#WCRI2020: Post conference thoughts


WCRI policy analyst Vennela Thumula discusses trends in opioid use with Dr. Albert Rielly of Massachusetts General Hospital.

By James Lynch, Chief Actuary, Insurance Information Institute

It’s a heavy pour in first class on the train back from Boston (Woodford Reserve), but it lets me absorb the idea-heavy Workers Compensation Research Institute conference just ended.

WCRI’s annual confab is heavy with the kind of wonkery that you can’t confess secretly fascinates you. Triple-I’s Twitter account was laden (or, in my opinion, enlivened) last week with talk of, say, how often injured workers need a second operation for injuries in the lumbar region. (The answer is 11%, and it follows the rule of thumb that surgeons employ.)

So here are general impressions, though I’ll add (and be the first to every say): For more in depth analysis, see our Twitter feed. (@iiiorg – #WCRI2020)

Coronavirus. Not fair to lead off with something beyond organizers’ control, but talking about the current “Is It A Pandemic . . . Yet” is, these days, the ultimate icebreaker.

First, handshakes are out: how do you greet each other without spreading viral havoc? WCRI President and CEO John Ruser kicked off the meeting with several options:

– the elbow tap, a sort of twist at the waist, lunge and nudge. Seems safe, but isn’t that the same elbow you are supposed to sneeze into?

– the boot tap, which had a viral moment earlier this year – a sort of Irish step dance for the middle-aged.

the Wai bow, a Thai tradition which best resembles the yogi’s namaste, except standing. (It also has an emoji – 🙏.)

Elbow tap won out, and I suspect you will see lots of nuzzling elbows soon if you have not already.

Second, discussion of how this might disrupt said spring conference season. It was rumored – not confirmed – that the sponsoring Boston hotel had no more conferences in March, the rest being canceled. I’ve heard of sporadic cancellations, but nothing I’m attending has been called off as of March 9.

Medical marijuana. Massachusetts recently legalized recreational cannabis, and attendees seemed concerned how this will play out. The obvious concern – sky-high employees – but also the quackery. People self-medicate with substances containing CBD – marijuana’s nonhallucinatory ‘medication’ (the quotes meaning there’s precious little evidence it medicates against anything), but have no way of knowing what else lurks in the palliative – THC, leads, toxins?

This resonated with me, because as I made my way to Boston last week, I stopped at a small downtown that had a CBD shop. It was handing out samples.

Workers comp and the aging workforce. The first conference sessions addressed the generational shift. Opening speaker Jennifer Deal studies how Boomers, GenXers, Millennials and GenZ’s see the world. Her general conclusion: The generations are more alike than different, and many of the differences stem from differences in the perspectives of 30-, 40- and 50-year-olds.

The next speaker, WCRI’s Bogdan Savych, brought the workers’ comp wonk to the topic: The rate of on-the-job injuries declines after workers turn 65 – fewer overexertion claims, but more falls. Sprains decrease, so do cuts. But fractures increase.

And the cost per injury rises with age, no small thanks to that increase in fractures.

Indemnity payments decrease – because older workers who get hurt make less than younger injured workers.

Finally, older workers find it a bit easier finding medical professionals to treat them. This might reflect the differences in injuries – easy to find a doctor to treat a fracture or a cut – or it might mean older workers can better negotiate the medical system.

Opioids. The workers comp world can be justifiably proud of its efforts to reduce overprescription of opioids. WCRI researcher Vennela Thumula showed that opioid dispensing fell between 2014 and 2018 in all the states the organization studied.

They still got the same amount of pain treatment, more or less. In some cases, they got non-opioid pain medications, but that didn’t take up all the slack. There were also increases in behavioral medicine – approaches that help people deal with the pain rather than mask it.

There were also increases in chiropractic treatments and – at least in California – an increase in acupuncture.

Next year’s conference is March 24 and 25 in Phoenix.

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