Article ID: 638ff6fad13d2460c8133d5e1f25126de8eede553a7a8561ccb1168b1cadea15
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Prior authorization adds to comp access challenges: Panel - Business Insurance Skip to content Register for free Search Search Log In Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Prior authorization adds to comp access challenges: Panel by Louise Esola Workers Comp , Workers Comp Cost Control Aug 26, 2026 ORLANDO, Fla. — Reducing prior authorization requirements for conservative, or less invasive, medical care and improving communication with providers could help workers compensation programs address growing problems with access to care, a panel of experts said. Physician shortages, administrative burdens and delays in specialty care are making it more difficult to provide injured workers with timely treatment, they said Tuesday at the Workers’ Compensation Institute’s Workers’ Compensation Educational Conference. Utilization review can help ensure appropriate treatment but is sometimes applied unnecessarily to routine care, said Mary Ann Lubeskie, Long Beach, California-based senior vice president of managed care at Tristar. Physicians already spend substantial time seeking prior authorizations, contributing to burnout and making accepting workers comp patients less attractive, she said. “You see utilization review being performed on any and everything,” Ms. Lubeskie said. “Why do that on something that’s conservative treatment? … It just makes more sense to get the patient treated.” Administrative burdens are among the factors prompting physicians to stop accepting workers comp patients, said Dr. Janet Cobb, Atlanta-based senior vice president of medical operations at Concentra. Paperwork and interactions with adjusters, payers, and attorneys can create barriers for clinicians who primarily want to treat patients, she said. At the same time, rising operating costs make reimbursement an increasingly important consideration for providers. Access problems are particularly concerning when they delay specialty care, said Dr. Latoya Abbott, Bethesda, Maryland-based global occupational health services director at Marriott International. Delays in orthopedics, neurology, pain management or therapy “can change the total trajectory of the claim,” increasing claim duration and complexity, she said. “It’s not just access to care that’s the crisis; it’s access to care by doctors and clinicians who understand occupational medicine that’s the crisis,” said panel moderator Dr. Jill Rosenthal, Boca Raton, Florida-based senior vice president and chief medical officer at Zenith Insurance, a unit of Fairfax Financial Co. Dr. Melissa Tonn, Dallas-based chief medical officer at Opus Medical, said dwindling numbers of physicians trained in occupational medicine compound shortages among specialists and subspecialists, some of whom are reluctant to treat workers comp patients because of administrative and legal complications. Panelists said earlier intervention and closer relationships among employers, payers and providers can help. Dr. Cobb said Concentra analyzed about 500,000 claims and found this integrated approach was associated with 25% lower total claim costs and 65 fewer days per claim. The model includes earlier treatment, multiple access points, integrated specialists and physical therapy and greater care coordination. “When our pro athletes get injured, they get rehab right on the sidelines,” she said. Similarly, providing prompt treatment for injured workers reduces delays. Tristar is also using its data to identify physicians who achieve better outcomes and to make it easier for them to treat injured workers, including by streamlining approvals and monitoring timely bill payment, Ms. Lubeskie said. “If you have somebody who gets really good results,” programs should consider why they would “delay approvals to get the treatment done,” she said. Technology could also improve access, panelists said. Dr. Abbott said Marriott is using artificial intelligence to identify claims earlier and uncover potential gaps and barriers to care, while emphasizing that the technology requires human review. Dr. Cobb said technology ultimately offers clinicians something increasingly scarce: more time with patients. “I’m excited about the use of technology and what it can do to allow clinicians to see more patients,” she said. 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