Montana Self Insurers' Association

August 2025 newsletter

MSIA Business & Annual Meeting
Governor’s Conference – Billings – Sept 3 – 5
Annual MSIA Issues Survey – Coming Soon
WCRI Report – Advanced Practitioners & WC Claim Outcomes
BBER Summer Seminar – Taxes, Tariffs & Trade Wars
WCRI Study – AI in Workers’ Compensation – Promises & Challenges
MSIA Business & Annual Meeting
Governor’s Conference – Billings – Sept 3 – 5
Annual MSIA Issues Survey – Coming Soon

The MSIA guest speaker this year will be Dr. Claire Muselman of Drake University who will present, Beyond the Punch in the Face: A Human-Centered Roadmap for Making Workers’ Compensation Work. The Muselman presentation is sponsored by Midland Claims Service/Industrial Injury Claims.

Dr. Claire Muselman is a Human Behavior Scientist, leadership strategist, and nationally recognized workers’ compensation expert. She is the founder of DCM, a consulting firm that helps organizations transform workers’ compensation programs, elevate leadership communication, and build resilient, high-performing teams. Muselman has led innovative claims initiatives, including founding the Workers’ Recovery Unit at WR Berkley and the Work Comp Center of Excellence at NARS. She serves as the COO of WorkersCompensation.com, and is the Dean of the School of Workers’ Compensation at CLM Claims College. Dr. Claire is also on faculty for Work Comp College and The Academy, and serves as Assistant Professor of Practice in Leadership, Human Resources, and Organizational Behavior at Drake University. Her work blends neuroscience, behavioral psychology, and practical claims expertise to help organizations reduce costs, improve culture, and deliver better outcomes for injured workers. Dr. Claire is known for her high-energy, evidence-backed presentations that leave audiences inspired, informed, and ready to take action. Muselman is also an MSIA friend.

The MSIA 2025 Business & Annual Meeting starts on Wednesday, September 3, at 8:15a (despite the Governor’s Conference agenda) in the Skyview Rooms on the 20th floor of the Doubletree Hotel in downtown Billings. The meeting is sponsored by Browning, Kaleczyc, Berry & Hoven and Definiti Comp Solutions /Definiti Rx.

This meeting is for ALL members - if you cannot join us, please provide your proxy to the MSIA office for quorum purposes.

At the Business meeting we will go through the Annual Members Issues Survey results, our financial results, budget and we will elect Board members. The meeting agenda is attached. Three seats on the Board are up for election, including the Chair and two at large seats. Any employer member is welcome to serve on the Board. If you are interested in one of the seats, please contact the MSIA office.

MT Governors Conference – Billings – Sept 3 – 5 You won’t want to miss this year’s Conference!

Click this link for details on this year’s Conference, Making Work Comp Work – and see the powerful line-up of speakers –

Dr. Lisa Fitzpatrick with XcelABLE – talking about FCEs (MSIA Member)
Amy Rolando with Minworx Health talking about medical innovation (MSIA Member)
Bob Wilson with WorkersCompCollege.com talking about Innovation & AI (MSIA Friend)
Dr. Tyrone Spears with the City of Los Angeles - successful return to work
Dr. Gary Franklin, Medical Director for WA Dept of Labor & Industry – talking about opioids in the system and new changes at the CDC
Dr. Jennifer Jutte, Associate Medical Director at the WA DLI – PTSD treatment guidelines
Brian Holmes Listening, Influencing and Persuading
James Benham – Insurance, Technology and Innovation
Amanda Frickle – MT AFL/CIO – a leader on public policy issues in Montana

We’ll also get a perspective on the legislative session just ended in April from Nick Mazanec with MSF, a Workers’ Comp Court Case Update from Judge Lee Bruner and a PT panel discussing the new changes permitting PTs to be Treating Physicians under MT WC law from Sam Schmidt and Lorena Petite Payne and Thomas Little of APTA-MT.

This really is a conference you don’t want to miss – starting with Muselman at the MSIA meeting! – Remember, despite the formal agenda, the MSIA meeting starts at 8:15a

2025 MSIA Annual Issues Survey – Coming Soon

Each year, MSIA asks you what keeps you up at night about the Montana Workers’ Compensation system, what changes we should consider and what’s working well. This completely confidential survey helps your Board of Directors identify what’s important and how to direct our legislative and public policy efforts.

Your responses are completely confidential. The individual comments are NEVER given attribution and all comments are welcome.

