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MONTANA SELF INSURERS' ASSOCIATION

November 2022 Update

  • WorkCompCollege.com Announces Launch
  • 2 NCCI Studies - Long COVID & Inflation in WC Medical Costs
  • Kids Chance Awareness Week Nov. 7 – 11
  • CMS Releases WC MSA Statistics
  • Welcome New MSIA Member – Ametros
  • Legislative Reporting to Resume
  • WorkCompCollege.com Announces Launch 

WorkCompCollege.com Announces Launch

At the Southern Association of Work Comp Administrators (SAWCA) conference in Colorado Springs, WorkCompCollege.com will formally launch their services to students on November 17, 2022 at 3:00p MST – it will be live-streamed at no charge here: WorkCompCollege.com Launch. Mark your calendars now! MSIA members can follow WorkCompCollege.com on LinkedIn and/or subscribe to their newsletter www.workcompcollege.com/subscribe-to-our-newsletter to stay updated on the launch and all activities that follow.

For those who could not join us at the MSIA Business & Annual Meeting in Missoula, WorkCompCollege.com is a new venture by Mark Pew, Bob Wilson and Donald Abrams. It will provide a unique educational experience through a virtual campus for every stakeholder in the workers’ compensation industry. The result of their Core Curriculum is a Workers’ Recovery Professional (WRP) certificate demonstrating professional development.

Their mission is to empower all workers’ compensation professionals to elevate the standard of practice within the industry as a whole. Their whole-person recovery management approach optimizes outcomes for each stakeholder and advances the industry with the next generation of leaders. It is their goal to:

  • Create an industry-wide “Whole Person Recovery Management” mindset
  • Educate and empower the next generation needed for long-term viability
  • Focus on the “how” (technical proficiency) as well as the “why” (goals & rationale)
  • Add-on to the standard onboarding training that will create more effective new hires
  • Provide a Work Comp 360° view personal development model so all involved in the work comp system see beyond their desk

Through an esteemed Board of Trustees, experienced Deans for the eight Schools of Discipline, and an expert Faculty, they are delivering content that is broad (connecting all the dots in the work comp ecosystem) and focused on a workers’ recovery / claims advocacy / biopsychosocial mindset.

This educational program will enhance retention, recruitment, and onboarding for self-insurers, TPAs, carriers, clinicians, attorneys, risk managers, regulatory agencies, public entities, brokers/agents, service providers, and anyone else interested in the ongoing viability of this industry by investing in talent. For more details on the program, review their FAQ at www.workcompcollege.com/frequently-asked-questions.

MSIA members are involved with the College. As well, as we heard in Missoula, MSIA Secretary/Treasurer Mike Marsh of Midland Claims Service is working with MSU-Billings to pilot a WC educational program in the state, and, to potentially provide the WorkCompCollege.com their first state-specific program. Discounts for the WorkCompCollege.com program are still available.

2 NCCI Studies - Long COVID & Inflation in WC Medical Costs

Last month, NCCI released two studies – Long COVID in Workers Compensation: A First Look and Inflation and Workers Compensation Medical Costs – Overall Medical   Insights-Long-COVID-Insights-Brief.pdf (ncci.com)  Inflation and Workers Compensation Medical Costs—Overall Medical (ncci.com)

In Long COVID in Workers Compensation: A First Look, NCCI found:

  • 24% of WC COVID claims involved Long COVID;
  • 20% of non-hospitalized and 47% of hospitalized COVID claims developed Long COVID
  • The Age distribution of Long COVID was about the same as COVID (more prevalent in older populations)
  • Women were much more prone to Long COVID than men
  • A 4 – 1 distribution for hospitalized COVID patients
  • Almost 2 – 1 for non-hospitalized patients
  • Nine of the top 10 Long COVID class codes were health care and first responders (only clerical – 8810 - was not a health care/first responder code)
  • 60 – 70% of COVID medical claim costs were associated with Long COVID claims
  • Temporary benefit durations, on average, were 159 days for hospitalized Long COVID and 93 days for non-hospitalized Long COVID claims

The study provides a reasonable first effort at quantifying the impacts of Long COVID, particularly since we only have just over two years of history with any COVID claims. The ID-10 codes associated with COVID and Long COVID include some pretty serious issues including pulmonary, cardiovascular and neurological issues. What we do not know, of course, it what happens in future years to those of us who have had COVID or present with Long COVID. With over 50 million COVID cases and over 1 million COVID related deaths in the US, we unfortunately have a reasonable database to continue to track the impact of the disease on our systems. 

Inflation and Workers Compensation Medical Costs – Overall Medical

This NCCI article is the first of a four-part series on the impact of inflation on workers’ compensation. At this point, regarding medical costs in the system, NCCI’s answer to the question about the inflationary impact in the WC systems is, “it’s complicated.”

