AI and Value-Based Care Are Transforming Workers’ Comp Claims Management

Workers’ compensation is undergoing a major transformation, fueled by the integration of artificial intelligence (AI), automation, and the growing adoption of value-based care. As claims become more complex and encompass both physical and mental health components, these tools are reshaping how injuries are identified, treated, and managed. Early triage, predictive analytics, and risk stratification powered by AI are enabling claims professionals to pinpoint high-risk cases faster and direct resources more efficiently.

Meanwhile, the shift toward value-based care—where providers are rewarded for outcomes rather than service volume—is proving beneficial for long-duration claims. These models align provider incentives with recovery success, reducing unnecessary treatments and improving coordination, especially for mental health-related cases. For claims professionals, the combination of these approaches means better health outcomes, lower costs, and a more holistic path to recovery.

Automated systems are also alleviating administrative tasks, freeing up healthcare providers to focus more on patient care. This streamlined communication between stakeholders fosters a human-centered approach, further enhancing the injured worker’s experience. Together, AI and value-based care are modernizing the way claims are managed, setting a new standard in workers’ comp efficiency and effectiveness.