Telemedicine and remote opinions continue to shape (and reshape) how patients access medical expertise. It is also changing how workers’ compensation claims directors review complex musculoskeletal cases. A newly published study by BICMD takes a closer look at how digital Expert Medical Opinions (EMOs) influence clinical decision-making.
Key Findings That Matter to Workers’ Compensation Stakeholders:
The following results highlight the real value of expert medical opinions in workers’ compensation cases:
- 40.1% of cases resulted in surgical diversion, meaning surgery was avoided
- 53.0% of treatment plans changed after an EMO
- 22.5% of diagnoses were revised, improving clinical accuracy
- Average estimated savings of $8,146.89 per EMO
When we applied this data to real-world client numbers to determine cost savings:
- A medium-sized carrier with 10,000 annual claims could see estimated savings of $754,558
- A large carrier with 30,000 annual claims could see savings of more than $2.26 million
Proven Value of Expert Medical Opinions by BICMD:
Expert EMOs influence treatment direction and add an overall value to the cost of the claim. The findings in a remote opinion offer valuable insights for workers’ compensation case workers, payers, and employers focused on getting clear answers quickly. Finally, they help patients achieve better outcomes and return-to-work earlier than traditional reviews have done in the past.
Why This Study Is Important for Workers’ Compensation Claims:
In all workers’ compensation claims, early and accurate clinical direction is critical. If a diagnosis is delayed or a treatment plan is stalled it can cause.
- Increase costs of care
- Prolonged recovery
- Frustrated workers
- Loss of revenue for the employer and loss of wages for the employee
While telemedicine has become more common, there has been limited data showing how often second opinions actually change diagnoses or treatment plans. We haven’t understood until now just how impactful expert EMOs can be.
This study helps close that gap by analyzing real-world EMO data from BICMD’s specialized musculoskeletal telemedicine platform and measuring both clinical and economic impact.
Study Overview and Methodology for EMOs:
Our study reviewed 544 musculoskeletal Expert Medical Opinions (EMOs) conducted between 2020 and 2024. The researchers evaluated how often expert opinions led to changes in diagnosis, treatment strategy, and surgical recommendations. An economic analysis was then performed using CPT-based cost estimates and real-world client data. With this information, we were ablet to determine and project potential savings across different payer sizes.
Key parts of the claims that were reviewed included:
- Diagnosis
- Treatment plan changes
- Cases where surgery was avoided
- Estimated cost savings per case
- Projected savings by claim volume
What This Means for Workers’ Compensation Stakeholders:
For workers’ compensation case workers, these findings reinforce the value of early access to trusted, independent expert opinions. BICMD’s EMOs help give clear direction in complex cases sooner. This often reduces unnecessary or inappropriate surgery. We also help guide evidence-based treatment decisions that support faster recovery and a quicker return-to-work timeline.
The study presents compelling data on BICMD’s outcomes and on the many ways we support our clients. We are excited to promote these insights both on LinkedIn and directly with our workers’ compensation partners. By sharing this data, we help workers’ compensation case workers get clear, reliable information they can trust. They can then make the best decision for the worker and their care.
A Stronger Path Forward for Workers’ Comp Cases:
This BICMD-published study shows that expert medical opinions through telemedicine do far more than make care easier to access. We help deliver clearer answers, avoid unnecessary treatment, and support better decisions for injured workers and for the teams managing their care.
As workers’ compensation continues to change, having reliable, data-backed clinical guidance like BICMD offers creates a smarter, more efficient pathway to better outcomes for everyone involved.
Put BICMD’s Findings to the Test for Early Clinical Direction:
If you are a workers compensation case worker, or an employer and want faster clarity for your injured worker, you’ve come to the right place. We can help your employees avoid unnecessary procedures and attain a clearer path forward. Learn how BICMD’s Expert Medical Opinions can help you guide cases more efficiently. We can control costs and support better outcomes for injured workers.
