Medical Cost Projections: Planning for the Future of Sports-Related Injuries

Oct 30, 2024 | Healthcare, Legal Nurse Consultants, Medical Cost Projections

Every parent hopes that their children will stay safe while playing sports. Whether it’s soccer, basketball, or gymnastics, organized sports are a big part of growing up for many kids. While sports bring benefits like teamwork and physical health, they also come with risks. With these risks in mind, it’s crucial to consider medical cost projections associated with potential sports injuries, as they can significantly impact families.

Understanding the Scope of Sports Injuries

Every year, millions of athletes – from youth leagues to professional sports – face injuries that require medical attention. After hitting record lows during the 2020 lockdown, sports injuries rebounded dramatically according to the National Safety Council. There was a 20% increase in 2021, 12% increase in 2022, and a 2% increase in 2023.

The 2024 Gitnux Report noted that over 3.5 million children aged 14 and under seek medical treatment for sports injuries annually. The story isn’t much different in professional sports. The Gitnux report revealed that 67% of National basketball players suffer at least one injury per season, while one in six NFL players miss games due to injuries. The Miami Dolphins quarterback, Tua Tagovailoa, sustained three concussions in three years – beginning in college and continuing into his NFL career.

Participation in sports comes with the likelihood of a sports injury along with its associated costs. With average emergency room visits costing $2,000-$5,000 and surgical procedures often exceeding $50,000, understanding future medical cost projection becomes crucial for families and legal teams alike.

What Is a Medical Cost Projection?

It is a tool that provides detailed estimates of future expenses over a specific timeframe. Think of it as a financial roadmap that helps families and legal teams understand and prepare for upcoming medical expenses. These projections are particularly valuable in cases involving sports injuries, where treatment might span months, years, or even decades.

Based upon current medical records, healthcare providers recommendations and input, the expected costs of medical treatment, surgeries, therapies, etc.  is quantified.

Potential Long-Term Consequences in Youth of Sports Injuries

Unfortunately, for some children, sport injuries are more than just bumps and bruises. Serious injuries like fractures, concussions, and ligament tears can lead to long-term health care needs. It’s important to understand how these injuries can affect a child’s future and help attorneys and families plan for the medical costs that may arise down the road. Whether it involves in-home long-term care services or care provided in medical long-term care facilities, the future medical care youth may face requires assessment.

Physical Impact

Sports injuries can have lasting effects that extend well into adulthood:

  • Chronic pain syndromes
  • Reduced range of motion and flexibility
  • Early-onset osteoarthritis
  • Increased vulnerability to subsequent injuries
  • Potential need for ongoing surgical interventions

Cognitive Effects

Particularly in cases of head injuries:

  • Persistent memory challenges
  • Attention and concentration difficulties
  • Academic performance issues
  • Risk of developing long-term neurological conditions
  • Potential impact on career choices and opportunities

Psychological Considerations

The mental health impact of sports injuries often goes overlooked:

  • Performance anxiety upon return to play
  • Depression during extended recovery periods
  • Post-traumatic stress related to injury circumstances
  • Identity crisis when unable to participate
  • Social isolation during recovery

Planning for the Future: Future Medical Cost

The medical needs of a sports injury can continue for years or even a lifetime. Projecting the future costs of care can include many possibilities depending on the injury.

Medical cost projections typically account for:

  • Future surgical procedures
  • Ongoing physical therapy ($150-300 per session)
  • Medical equipment and supplies
  • Follow-up doctor visits ($200-500 per visit)
  • Medication needs
  • Diagnostic testing and imaging ($500-3,000 per scan)

Common Sports Injury Scenarios and Associated Costs

ACL (knee ligament tear) Reconstruction Example

A typical ACL injury might include:

  • Initial surgery: $20,000-50,000
  • Post-operative care: $2,000-5,000
  • Physical therapy (3x/week for 6 months): $11,700-23,400
  • Follow-up imaging: $1,500-4,500
  • Return-to-sport testing: $500-1,500
  • Potential revision surgery (15-20% chance): $25,000-60,000

Concussion Management

Multiple concussion care might require:

  • Initial neurological evaluation: $800-2,000
  • Neuropsychological testing: $1,500-4,000
  • Monthly follow-up visits: $200-500 each
  • Cognitive therapy: $100-250 per session
  • Annual neurological imaging: $1,500-3,000

Legal Strategy Considerations

Medical cost projections provide:

  • Evidence-based documentation for settlement negotiations
  • Clear financial parameters for case evaluation
  • Objective data for presentation
  • Support for damage calculations

 Strategic Decisions

  1. Create clear timelines to:
  • Keep-case moving efficiently
  • Ensure thorough preparation
  • Allow adequate time for each step
  • Prevent delays in case development

2. Documentation Requirements

  •  Complete medical records from all providers
  •  Expert medical opinions on future care needs
  •  Current medical billing and coding data
  • Possibly photographic evidence of injuries/recovery
  • Therapy progress notes and recommendations

Building a Strong Case

  1. Medical Expert Coordination
  •  Retain relevant specialists early
  •  Schedule independent medical examinations
  •  Document all expert opinions formally
  • Create timeline of medical interventions

2. Cost Documentation Strategy

  • Obtain facility-specific cost data
  • Research geographic cost variations
  • Document insurance coverage limitations
  • Calculate lifetime cost projections

Working with Medical Cost Projections

For Attorneys

  • Strategic Considerations
    • Time medical cost projections for maximum settlement leverage
    • Consider inflation factors 
    • Account for medical advancement possibilities
    • Document geographical cost variations
  • Settlement Strategy
    • Present costs in present-day values
    • Include contingency planning for complications
    • Factor in insurance coverage limits
    • Consider structured settlement options

For Families

  1. Practical Financial Planning
  • Track all current medical expenses
  • Document insurance coverage denials
  • Keep receipts for out-of-pocket costs
  • Maintain a treatment calendar
  1. Future Planning Considerations
  • Insurance coverage limits and duration.
  • Deductible and co-pay obligations.
  • Potential need for supplemental insurance.
  • Impact on family financial planning.

Making Informed Decisions

Cost Projection Analysis

  1. Review Components
  • Verify included services match treatment plan.
  • Check timeline assumptions.
  • Validate cost calculations.
  • Consider geographic cost variations.
  1. Quality Control Measures
  • Cross-reference with similar cases.
  • Verify current medical pricing.
  • Update projections for medical advances.
  • Account for patient-specific factors.

The Role of Legal Nurse Consultants

Legal nurse consultants enhance medical cost projections by:

  • Analyzing medical records for future care needs
  • Researching current medical costs and trends
  • Coordinating with healthcare providers
  • Providing expert documentation
  • Testifying about projected medical needs

When More Comprehensive Planning Is Needed

While medical cost projections suffice for many sports injury cases, some situations may require a comprehensive life care plan, particularly when:

  • Injuries result in permanent disability
  • Multiple body systems are affected
  • Lifetime care is anticipated
  • Complex medical needs exist

Conclusion

Medical cost projections serve as essential tools in planning for the future medical needs of injured athletes or those with other injuries. With proper documentation and strategic timing, these projections help both families and legal teams make informed decisions about future medical care and case resolution. Understanding the specific costs involved – from initial treatment through long-term care – provides crucial guidance for all parties involved in sports injury cases.

For cases requiring more extensive planning, consultation with a legal nurse consultant can help determine whether a comprehensive life care plan might be more appropriate. However, for many sports injury cases, a well-prepared costing provides the necessary framework for understanding and preparing for future medical needs.

Should you have a case in which the costs of future medical care are needed, contact us, E Wills Legal Nurse Consultants.