Nursing costs, more serious injuries hike post-acute workers comp spending

The average cost of skilled nursing associated with workers compensation claims have steadily increased, with a new report showing a jump from $14,700 per claim in 2015 to  $33,200 in 2024.

The increases have outpaced the rate of inflation by “wide margins” since 2020, notes a Wednesday report from NCCI, a clearinghouse for workers comp data. While that may be due to increases in the amount of services used or prices charged, it also could reflect a shift toward more serious workers comp claims, the organization said.

More serious injuries may also be making it more difficult for injured workers to access certain post-acute care services, NCCI added.

While in-home recovery is often assisted by nurses, physical therapists and home health aides who deliver routine care such as wound dressing, physical therapy or meal preparation, other injured workers needing more continuous monitoring and more intense care typically are referred to a skilled nursing facility.

“But one challenge is that many injured workers needing these services suffer from serious injuries, such as spinal cord, neck or traumatic brain injuries,” the report said. Not all nursing homes are equipped to provide such specialty services. “Other challenges include a shortage of RNs or LPNs.” 

The report tracks the proportion of claim spending on home health and skilled nursing for decades after a covered injury, and identifies injuries that trigger major spending in each setting. Skilled nursing care accounts for more than 34% of all spending on traumatic brain injury claims, NCCI showed. Spinal cord injury and respiratory issues also drove major SNF spending.

Providers focusing on managing long-term conditions such as chronic pain and patients that require additional surgical procedures over time also lead to costs that spike, and then drop again, over time. While home health accounts for more long-term workers’ comp spending overall, skilled nursing home care can make up more than 5% of spending for the costliest incidents, the report said. 

“NCCI’s workers compensation medical data shows that, while as a share of total medical expenditure these are relatively minor costs, for those injuries where medical interventions exceed the $1M threshold, these costs are substantial, accounting for more than $1 in $4 of medical costs,” the report concluded.