NCCI Medical Data Agenda: Why Reserves Move Before Rates
NCCI's June 23 MDCRC agenda puts utilization, wages, treatment patterns, and comorbidities in one frame. Contractors won't see that first in rates. They'll see it in reserves.
NCCI medical data agenda matters to contractors because medical severity assumptions can move open claim reserves before a new rate filing appears. NCCI's 2026 State of the Line shows total medical cost per lost-time claim rose 6%, split between 3% utilization and 3% price (NCCI, May 2026). That is why it belongs on the EMR watchlist.
The NCCI medical data agenda, from the National Council on Compensation Insurance, is not a rate filing. That is why contractors should pay attention.
NCCI's Medical Data Call Research Committee (MDCRC) met on June 23, 2026, and its agenda centered on medical utilization in classification development, treatment patterns, wage correlation to medical severity, and claim outcome measures (NCCI MDCRC, June 2026). Class-code loss costs move slowly. Open claim reserves can move now.
That is the practical signal. If carriers believe the medical cost curve has changed for a type of claim, they don't have to wait for a bureau filing to reflect that belief. They can strengthen reserves on the claims already sitting inside your Experience Modification Rate (EMR, or the mod).
Why the NCCI medical data agenda moves reserves first
The MDCRC is not a public hearing on your premium. NCCI says the committee meets twice each year to review selected research projects that use Medical Data Call data (NCCI, July 2026). That data is line-level medical billing information: hospital stays, office visits, physical therapy, prescriptions, MRIs, and X-rays (NCCI Introduction to Medical Data Call, 2026).
The timing matters. NCCI's Medical Data Call rules say all medical transactions in a quarter must be reported by the end of the following quarter, with monthly reporting also available (NCCI Introduction to Medical Data Call, 2026). A rate filing may lag. Medical transaction data does not wait for the next renewal packet.
Raji Chadarevian, NCCI's Executive Director of Actuarial Research, put the issue plainly: "Medical costs, including medical severity, remain a top industry concern, but no single metric tells the full story" (NCCI AIS preview, March 25, 2026). That is the agenda in miniature: price, utilization, timing, wages, comorbidities, and claim duration.
Utilization is already carrying half the increase
NCCI's 2026 State of the Line Guide gives the cleanest current read. Total medical cost per lost-time claim rose 6% from 2024 to 2025p, with 3% from utilization and 3% from price (NCCI SOL Guide, May 2026). A year earlier, total medical rose 6%, but utilization accounted for 4% and price for 2% (NCCI SOL Report, May 2026).
That split matters more than the headline. Price gets baked into filings. Utilization gets baked into reserves. More visits, a different site of care, delayed physical therapy, or a surgery path that stretches longer than expected can change the carrier's view of the ultimate claim value before the employer sees any filed rate change.
The worked example is small enough to miss. NCCI put average lost-time medical claim severity at $30.6K in 2025p, up from $29.5K in 2024 (NCCI SOL Presentation, May 2026). That is $1.1K more on one average lost-time medical claim. If that extra cost lands in a reserve during the mod window, the worksheet records the incurred number. It does not care whether the increase came from provider price, treatment volume, or a longer path to closure.
Construction gets the harsher read-through
Construction is where this agenda stops being theoretical. NCCI reported that construction had the highest medical claim severity and an about 13% year-over-year increase in lost-time medical severity for accident year 2024p (NCCI SOL Presentation, May 2026). Its class view included residential carpentry 5645, electrical 5190, roofing 5551, plumbing 5183, and HVAC 5537 (NCCI SOL Presentation, May 2026).
That is why the wage-correlation topic on the June 23 agenda is not academic. Higher-wage craft labor usually means higher indemnity exposure. The sharper question is whether worker, job, and treatment patterns point to a larger medical reserve before the claim has fully matured.
In our reviews of Southeast construction worksheets, the expensive claim is often not the surprise accident. It is the claim that looked ordinary at first report and then stayed medically active long enough for the reserve to absorb a new severity assumption. The mod does not announce that change. It just multiplies by it.
Treatment timing is the hidden variable
NCCI's AIS 2026 medical severity session made the same point. Its key takeaways said demographics and comorbidities, including age, wage, and health status, drive complexity, duration, and cost (NCCI, May 12, 2026). The same summary said delays in physical therapy or major surgery put upward pressure on medical utilization, and claims closed within two years vary by jurisdiction from 30 to 50 weeks on average (NCCI, May 12, 2026).
That is the reserve lever. A claim that is still medically unresolved near a valuation date is not just open. It is being priced against the carrier's current view of treatment duration and medical complexity. If NCCI's research pushes the market toward a more granular view of utilization, carriers have every reason to make reserves reflect that view before filed loss costs do.
What an audit would check
An audit checks whether the medical reserves inside the experience period reflect the specific claim path or a broad severity assumption applied to the carrier's book. It also checks whether medical-only status, lost-time coding, and current claim values align with the worksheet being used for the next rating date. The point is not to argue with the medical agenda. It is to keep a contractor's mod from absorbing reserve drift that does not belong to that account.
If your open claims are carrying medical reserves into the next valuation date, send us your NCCI worksheet and we'll review whether the mod is tracking the claim or the trend.