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Medical severity, care access top comp trends: report - 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 Medical severity, care access top comp trends: report by Louise Esola Workers Comp Coverage , Workplace Safety Jun 2, 2026 Workers compensation insurers continue to benefit from strong underwriting results, but several key tailwinds are shifting as medical severity, utilization, access to care and claim complexity emerge as top issues to watch, according to a trends report released Tuesday by Enlyte. The report, released by the San Diego-based claims technology and managed care company, said workers compensation remains one of the property/casualty industry’s most profitable lines. Calendar-year combined ratios have remained below 100% since 2015, with average combined ratios around 90% over the past five and 10 years, according to Assured Research analysis included in the report. But Enlyte said the line may face more pressure in late 2026 and 2027 as the wage and medical inflation gap narrows, labor market softness affects return-to-work opportunities, and health coverage shifts potentially push more injuries into the comp system. The One Big Beautiful Bill Act could put upward pressure on workers compensation claims by shifting some medical costs into the comp system. Enlyte’s report says the law’s health coverage effects are still unfolding, but cites Congressional Budget Office estimates that millions of Americans could lose health coverage, creating a greater likelihood that injured workers without insurance — or those moving to high-deductible employer health plans — will file claims as work-related, particularly for soft-tissue injuries such as sprains, strains and tears. The report says those injuries account for about one-third of comp claims and costs, and that insurers may begin seeing signs of this cost-shifting in claim data by late 2026 or early 2027. On the claims side, Enlyte said medical severity — rather than overall claim frequency — is the defining workers comp trend. Overall comp claim frequency remains flat to declining nationally, but allowed medical cost per claimant rose 9.5% from 2022 to 2025, reaching $4,398 in 2025. The increase came despite a 2.5% decline in allowed cost per unit, suggesting that fee schedules and negotiated rates are restraining unit prices while utilization is driving costs. Units of service per claimant rose 12.3% during the period, to 112.5 units in 2025 from 100.1 in 2022. Enlyte said injured workers are receiving more services within broadly similar treatment durations, pointing to greater “service density” rather than longer claim duration. Access to care is also becoming more uneven. Average days to first treatment rose to 16.1 days in 2025 from 9.2 days in 2022, while the median remained at one day. Enlyte said the split indicates most injured workers still access care immediately, but a subset is experiencing materially longer delays, particularly for professional office visits. Urgent care use increased to 20.5% of injured workers in 2025 from 16.7% in 2022, while professional office utilization declined slightly. Telemedicine grew but remained a small share of encounters. Behavioral health and comorbidities are also major severity drivers. Lost-time claims with behavioral health treatment had nearly four times the medical costs and more than twice the treatment duration of claims without such treatment. Separately, 67.3% of case management cases had at least one confounding factor, such as obesity, surgery, hypertension, attorney representation, opioids or depression. Pharmacy remains an early warning signal. Enlyte said high-dose opioids, polypharmacy, psychotropic medications and high-cost topicals can identify claims at risk of prolonged duration and higher costs. The report said employers and payers that emphasize early access, care coordination, utilization management, pharmacy oversight and return-to-work planning will be best positioned to manage comp severity while improving injured worker outcomes. 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