One of the nice things about this report is specific MT system results is available.

We have seen stable medical cost increases in WC for the past ten years or so, with increases in at about 1.5% per year on average. Two things drive WC medical costs, the price of the services and the utilization of those services. Price is what is paid per medical service provided. Utilization is a measure of how many medical services are provided and the mix of those services. WC tends towards emergency department, orthopedic and physical therapies more so than personal health care.

The latest NCCI information (2021) indicates a countrywide increase in WC medical costs from 2020 to 2021 of about 2%. It is nothing like the days of 6 – 8% annual inflation rate but is a significant change from the past few years. Interestingly, the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) is projecting about a 3.7% increase in personal health care costs in 2022 and to be in the range of 2.5 – 3% beyond 2022.

Overall, the western region NCCI states (which do not include CA, WA, ND or WY) see lower WC medical inflationary trends than the countrywide results. Montana seems to track with the NCCI western region pretty well. Montana medical costs tend to be higher for drugs and facility costs and lower for physicians. While all system drug costs are declining, Montana remains relatively high in comparison to other states. 

The next NCCI article on inflation will be on facility costs, which again according to NCCI, have been the most significant contributor to WC medical costs.

Awareness week Nov. 7-11, 2022 

When a worker gets injured on the job, it doesn’t just affect them – it affects their entire family, especially their kids.  Every Action makes a difference in these kids’ lives. 

That’s why the 50 Kids’ Chance state organizations provide scholarships and support to the kids of workers who have been injured on the job. We envision a future when all affected children can complete their education and pursue their desired career path. 

How can you get involved? 

As a nonprofit organization, we depend on support from friends, family, and industry leaders to meet our mission. It will make a difference in a kid’s life. Kids’ Chance of Montana is proud to currently assist 15 students pursuing various post high school educational opportunities. Since our inception in 2017 we have assisted a total of 25 students (most for multiple years) with $146,500 in scholarships and have started our endowment fund. We appreciate any support you can provide. 

This is presented at the request of Kids Chance of Montana. MSIA members are actively involved in the organization including serving as Board Chair and Board members.

CMS Releases WC MSA Statistics

The Sanderson Firm reports CMS has released what is likely the first ever publication of WC MSA statistics, WC MSA Statistics 2020-2022. We have discussed how important MSA’s are, and in the future will be for WC settlements. Self insurers and carriers have liability not only to CMS for Medicare as Secondary Payers, but also to the private Medical Advantage Plan carriers and Drug coverage plans (Plan C & D).

Here’s my fast break-down of the information provided by CMS –

  • WC MSA’s are coming back about 14% higher than the submissions
  • Overall reviewed submission numbers are down – that may be based on the pandemic, given the years reported, but we need more information before we can figure out what that might mean
  • Prescription costs make up between 25 – 30% of total WC MSA costs

Overall, in the last three federal fiscal years workers’ compensation MSA’s generated over $4.5 billion in payments CMS will not make as a result of the self-insurers and carriers accepting ultimate responsibility for meeting their Medicare as Secondary Payer responsibilities. This information only reflects the MSAs submitted for review during this time.

Welcome New MSIA Member – Ametros

Ametros was founded in 2010 with the vision of making healthcare easy for injured individuals and anyone that is paying for their medical needs out-of-pocket. Our mission is to help those individuals save money on their ongoing medical expenses, and to help them save time from dealing with the hassle of the complex healthcare system.

Ametros helps injured parties settle seamlessly, providing resources to transition and adjust to life post-settlement. With Ametros services, injured parties can save on their healthcare expenses, allowing their medical funds to last longer. Our team can provide full professional administration, meaning injured parties never touch a medical bill. With Ametros, injured parties spend less time worrying about medical care, and more time on returning to health. For more information about Ametros, contact Daniel Tiscareno Romero at DTiscarno@Ametros.com or 916-217-5574.

Legislative Reporting to Resume

As of this writing, we’re just short of being a week away from election day. I am not about to take a guess at what the results will be, other than we will again have a Republican majority in both chambers.

How big that majority will be is subject to a fair amount of speculation. Last session, we saw the first Republican Governor in 16 years. As well, the Republicans were two Senate seats away from having a super-majority in the legislature. The difference is that with 100 votes, a 2/3 majority in both chambers, the party in control can directly propose Constitutional Amendments or a Constitutional Convention for the ballot, assuming everyone in the caucus agrees. In at least the past two sessions we have seen the “Solutions Caucus” reach across the aisle to work to address different issues.

Regardless of the election outcome, I expect to report to you every week again during this legislative session.

If you know of something we should report on or have any questions regarding the Montana workers’ compensation system, don’t hesitate to reach out to us!