Comp sees increase in advanced medical practitioners treating workers

The workers compensation industry has seen a steady rise in the number of nurse practitioners and physician assistants tending to injured workers during first medical visits — a shift researchers say was spurred by physician shortages but that has had little impact on claims costs, according to a Workers Compensation Research Institute report released Thursday.

The percentage of first office visits with physicians decreased from 81% in 2013 to 60% in 2022, while the percentage of first office visits with physician assistants or nurse practitioners increased to 22% from 11% and to 16% from 5%, respectively, the Waltham, Massachusetts-based institute found.

The report also found that pandemic-related increases in provider vacancies — a measure of provider shortages — did not “meaningfully contribute to changes in claim costs, duration of disability, and types of care provided.”

The reliance on advanced practitioners varied across states. In 2022, the percentage of first office visits with advanced practitioners was less than 25% in Delaware, Kentucky, New Jersey and Virginia, and more than 50% in Indiana, Nevada, New Mexico and North Carolina.

Nurse practitioners are playing an increasing role in rural areas; in 2022, they provided 26% of first office visits in such areas, according to the report.

The report said that “shifts in the provider landscape affected who provided care but had minor effects on most outcomes,”

including time to first service, types of services provided and claim costs.”