Workers' Compensation Insurance
Travelers Models Chronic Pain Probability
A depiction of drug dependency. Fanatic Studio via Newscom.
Injuries sustained by construction workers put many on a path to chronic pain, opioid pain relievers and possible dependence and abuse. Insurer Travelers said this week that it has developed a predictive analytics tool to estimate the risk of chronic pain and that it can help head off such long-term and costly consequences.
“Were avoiding an unfortunate dependence on opioids and returning the employee to work faster.”
– Richard Ives, vice president for workers' compensation claims, Travelers
The number of work injuries and workers’ compensation claims in all industries has fallen by one-third from 2006 to 2017, according to the National Council of Compensation Insurers, the rate-making organization owned by its member insurers. About half of workers compensation claims Travelers sees from the construction industry include opioid prescriptions, says Richard Ives, Travelers’ vice president for workers’ compensation claims.
Based on its extensive claims data, Travelers’ says its model can be used to identify a claim where the possibility of chronic pain exists. The claim is then reviewed by a team of medical and claims specialists. If the claim is accepted into the program, the insurer helps create an action plan, which may involve changes in treatment.
In the progress of a typical injury, the employee’s pain may progress from acute phase to chronic over time.
“A lot of individuals may not develop chronic pain until months after their first doctor’s visit,” says Ives. A doctor may prescribe an opioid and that may help. But if the pain persists, the pain reliever’s morphine equivalency may need a higher dosage over time for it to be effective.
The value of Travelers’ Early Severity Predictor model is in being able to "get ahead of the higher level before it becomes dangerous,” says Ives.
But in a common scenario playing out during the opioid epidemic, he adds that a doctor may decline to increase the dosage, possibly prompting the employee to look to illegally obtained drugs for relief.
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Travelers processes over 250,000 workers’ compensation claims and 3 million medical bills a year, says Ives. About 50,000 employees have already been through the Early Severity Predictor program.
Says Ives: “We’re avoiding an unfortunate dependence on opioids and returning the employee to normal life faster. The win for our customers is lower claim costs by treating root cause.
That may mean a higher claim cost up front, he notes, “but it’s better to help keep down the total cost and return an employee to work. And that’s especially helpful in construction, where labor is so tight.”
