Musculoskeletal Insurance Costs
Musculoskeletal (MSK) conditions account for a high proportion of the value of claims on corporate schemes – typically 35 to 40% of the total claims spend – and are also responsible for around 33m days sickness absence per year*. However, Jelf Employee Benefits is urging employers to take a more active role in managing their health insurance costs by tackling the issue of MSK directly.
Matthew Judge, technical Director for Jelf Employee Benefits says: “The industry as a whole has woken up to the fact that rising healthcare costs are unsustainable. Given that musculoskeletal claims comprise such a significant proportion of total claims, many providers, advisers and employers are working together to produce more creative solutions to manage these costs.”
Jelf Employee Benefits explains that some insurers are offering specific MSK claim pathways. In practice this means a GP referral may not be necessary resulting in employees accessing more appropriate treatment faster often resulting in fewer sessions of treatment and a faster recovery time.
Where the provider, intermediary and employer work more closely together, employees benefit from a more joined-up approach and again receive more appropriate treatment, more efficiently.
Employers also need to take responsibility for analysing claims data and make better use of provider reports which detail their MSK spend. If they are concerned about the proportion of MSK claims they can work with their intermediary to find more effective ways of managing these cases.
Matthew Judge concluded: “It used to be the case that all musculoskeletal conditions were treated by utilising all the available medical benefit such as ‘ten sessions’ of physio. However, experience has shown that when MSK conditions are managed more effectively not all the available benefit is utilised or a different type of therapy or treatment is considered. The outcome is often lower claim costs, which in turn helps the employer manage future insurance premiums.
“Employers have a choice – they can either accept premium hikes every year or try to take a more forensic approach resulting in a better understanding of the make up of their claims, particularly MSK claims.”
*Data taken from the Office of National Statistics, Labour Force Survey. Specific ‘back pain’, ‘neck and upper limb problems’, and ‘other musculoskeletal problems’ absence days for the past three years were averaged. A working day is defined as 7.5 hours and figures were calculated for all people in employment aged 16 and over.