Over the last few years, the workers’ compensation industry has been considering how factors like age or mental health affect recovery, but few have attempted to quantify how these factors affect claims in terms of how many additional visits a patient struggling with comorbidities may need.

“As all that information is gathered, it paints this picture of their recovery,” said Brian Peers, vice president, clinical services for MedRisk.

Recovery from musculoskeletal injuries in particular can be affected by outside factors. Older workers might need more physical therapy visits than younger workers, for instance. Those struggling with mental health conditions might avoid going to visits, causing recovery to drag on for longer.

To better understand how these factors are affecting physical therapy, MedRisk has turned to claims data they have amassed over decades in the workers compensation industry. Data can show how many more physical therapy visits older workers tend to need, and it can help payers and providers understand how mental health conditions affect claims.

Quantifying How Age Affects Recovery

Brian Peers, Vice President, Clinical Services, MedRisk

Workers’compensation professionals know that older workers taken longer to heal compared to younger employees, but many have not quantified how this affects physical therapy utilization. Older folks may need more physical therapy appointments to achieve the same outcomes.

As the workforce ages — 39% of the workforce is expected to be older than 55 in 2026 — preparing for how age affects recovery will be an important step for workers’ compensation professionals.

“Most people in the industry would assume that with advanced age comes complexities, longer duration of care, or delayed return to work,” Peers said, but many believed the connection was a bit “nebulous” and difficult to quantify. New research from MedRisk has found that injured workers older than 56 have 21% more physical therapy visits than those younger than 55. Peers estimates that after 55, workers will need an extra PT visit for each decade of age.

“What we found is it is maybe a little more predictable than what maybe we would have thought,” Peers said. “There seems to be a direct correlation between the decade of your age and the amount of time that you spend in physical therapy for your injury.”

By understanding the connection between age and the number of physical therapy visits, physical therapy providers can help set expectations and help ensure a good provider match

In today’s world, where it’s easy to turn to the internet after receiving a diagnosis, many workers may have encountered inaccurate information about their recovery or they might have found articles geared toward younger people. When they don’t recover in the timelines they might find online, they could become frustrated, further complicating their treatment. Physical therapists can prevent these issues by communicating with workers about how age impacts recovery.

“A lot of it is really calibrating the expectations to align somebody and position them very well for the rehab process,” Peers said.

Mitigating Mental Health Concerns

Aubrie Cunningham, Senior Vice President, Business Intelligence and Analytics, MedRisk

Frustration is just one emotion that can complicate claims. Conditions like anxiety or depression might influence an injured workers’ recovery. After an injury, a worker might be anxious about recovering or getting back to work, so they can feel financially secure.

A loss of function — even a temporary one — could cause a worker to feel depressed. Fifty percent of injured workers experience depressive symptoms during the first month after their injury, according to MedRisk’s 2023 Industry Outlook.

As with age, these factors can cause a worker to take longer to recover and utilize more physical therapy sessions than someone who may not be experiencing depression and anxiety. Per MedRisk’s report, injured workers with anxiety have 7% higher physical therapy utilization than those without.

Physical therapy providers, who often meet with patients frequently, are in a great position to assess whether a patient is struggling with mental health concerns and determine how those factors are impacting recovery.

“There’s a lot of opportunity to gather the type of intel that’s needed to really paint a picture of what might be going on in these cases,” Peers said.

“You’re spending a lot of time getting to know someone, engaging in how this is impacting their life, how it’s impacting their financial situation, their relationships at home, their relationship with their coworkers.”

Once a provider understands if a worker is struggling with depression and anxiety, they can try to mitigate it by easing fears about the recovery process and assuring the injured worker they will heal, even if they’re struggling with PT exercises or feeling pain in the moment. That additional support during the process can go a long way in shifting recovery outcomes.

“There’s things that can be done when you know that there’s anxiety and depression to be able to craft treatment programs that with evidence-based guidelines to account for these things that provide the type of support that someone might need as they work through the rehab process,” Peers said.

A Partner Suited for Today’s Risks

MedRisk uses their extensive claims data to identify the best providers for a particular case, helping improve recovery outcomes. They consider a provider’s experience with different types of injuries, how they work with workers from different industries and their record of helping employees return-to-work.

“​​We’re able to leverage all that data that we have to be able to say that we can find the best provider for an individual case,” said Aubrie Cunningham, MedRisk’s senior vice president of business intelligence and analytics.

Once a provider is selected, MedRisk supports them throughout the claim’s process. If outside factors, like age or mental health, are impacting a claim and delaying an injured worker’s recovery, MedRisk’s team of physical therapists will step in and help the provider make a plan to get things back on track.

With over 27 years in the business, MedRisk is uniquely positioned to help clients manage physical therapy challenges that could arise from age and mental health-related concerns. The company draws on their extensive experience to create solutions that support patient recovery and improve outcomes.

The firm scores the potential risks associated with individual claims and makes recommendations for recovery. Their system is able to rapidly gather claims insights and share them with payers and providers alike.

“Part of our task is to try and make things a little easier for the providers while also making things easier and more convenient transparent for the payers,” Cunningham said. “It’s an opportunity to leverage the data that we’re collecting in a way that can help others make meaningful decisions.”

To learn more, visit https://www.medrisknet.com/.

This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with MedRisk. The editorial staff of Risk & Insurance had no role in its preparation.