heroin, accounted for more than half of these overdoses.² Having insight about who may be at risk to develop chronic pain can help injured employees avoid the dangers of opioid addiction and can help companies reduce growing workers compensation loss costs.

The costs associated with chronic pain and opioid addiction are taking an increasing financial toll on businesses. Medical costs associated with pain care and economic costs related to disability days, lost wages and productivity costs an estimated $560 to $635 billion each year,³ which is driving up workers compensations loss costs. By 2019, an estimated 67 percent of workers compensation loss costs will be from medical, including chronic pain.⁴

A new Early Severity Predictor^® model from Travelers can help identify and predict who among injured employees is at higher risk of developing chronic pain. By adjusting medical care and resources, the Early Severity Predictor model can help address potential drivers of chronic pain, a condition that is largely treated with the use of opioids or other painkillers.

“Millions of American workers are injured on the job each year, and the number of cases in which chronic pain interferes with an employee’s recovery has risen from less than 10 percent a decade ago to more than half of all serious injuries today,” said Dr. Adam Seidner, the National Medical Director at Travelers. “The Early Severity Predictor model is designed to reverse the sharp rise in chronic pain caused by workplace injuries.”

How It Works

The Early Severity Predictor model analyzes claim data and predicts which injured employees are at most risk for chronic pain. Once the Early Severity Predictor model identifies a claim, a team with a variety of viewpoints, including medical and claim, reviews it. If the claim is accepted into the program, the group creates a specific action plan, which may involve potential changes to the treatment plan.

For businesses, the Early Severity Predictor model can lead to up to 50 percent of total savings on workers compensation claims that involve chronic pain. Employees can return to work as soon as medically appropriate. They are less likely to live with chronic pain managed by medication, can expect a shorter treatment duration and a higher likelihood of pre-injury quality of life. Claims that have a higher risk of exposure over time can be proactively managed to avoid injured employees developing chronic pain over time.

Injured employees who participated in the program in the first year have, on average, recovered and returned to work more quickly. They were also far less likely to receive a prescription for opioids, and when they did, it was typically a lower dosage or only for short-term use. At the same time, medical expenses, which cost American employers an average of nearly $40,000 per injury, were reduced by as much as 50 percent.

What Employers Can Do

“Helping employees avoid chronic pain and the slippery slope to possible opioid dependency is critical to reversing this disturbing and costly health crisis,” said Seidner. Employers can help injured employees avoid opioid dependency by having a post-injury management strategy that takes a systematic and positive approach to handling employee injuries.

Responding immediately to injuries and providing attentive medical case management can help prevent an injured employee from developing chronic pain for which opioids would be prescribed. This approach can help actively manage an injured employee’s return to work as soon as medically appropriate. Helping employees recover from their injuries can also have a positive ripple effect within an organization, helping to prevent disruptions in production, quality and morale.

Sources:
¹ http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
² http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
³ Institute of Medicine Report. Pain is a significant public health problem that costs society at least $560-$635 billion annually, an amount equal to about $2,000.00 for everyone living in the U.S. This includes the total incremental cost of health care due to pain from ranging between $261 to $300 billion and $297-$336 billion due to lost productivity based on days of work missed, hours of work lost and lower wages.
⁴ Approximately 60% of WC loss costs today are from medical and are projected to increase to 67% by 2019. Insurance Information Institute. Note: variation of the statement below. Top five states only, normalized by state includes medical only and indemnity claims. Accident Year evaluated at 24 months. As reported in NCCI State of the Line Report.