First Visit to Medical Provider Key in Reducing Comp Costs

An injured worker's first visit to a network medical provider is\r\nkey in reducing workers' compensation costs, says a WCRI study.

A new study of workers'' compensation medical networks found that an initial non-emergency visit to a network medical provider by an injured worker plays a significant role in managing workers'' compensation costs.

Both this study and an earlier study by the Workers Compensation Research Institute (WCRI) reported treatment by network health care providers reduced medical costs without increasing income benefit costs.

This study also finds that the likelihood of continued network care is much greater if the injured worker''s first non-emergency visit is with a network doctor.

"The initial non-emergency visit plays an important role in determining the extent of network/non-network cost differences," said Dr. Richard Victor, executive director of WCRI, who co-authored the study. "That first visit is key because it is the single largest factor that determines continued care by network providers."

The WCRI study, The Impact of Initial Treatment by Network Providers on Workers'' Compensation Medical Costs and Disability Payments, reaffirmed earlier studies that found workers'' compensation networks generally are associated with lower medical costs -- 16 percent to 46 percent lower if the patient is treated exclusively by network providers and up to 11 percent lower for similar claims if the treatment is predominately, but not exclusively, within network.

The study also found that lower network medical costs do not raise indemnity benefit costs among claims treated in networks. Indemnity benefits are paid to compensate injured workers for wages lost while they are away from their jobs.

The quality and accessibility of medical care are not directly measured in this study.

The study is based on nearly 300,000 workers'' compensation claims in eight states and 20 different workers'' compensation networks.

by Virginia Foran

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