A newly released decade-long study by the Workers’ Compensation Research Institute (WCRI) indicates that claims initiated by nurse practitioners and physician assistants didn’t lead to negative outcomes and suggested some benefits when compared to those led by primary care physicians.
The report, “Advanced Practitioners and Workers’ Compensation Claim Outcomes,” tracked claims from 29 states between 2013 and 2022 and explored how the initial treating provider affects a claim’s medical and indemnity trajectory.
The data highlight how workers’ compensation insurers are navigating limited provider availability in rural settings and the impact of using advanced practitioners, demonstrating improved time to treatment.
“The question isn’t whether nurse practitioners (NPs) or physician assistants (PAs) can manage injured workers effectively. The data shows they already are—and have been for years,” said WCRI economist and study co-author Dr. Bogdan Savych.
The percentage of claims with the first non-emergency E&M visit (evaluation and monitoring/office visit) with an advanced practitioner varied from less than 20% in Delaware, Kentucky, New Jersey and Virginia to more than 40% in Indiana, Nevada, New Mexico and North Carolina.
The report found that in the typical study state, 33% of claims with more than seven days of lost time had the first non-emergency office visit with either a nurse practitioner or a physician assistant.
Data shows the changing dynamics of emergency room treatment over the years, with more claimants being examined by advanced practitioners rather than primary care physicians (PCPs).
Injured workers treated first by NPs received non-emergency care 2.3% faster on average than those whose care was initiated by a physician. The effect was even more in rural regions, where limited provider availability often delays treatment for days, in some cases.
In rural areas, advanced practitioners are already the most prevalent provider, the report found.
More importantly, “the first provider strongly predicts subsequent care,” according to the researchers. The data showed PAs helped expedite access to specialty services, such as diagnostic imaging, pain injections, and neurology consults.