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Closure rates, rising medical costs trouble comp claims managers

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More than 50% of workers comp claims officials report a growing claims inventory, finding that closing claims within the first year is becoming more difficult, according to the results of a survey released Monday.

Rising Medical Solutions, a Chicago-based national firm that provides medical cost containment and medical care management services to the workers compensation sector, surveyed 572 claims officials for its annual benchmarking study.

One of the key indicators of the health of the comp industry is the claims closure ratio, according to the report. Twenty-four percent of respondents have an average closure ratio of 101% or greater within the first year of a claim, as experienced in 2016, and 58% report an average closure ratio of less than 100%, up from the 37% that reported a subpar claims closure rate in 2014, according to the report.

“These results indicate an overall decline in performance from the 2014 study, with more than 50% of participants reporting growing claims inventories,” the report states.

A closure ratio less than 100% means claim inventory is growing; a ratio greater than 100% means inventory is declining, according to the report.

The survey also found that fewer companies are engaging in self-assurance or auditing of best practices, with 59% in 2017 confirming that those programs remain intact, down from the 65% that reported having in place such programs aimed at improving claims outcomes.