Claim Cost Drivers A First Look

Transcription

1 Claim Cst Drivers A First Lk Nvember 17, 2011 Three ways t think abut high High ttal Ttal primarily include medical treatment and wage replacement High Days away frm wrk cntribute t bth direct and indirect High medical after clsure May signify lingering injury/illness, severity f impact n wrker, etc. 2 1

2 Highest ttal Event f Injury All s reslved in 2010 ttal medical 18,526 $22,720 $12,180 $10, Event f injury ttal medical Transprtatin 733 $35,304 $18,121 $17, Falls 3,616 $26,958 $14,381 $12, Unknwn 1,009 $25,396 $13,397 $11, Repetitive Mtin 1,912 $22,804 $13,185 $9, Only includes categries with at least 50 reprted s 3 Highest ttal Industry All s reslved in 2010 ttal medical 18,526 $22,720 $12,180 $10, Industry ttal medical Lgging/Frestry 230 $45,361 $24,798 $20, Cnstructin 1,525 $35,642 $21,666 $13, Truck Transprtatin 752 $29,672 $18,229 $11, Manufacturing 2,409 $26,579 $15,266 $11, Office Trades 998 $23,648 $12,300 $11, Whlesale Trade 781 $23,405 $12,798 $10, Only includes categries with at least 50 reprted s 4 2

3 Highest ttal Nature f injury r illness All s reslved in 2010 ttal medical 18,526 $22,720 $12,180 $10, Nature f injury ttal medical Bth injury and disease 1,516 $66,977 $39,118 $27, Dislcatins 647 $43,911 $24,797 $19, Other systemic diseases 84 $39,242 $23,711 $15, Other diseases 60 $38,882 $25,049 $13, Multiple injuries, ther 1,563 $33,330 $17,906 $15, Fractures 2,065 $30,926 $15,817 $15, Musculskeletal diseases 651 $23,705 $13,879 $9, Only includes categries with at least 50 reprted s 5 Highest ttal Event f injury Thusands Transprtatin Falls Unknwn Repetitive Mtin Industry Thusands Lgging/Frestry Cnstructin Truck Transprtatin Manufacturing Office Trades Whlesale Trade Nature f injury Thusands Bth injury and disease Dislcatins Other systemic diseases Other diseases Multiple injuries, ther Fractures Musculskeletal diseases Only includes categries with at least 50 reprted s 6 3

4 Nte regarding data quality Exercise cautin abut drawing strng cnclusins Average, particularly n few s, are highly susceptible t data errrs (e.g., an extra zer) and utliers (e.g., a particularly expensive ) with missing data regarding the event f injury (unknwn event) are sme f the mre cstly s Perhaps this shuld be taken int cnsideratin when determining hw diligent we will be in pursuing missing data. with multiple injuries have a significant cst attached t them The Multiple Cnditins Prject will prvide much mre infrmatin abut these s 7 Highest ttal When lking at the highest within a given categry, generally the same patterns emerged Fr example, the highest cst events in the cnstructin industry are Transprtatin, Falls, Overexertin, etc. There are sme ntable exceptins 8 4

5 Mst expensive fractures Highest ttal Lgging and Frestry ttal All s reslved in ,526 $22, Lgging and Frestry 230 $45, Event f injury ttal Struck by r against 89 $54, Falls 64 $37, Only includes categries with at least 50 reprted s 9 Highest ttal Fractures frm Falls in Cnstructin ttal Falls in Cnstructin 352 $47, Fractures frm Falls in Cnstructin 129 $59, Event f injury ttal Fall frm scaffld 10 $155, Fall t flr, same level 24 $66, Fall frm rf 7 $56, Fall frm ladder 44 $51, Falls, nt elsewhere classified 13 $50,

6 Highest ttal Back Dislcatins ttal Back injuries 4,078 $18, Dislcatins 647 $43, Back Dislcatins 152 $81, Event f injury ttal Overexertin 69 $95, Unknwn 12 $76, Bdily Reactin 28 $73, Repetitive Mtin 20 $72, Falls 16 $64, Only includes categries with at least 5 reprted s 11 Other ways t think abut high High Highly crrelated with ttal and did nt yield ntably different results in initial analysis High medical after clsure Only just begun lking at this data Apprximately 25% f s have sme srt f medical after clsure with Bth injury and disease significantly mre likely t have after clsure (55% f s) Generally medical are mst likely pharmaceuticals Wuld be interesting t see distributin f services used (pharma, surgical, physical therapy, etc.) 12 6

