Workers' compensation experienced another strong year in 2023, marking a decade of profitability for private carriers, according to the National Council on Compensation Insurance (NCCI). Private workers' compensation carriers achieved a combined ratio of 86 for the 2023 calendar year, making it the seventh consecutive year the combined ratio stayed below 90, based on NCCI's data. Workers' compensation premiums rose to $43 billion, a 1% increase from 2022. Additionally, the sector's reserve redundancy expanded to $18 billion. The voluntary market carriers demonstrated their strength as the residual market's share of the workers' compensation line continued to decline, dropping from 6.1% in 2022 to 5% in 2023. Comparatively, the residual market held a 12.5% share in 2003, according to NCCI data. In 2023, the frequency of lost-time claims fell by 8%, which is twice the rate of the long-term average decline. Additionally, the severity of claims showed moderation last year, with NCCI reporting a 2% rise in medical-claim severity and a 5% rise in indemnity-claim severity. Opioid utilization in workers' compensation claims saw one of its largest declines in recent years, according to Enlyte Group, LLC, with a 9.7% drop in utilization per claim and a 7.2% decrease in cost per claim. However, alternatives to opioids also saw declining utilization, though to a lesser extent. Non-steroidal anti-inflammatory drugs (NSAIDs) saw a 3% drop, while anticonvulsants declined by 7.4%. In the past year, eight of the top 10 therapeutic drug classes experienced an increase in prescription costs, with two classes seeing costs rise by more than 10%. Enlyte reported that utilization per claim fell in every class except for medications treating migraines. Migraine medications saw a 17% increase in utilization and a 10.2% rise in cost, while respiratory medications had the largest cost increase at 14.7% per script. The slideshow above reviews the states with the highest workers' comp costs based on the Workers' Compensation Index Rate, which is a biennial survey conducted by the Oregon Department of Consumer & Business Services' Information Division. The index rate is tabulated per $100 of payroll and are the basis for determining final premiums for workers' compensation insurance. Related: |

• Best practices in small business claims mitigation
• Private carriers see 10th year of profitably from workers' comp line
• Workers' compensation claims seeing fewer opioid prescriptions