The National Council on Compensation Insurance (NCCI) recently conducted a comprehensive survey of more than 100 workers compensation executives addressing key issues for 2025.The financial health of the workers compensation system, medical inflation, economic uncertainty, and the shifting workplace and workforce continue to be top concerns for industry executives, a recent survey reveals.

“Each year, our Carrier Executive Survey captures the pulse of the industry and helps us pinpoint key issues facing workers compensation stakeholders,” remarked Bill Donnell, President and CEO of NCCI. NNCCI said it is dedicated to staying ahead of emerging trends and equipping stakeholders with data and insights to make informed decisions for the future.

The survey report highlights two key concerns that appear more than any others:

First: Financial Health of the System – Will There Be a Turn?

This and other related questions are common from inquiring stakeholders. All metrics point to a healthy and strong system, as evidenced by nearly a decade of combined ratios below 90%.

Preliminary results for 2024, based on National Association of Insurance Commissioners data through midyear, suggest another strong year with a combined ratio of 90% or below. Improvements in safety and automation have contributed to nearly 20 years of frequency decline in states where NCCI provides ratemaking services.

NCCI expects this trend to continue.

Secondly: Medical Inflation.

“Industry stakeholders consistently name medical inflation as a top concern, and this year, it is more prevalent than ever. Currently, medical inflation and its impact on workers comp is moderate and in the range of 2.5-3.5%. Medical inflation behaves differently in workers compensation compared to the broader economy.

There are two main considerations when evaluating medical inflation and its impact on workers compensation.

– – Fee schedules are a major factor in keeping workers compensation (WC) medical costs in control. These state-mandated cost containment mechanisms put limits on WC payments to healthcare providers and how much those payments can change from one year to the next.
– – Medical inflation in WC is different than medical inflation in the broader economy. Consider the different types of injuries and treatment in WC – the differentiation matters. The categories of treatment are also weighted differently. It’s important to look behind the numbers, as NCCI has identified in the Workers Compensation Weighted Medical Price Index.

NCCI’s annual Carrier Executive Survey is part of its ongoing communication efforts that identify key issues facing workers compensation stakeholders. This year’s survey highlights familiar top concerns and other emerging issues like legalization of medical marijuana, how climate impacts workers, and the evolving regulatory and legal landscape.

For more information, view NCCI’s Focus on Top Industry Concerns. These and other important issues will be addressed at NCCI’s Annual Insights Symposium 2025.