7 Average temprary disability and average paid fr reslved accepted disabling s, Oregn, 2010 Tp categries with highest average fr event f injury, nature f injury, and industry All s reslved in 2010 cst per 18,526 $22,720 $12,180 medical $10, cst per medical Event f injury Transprtatin 733 $35,300 $18,120 $17, Falls 3,616 $26,960 $14,380 $12, Unknwn 1,009 $25,400 $13,400 $12, Repetitive Mtin 1,912 $22,800 $13,190 $9, by event Transprtatin Falls Unknwn Repetitive Mtin Thusands cst per medical Industry Lgging/Frestry 230 $45,360 $24,800 $20, Cnstructin 1,525 $35,640 $21,670 $13, Truck Transprtatin 752 $29,670 $18,230 $11, Manufacturing 2,409 $26,580 $15,270 $11, Office Trades 998 $23,650 $12,300 $11, Whlesale Trade 781 $23,410 $12,800 $10, by industry Lgging/Frestry Cnstructin Truck Transprtatin Manufacturing Office Trades Whlesale Trade Thusands cst per medical Nature f injury Bth injury and disease 1,516 $66,980 $39,120 $27, Dislcatins 647 $43,910 $24,800 $19, Other systemic diseases 84 $39,240 $23,710 $15, Other diseases 60 $38,880 $25,050 $13, Multiple injuries, ther 1,563 $33,330 $17,910 $15, Fractures 2,065 $30,930 $15,820 $15, Musculskeletal diseases 651 $23,710 $13,880 $9, by nature Bth injury and disease Dislcatins Other systemic diseases Other diseases Multiple injuries, ther Fractures Musculskeletal diseases Thusands Ftntes n fllwing page

8 Average temprary disability and average paid fr reslved accepted disabling s, Oregn, 2010 Tp categries with highest average fr event f injury, nature f injury, and industry Ftntes: Accepted disabling s are s, accepted by insurers, arising frm ccupatinal injuries r diseases that entitle wrkers t cmpensatin fr disability r death. Fatality s, permanent ttal disability (PTD) s, s with n, and s with unreasnably high, as well as their assciated, are excluded frm this analysis. are reprted by the year f reslutin, which is the year f the latest ntice f clsure, determinatin rder, r dispsitin agreement fr initial penings. This may be different than the year f injury r year f acceptance. Event and nature f injury are classfied accrding t the Bureau f Labr Statistics' Occupatinal Injury and Illness Classificatin System (OIICS). Industry is classified accrding t the Nrth American Industrial Classificatin System (NAICS), 2002 editin. Emplyees f client leasing cmpanies are reprted by the industry in which they were wrking at the time f injury. Claim cst is the cmpsite f medical and. The cmpnents f are temprary disability, permanent partial disability, dispsitin agreement, disputed settlement, and vcatinal assistance. Average cst statistics are means, unless therwise specified. Csts have been runded, and cmpnents may nt sum t cmpsite averages. In additin, due t the estimatin prcess, cnclusins shuld nt be drawn fr rws with a small number f s. Average fr the cmpnents are cmputed ver the ttal s reslved. The temprary disability and dllars include estimates f temprary disability fr initial s reslved by dispsitin agreements rather than clsure. Insurers d nt reprt this data t the department. Indemnity incurred after clsure that were paid thrugh mid-april 2011 are als included in this table. This primarily includes permanent partial disability mdified by dispute reslutin, disputed settlements, and vcatinal assistance. These after reslutin generally increase ver time. Wrker, emplyer, and insurer reimbursements frm the Wrkers' Benefit Fund are als excluded. Medical include estimates fr initial s resvled by dispsitin agreement rather than clsure. Medical after reslutin, which are ften substantial, are nt included in this reprt. Data in this table will change. The cunts will change as s are repened and reslved. Als, as mentined abve, pst-clsure will increase ver time. Hwever, if past trends cntinue, then the temprary disability and fr the mst recent year will decline as s are repened and then clsed in future years. Surce: Infrmatin Management Divisin, Oregn Department f Cnsumer and Business Services, January 2012