Look for this year’s survey coming in the next week or so and provide your responses. Last session, we were able to

Enact PAs as Treating Physicians
Overturn Rainey and avoid the 14 day notice when there is a full duty release back to work
Provide direction to the Courts limiting coverage when the employer provides a vehicle to work related accidents
Avoided – perhaps for the last time – PTSD coverage in the Montana system
Defeated changes to the Choice of Physician, the elimination of benefit caps and additional requirements for the housing application for benefits.
We came thisclose to enacting significant changes to IMEs.

Our positions and efforts start with you. Your opinion matters and makes a difference in our positions, and ultimately in how well the Montana workers’ compensation system works. Please respond when the Annual MSIA Issues Survey comes out. All responses are completely confidential.

WCRI Report – Advanced Practitioners & WC Claim Outcomes

Here’s a news flash: There is a physician shortage in the US – if not the world. As a result, we all have been using more mid-level medical professionals for more of our visits. The same is true in workers’ compensation. This past session, Montana, like many other states, passed a law with MSIA support to permit Physician Assistants (PAs) to be treating physicians, after a period of practical experience under the supervision of a physician.

The question is – What is the impact on outcomes in a WC claim when mid-level practitioners are the primary medical care providers?

The Workers’ Compensation Research Institute (WCRI) has just issued a new report, Advanced Practitioners and Workers’ Compensation Claim Outcomes which initially indicates there is not much difference. It seems injured workers are seen faster, and while there may be more testing and specialist involvement, overall, the results balance out

The study relies on data collected from pulled from 29 states (Montana is not one of those states) representing some 80% of all workers’ compensation claims paid between 2012 – 2022. Claims data reflected payment activity at 6 and 12 months after injury. The conclusion – at this point - there is little difference in the claim outcomes, based on physician or mid-level primary treatment.

Physician Assistants or Nurse Practitioners saw 37% of first non-emergent office visits representing a significant change from th3e 18% identified for 2013; Rural areas reflected 43% of visits with PAs and NPs;
Injured workers who saw either PAs or NPs saw a 2.3% shorter duration to first E & M treatment than those who saw standard primary care physicians; In rural areas it was a 9.9% shorter duration in first treatment time);
The number of visits, use of specialty care, or timing, overall medical payments and indemnity benefits saw little difference based on the use of PA/NPs; Although there was slightly higher use of some specialty services – major surgery and pain management injection (0.9% and 0.6% respectively).

Overall, there was a 4% increase in medical payments and a 5.2% decrease in indemnity payments per claim. When viewed from the perspective of PA/NPs in the same practice as primary physicians, the differences become smaller.

The conclusion: there is little difference in the ultimate outcome of the claims based on physician or Advanced Practice providers specific provider seen. MSIA is a member of WCRI, through one of our members. For more information on this or other WCRI reports or studies please contact our office.

BBER Summer Seminar – Taxes, Tariffs & Trade Wars

Every year, the University of Montana Bureau of Business & Economic Research (BBER) produces an in depth winter program and an overview of economic results in the summer. The winter series typically breaks down all aspects of Montana’s economy and provides a city-specific outlook. The summer seminar tends to take a higher level look at our economy, reviews what data we might have for the year to this point and provides a on-the-ground political perspective on our economy.

This year’s summer seminar, Taxes, Tariffs & Trade Wars started off with a bang. Todd O’Hair, President of the Montana Chamber of Commerce, identified he was shooting his political career in the foot by asking us to look at our tax structure. He reviewed the recently concluded session activities on property taxes as an example of some of the problems in our system.

There was little question, regardless of politics, that something had to give on property taxes this past session. The charge was provided to do something – but not to look for new revenue, or impact other taxes. So, the property tax system would continue to have to generate the same revenue expected - - and homeowners demanded some relief from the current system.

With those limitations, the legislature enacted a ‘reform’ that saw a potentially sizeable increase in commercial properties, a BIG increase in second home property taxes and some relief for primary residences. The issue here is it is only a shift in taxes – it does not fundamentally change the structure. To pay for primary property tax relief, commercial and second home taxes are going up. When commercial taxes go up, the price consumers pay for those commercial enterprises goes up. Of course, we have not yet discussed the average 68% increase in property taxes for second homes. While we all agree we’d like out-of-state second homeowners pay more – we are also increasing the taxes for our cabins in the mountains or at the lake.

O’Hair stressed that we’re dealing with an outdated system trying to work in a changing economy. Consider that state revenues come from three places – income tax, property taxes and natural resource taxes. That’s not bad as far as it goes – however, mining has been declining for decades; timber has been declining for decades, coal has been declining for decades. So – one leg of that stool is shrinking – and has been for some time. What’s been growing in Montana’s economy is high tech, business services and tourism. In simple terms, in comparison, these industries are getting a great deal.

