COVID-19’s Outsized Impact on Workers’ Compensation

The 2020 myMatrixx Drug Trend Report analyzes trends in workers’ comp pharmacy spend – all dramatically impacted by the pandemic.

While it’s obvious the COVID-19 pandemic has had an unprecedented effect across the health care continuum, we recognize the truly historic impact on the workers’ compensation industry in analyzing prescription data for the 2020 myMatrixx Drug Trend Report.

In a year like no other, myMatrixx successfully delivered positive outcomes for injured workers while keeping costs down for payers. Overall prescription utilization decreased 4.9% and cost per days’ supply decreased 2.6%.

COVID-19 Distortion: Impact on Injured Worker Claims Data

The most evident effect of the pandemic was the decline in new workers’ compensation claims as a result of widespread unemployment and a shift to remote work.

For the past 3 years, the myMatrixx Drug Trend Report has highlighted age of claim, which shows drug costs and utilization rates tend to increase the longer a workers’ comp injury case stays open. With dramatically less new claims, older claims distort the average overall prescription utilization, leading to a statistical increase of 12.2% average prescription utilization at the individual injured patient level.

By identifying this impact – which we’re calling the COVID distortion effect – we’ve shown that there has been no major change in utilization behavior at the injured patient level. However, this will continue to be an important benchmark as we measure the long-term effect of the pandemic on claims data.

Behavioral Heath’s Role in Workers’ Compensation

Historically, workers’ compensation payers have avoided taking on behavioral health claims due to their tendency to become long-term cases. And yet, there is growing evidence of the interconnectedness of chronic pain and mental health. Not addressing the mental health of injured workers can delay return-to-work, increase the risk of opioid addiction or both.

This became even clearer during the pandemic and resulting quarantine, where health care professionals took a closer look at the effects of increased isolation and uncertainty about the future would have on mental health.

Research from Evernorth found there was a sustained increase in use of antidepressant medication prescriptions, especially among people with no previous prescription history.

In a sense, injured workers go through their own quarantine every time they are seriously injured.

We believe targeted behavioral health interventions offer a unique opportunity for long-term cases – especially those with high opioid utilization – to overcome chronic pain and reduce drug dependence.

Other Key Findings from the 2020 myMatrixx Drug Trend Report

  • 40.7% of workers’ compensation plans managed by myMatrixx reduced their drug spend in 2020

  • Payers spending on opioids declined by 15.1% in 2020, outpacing the decline in overall Rx utilization, which was 11.4%.

  • Generic efficiency remained at or near 100% for all clients

  • myMatrixx payers spent over $200 less per injured worker for the top 10 therapy class drugs

  • Electronic prescribing grew for workers’ compensation by 7.6%

  • The average per-prescription costs for myMatrixx home delivery was 25% less than those using retail pharmacies

For additional data and workers compensation trend insights, view the 2020 myMatrixx Drug Trend Report here.

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