9 Average temprary disability, average paid, and estimated annual ttal paid fr reslved accepted disabling s, Oregn, 2010 Tp five categries with highest estimated annual fr event f injury, nature f injury, and industry All s reslved in 2010 cst per 18,526 $22,720 medical Estimated ttal system cst $12,180 $10, $420,910,720 cst per Estimated Event f injury ttal Falls 3,616 $26,960 $97,480, Overexertin 4,263 $22,720 $96,849, Bdily reactin 2,714 $19,130 $51,917, Repetitive mtin 1,912 $22,800 $43,601, Struck by/against 2,409 $17,540 $42,247, Estimated ttal by event Millins $0 $20 $40 $60 $80 $100 $120 Falls Overexertin Bdily reactin Repetitive mtin Struck by/against cst per Estimated Industry ttal Manufacturing 2,409 $26,580 $64,029, Cnstructin 1,525 $35,640 $54,353, Health care 2,744 $16,930 $46,447, Retail trade 2,254 $20,150 $45,424, Admin and waste svcs. 1,173 $22,070 $25,892, Estimated ttal by industry Millins $0 $20 $40 $60 $80 $100 $120 Manufacturing Cnstructin Health care Retail trade Admin and waste svcs. cst per Estimated Nature f injury ttal Sprains, strains 8,554 $13,130 $112,268, Bth injury and disease 1,516 $66,980 $101,536, Fractures 2,065 $30,930 $63,862, Multiple Injs, ther 1,563 $33,330 $52,095, Dislcatins 647 $43,910 $28,410, Estimated ttal by nature Millins $0 $20 $40 $60 $80 $100 $120 Sprains, strains Bth injury and disease Fractures Multiple Injs, ther Dislcatins Ftntes n fllwing page

10 Average temprary disability, average paid, and estimated annual ttal paid fr reslved accepted disabling s, Oregn, 2010 Tp five categries with highest estimated annual fr event f injury, nature f injury, and industry Ftntes: Accepted disabling s are s, accepted by insurers, arising frm ccupatinal injuries r diseases that entitle wrkers t cmpensatin fr disability r death. Fatality s, permanent ttal disability (PTD) s, s with n, and s with unreasnably high, as well as their assciated, are excluded frm this analysis. are reprted by the year f reslutin, which is the year f the latest ntice f clsure, determinatin rder, r dispsitin agreement fr initial penings. This may be different than the year f injury r year f acceptance. Event and nature f injury are classfied accrding t the Bureau f Labr Statistics' Occupatinal Injury and Illness Classificatin System (OIICS). Industry is classified accrding t the Nrth American Industrial Classificatin System (NAICS), 2002 editin. Emplyees f client leasing cmpanies are reprted by the industry in which they were wrking at the time f injury. Claim cst is the cmpsite f medical and. The cmpnents f are temprary disability, permanent partial disability, dispsitin agreement, disputed settlement, and vcatinal assistance. Average cst statistics are means, unless therwise specified. Csts have been runded, and cmpnents may nt sum t cmpsite averages. In additin, due t the estimatin prcess, cnclusins shuld nt be drawn fr rws with a small number f s. Average fr the cmpnents are cmputed ver the ttal s reslved. The temprary disability and dllars include estimates f temprary disability fr initial s reslved by dispsitin agreements rather than clsure. Insurers d nt reprt this data t the department. Indemnity incurred after clsure that were paid thrugh mid-april 2011 are als included in this table. This primarily includes permanent partial disability mdified by dispute reslutin, disputed settlements, and vcatinal assistance. These after reslutin generally increase ver time. Wrker, emplyer, and insurer reimbursements frm the Wrkers' Benefit Fund are als excluded. Medical include estimates fr initial s resvled by dispsitin agreement rather than clsure. Medical after reslutin, which are ften substantial, are nt included in this reprt. Estimated ttals are calculated by multiplying the average cst acrss all reprted s. Data in this table will change. The cunts will change as s are repened and reslved. Als, as mentined abve, pst-clsure will increase ver time. Hwever, if past trends cntinue, then the temprary disability and fr the mst recent year will decline as s are repened and then clsed in future years. Surce: Infrmatin Management Divisin, Oregn Department f Cnsumer and Business Services, January 2012