Access to Specialists May Reduce Workers' Compensation Costs

Aug. 10, 2001
In contrast to managed care approaches, a program offering direct access to specialist doctors and increased physicians' fees may reduce workers' compensation costs, according to a study.

In contrast to managed care approaches, a program offering direct access to specialist doctors and increased physicians'' fees may reduce workers'' compensation costs, according to a study in the August Journal of Occupational and Environmental Medicine.

Dr. Stephen Atcheson of Reno, Nev., and colleagues evaluated a "specialist-direct" approach to workers'' compensation cases from two large hotel-casinos.

In the new approach, workers with on-the-job injuries had direct access to physicians specializing in the care of musculoskeletal injuries.

Over two years, the program reduced overall workers'' compensation costs by 63 percent.

Indemnity cost -- including compensation for missed work time and disability payments -- decreased by 85 percent.

Rapid access to specialists was a major factor in reducing indemnity costs, according to the study.

For minor injuries, the specialists were likely to recommend that the worker stay on the job with modified duties.

For more serious injuries, seeing a specialist early shortened the time until the patient received definitive care.

The specialist-direct approach also increased the fees paid to the primary care doctors treating the injured patients, but did not allow them to profit from "self-referral" for tests or treatments from which they might profit financially.

Under the new system, medical costs decreased by 45 percent -- even though the doctors received higher fees, the amount of services provided decreased.

Occupational injuries are an enormously expensive problem. In recent years, employers have considered managed care approaches, limiting limited access to specialists and discounted fees paid to physicians. However, these approaches have often failed to achieve expected cost reductions.

"Although more study of the specialist-direct approach is need, the preliminary results suggest it has the potential to achieve real cost reductions, rather than cost shifting, in the management of workers'' compensation cases," said Atcheson.

by Virginia Foran

About the Author

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Dave Blanchard, Editor-in-Chief: During his career Dave has led the editorial management of many of Endeavor Business Media's best-known brands, including IndustryWeekEHS Today, Material Handling & LogisticsLogistics Today, Supply Chain Technology News, and Business Finance. In addition, he serves as senior content director of the annual Safety Leadership Conference. With over 30 years of B2B media experience, Dave literally wrote the book on supply chain management, Supply Chain Management Best Practices (John Wiley & Sons, 2021), which has been translated into several languages and is currently in its third edition. He is a frequent speaker and moderator at major trade shows and conferences, and has won numerous awards for writing and editing. He is a voting member of the jury of the Logistics Hall of Fame, and is a graduate of Northern Illinois University.

Adrienne Selko, Senior Editor: In addition to her roles with EHS Today and the Safety Leadership Conference, Adrienne is also a senior editor at IndustryWeek and has written about many topics, with her current focus on workforce development strategies. She is also a senior editor at Material Handling & Logistics. Previously she was in corporate communications at a medical manufacturing company as well as a large regional bank. She is the author of Do I Have to Wear Garlic Around My Neck?, which made the Cleveland Plain Dealer's best sellers list.

Nicole Stempak, Managing Editor:  Nicole Stempak is managing editor of EHS Today and conference content manager of the Safety Leadership Conference.

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