Rethinking Access to Care for Rural Injured Workers

Access to timely, appropriate medical care has become one of the most important issues shaping outcomes for injured workers. The issue has become more complex as provider availability, hospital closures, rural geography, specialty care access, and delivery models continue to shift. While some injured employees have convenient access to care close to home, many, particularly those in rural areas, encounter more roadblocks to specialty care.

“Access to care, from initial injury to ongoing treatment, is not only a question of whether a provider exists somewhere in the system,” said Matt Sekula, Vice President, Workers’ Compensation Claims Strategy & Operations, Safety National. “For an injured worker, it also involves how quickly they can receive care, how far they have to travel, and whether they are likely to encounter treatment delays based on the availability of specialty services.”

Access to Care as a Claim Outcome Driver

A recent Workers Compensation Research Institute (WCRI) report found that hospital closures in rural areas can lead injured workers to receive initial care following an injury in settings other than an emergency room. The study noted that these injured workers had more visits to physical medicine services and spent more time traveling to evaluation and management services.

Notably, WCRI’s study found that among rural employees who were already farther from hospitals, emergency care use dropped by more than 10%. This shift in care settings can add stress to an injured worker’s recovery process. Transportation limitations, provider availability, or care coordination challenges can all influence how a claim progresses.

How the Industry Is Adapting

Employers and insurers are responding proactively to hospital closures as they adapt to an evolving healthcare provider landscape. One of the most significant changes is the broader use of provider networks as a care strategy, not just as a cost management tool. Network design is increasingly focused on provider availability, specialty access, geographic reach, and alignment with evidence-based treatment patterns. When used effectively, networks can help injured workers reach appropriate providers sooner and create more predictable pathways from initial treatment through recovery.

Nurse case managers have an increasingly important role in complex claims involving employees in underserved rural areas. They can anticipate challenges, in addition to keeping communication open between the injured worker, healthcare providers, employer, and claims team. Because they understand the case details, nurse case managers can help identify providers and prepare travel arrangements for injured workers.

While virtual care will not be appropriate for every claim, it can be useful in certain situations where access to care is limited. It can reduce travel burdens while also supporting faster follow-up appointments. When used thoughtfully, it can complement in-person care.

The industry is also placing greater emphasis on early triage and proactive care planning. By evaluating injury type, employee location, provider availability, and potential access barriers early in the claim, claims teams can help reduce avoidable delays before they affect recovery. This approach supports injured workers while also helping employers and carriers manage claim complexity more effectively.

Improving Access to Care at Intake

In addition to evaluating the injury, claims teams should consider where an injured employee lives and works during claims intake as well as how difficult it may be to access treatment options based on geography. If the employee is a considerable distance from appropriate providers, the claims team can get an early start on coordinating with the nurse case manager. When barriers exist, early coordination can help identify alternate providers, manage referrals, and reduce avoidable delays.

Access should also be monitored throughout the life of the claim. Missed appointments, repeated referrals, treatment gaps, or limited local specialty options may signal the need for additional support. By treating access to care as an ongoing claim management priority, teams can better support injured workers’ recovery while helping improve claim outcomes.