O’Hair pointed out that Montanans are very, very (and maybe another very) opposed to a sales tax. However, while there are some limited tourist taxes, our property taxes and income taxes are expected to make up for the declining revenues from the natural resource taxes. When there is a limitation on sales taxes to specifically subsidize property taxes – perhaps by constitutional amendment – the opposition to a sales tax softens. Consider that tourists come to the state in record numbers, utilize our infrastructure, and pay a minimal amount to do so – while we pick up the tab for the roads, water and waste systems. Maybe it is time to have a serious conversation about the potential of a sales tax.

Jeff Michael, Director of the BBER, reviewed the headlines on tariffs. Tariffs are much higher than they have been; during the first Trump presidency, tariffs were about 3% - they are now about 20%. However, according to Michael, they only impact about 11% of US consumer goods. While all that is good – the volatility and uncertainty created by all the tariff conversations and threats, has impacted business and how business is done. Business does not like uncertainty.

GDP (Gross Domestic Product) – the base measure of the country’s economy is down in Q 1 2025. In fairness, it was up in Q 4 2024 – likely because of increased spending with the expectation that increased tariffs, and therefore increased costs, would be hitting after January 20. The uncertainty of tariffs, and overall economic health as a result, has contributed to decreased business investment in 2025, so far. As well, inflation has been somewhat stubborn at about 3 – 4 %, some of that is attributable to tariffs – however, tariffs account to 1.5-2% of inflation.

Unfortunately, for us in Montana, we spend more on tariffed goods, than the national average. In simple terms, we buy more trucks than the national average – and they are expensive. While the idea of increasing the costs of imported goods to the benefit of domestically produced goods is a decent theory, it also gives domestic producers an opportunity to increase costs, while staying below the imported competition. The potential hit to Montanans pocketbooks for vehicles, parts and for clothing looks to be about 15%.

The conclusion – is we could see some impact to Montanans average spend, based on what we buy, and there is the possibility of decreased business investment based on uncertainty in the economy. Talk of a tariff fueled recession has died down, but we may face some increased costs in the short term and a slowing economy overall in the longer term.

Michael pointed out that business dislikes uncertainty – especially when it comes to taxes and government regulation. However, uncertainty is the story so far in 2025 as historically high tariffs are switched on and off seemingly on a daily basis and are driving a financial market roller coaster. In addition, Congress is starting work on major tax legislation that will shape the economy for years to come. The end result, as with so many big issues, likely will not be known for some time.

WCRI Study – AI in Workers’ Compensation – Promises & Challenges

WCRI released Artificial Intelligence in Workers’ Compensation: An Overview of Promises and Challenges in June. For this study, WCRI reviewed:

How WC stakeholders define AI;
the value of different tools in their organizations;
Challenges encountered in adopting AI and
Best practices and regulations that may mitigate those challenges.

WCRI relied on interview responses from industry leaders including employers, insurers, medical and other service providers, worker advocates and regulators. WCRI also looked at the most relevant literature and information regarding the development of AI tools. MSIA provided a May 2025 Webinar – Avoiding the AI & Automation Potholes – contact us for a copy of the presentation. The WCRI study conclusion and the MSIA webinar were similar in their messages – AI can do wonderful things, improve claim outcomes and results from all perspectives – including recovery, but there are issues which can take you in the wrong direction if not carefully managed.

According to the WCRI study, not all challenges in the WC system require AI solutions, but when applied appropriately and thoughtfully, AI can lead to fat claim resolutions, more consistent decision making and improved outcomes for inured workers.

AI can offer fast and consistent processing to structured and even unstructured data:
AI can offer an automation of routine tasks to speed up WC workflows and approval of proposed medical care; and
AI can offer better predictions of claim outcomes and improved identification of additional or early interventions.

The over-arching theme was that some AI applications can reduce administrative burdens on adjusters, attorneys and providers enabling them to focus more on managing the relationship and more severe issues involved with the individual case. Success depends largely on robust implementation – there has to be a recognition and testing to confirm models are accurate and fair, maintenance of human judgement and continuous monitoring of how the AI process if performing.

In addition, overall success requires a sound, accurate and accessible data systems and adequate training and acceptance of change management. One is technology based, clearly the second is management and people based. If not managed properly and if the known and unknown issues with AI are not addressed, there will be negative consequences.

MSIA is a member of WCRI. For more information on the study, please contact our office.