- Raising or lowering the amount paid out by a "workers' compensation" plan can have varying effects on employee health and care outcomes, according to a study by the Workers Compensation Research Institute (WCRI).
- When workers' comp pays less than group health insurers, increasing the price of workers' comp results in more care provided to injured workers and a small uptick in the duration of temporary disability, WCRI said. When workers' comp pays more than group health insurers, increasing the price of workers' comp even further may lead to somewhat faster non-emergency visits, fewer concerns about access to care and somewhat more care provided to injured workers, according to the report.
- The study found little relationship between increasing workers' comp prices and the recovery of workers' health and functioning, as well as speed of return to work, suggesting that factors other than medical prices are shaping differences in worker outcomes across states, WCRI said.
This study was triggered by longstanding concerns that when workers' compensation prices are set too low, workers experience problems getting timely access to medical care, leading to poor recovery and issues with getting back to work in a timely manner, John Ruser, president and CEO of WCRI, said in a statement. The study findings revealed a more nuanced conclusion, one dependent on the relative price of workers' comp and group health care in a given geographic area.
The intersection of workers' comp and group health benefits is an important area for employers: A separate WCRI study found that injured workers with high deductibles were more likely than their peers to file a workers' comp claim instead of a group health insurance claim. According to the study, an injured employee with an average of $550 remaining on his or her deductible was 1.4% more likely to file a workers' comp claim than someone with no deductible at the time of injury, leading to a 5.3% increase in the volume of workers' compensation claims.
Faced with rising healthcare costs, employers are increasingly looking for creative ways to save money, including the use of case management services, telemedicine, 24-hour hotlines, prior authorization requirements and healthcare claims utilization analysis.