How to Attract and Keep the Best Docs in Workers’ Comp

March 6, 2013 Insurance Topics 1

imagesAnnmarie’s WCRI Conference Wrap Up (Part 1)

Last week’s Workers Compensation Research Institute’s (WCRI) conference began with an impressive 350 attendees, the largest amount ever.

To draw such a large crowd despite the economy shows a great interest in improving workers’ compensation public policy. With each U.S. jurisdiction having its own workers’ compensation experiment taking place, there is always a lot to be learned just from finding out which approaches are working and why.

One familiar issue is why treatment approaches seem more popular in some states than others. These differences are due to policies regulating utilization, local practice norms and financial incentives to providers, said WCRI’s Dr. Rebecca Yang. The financial incentives issue is difficult. Some states continue to inadvertently encourage surgeries over other treatment approaches simply because there is more money to be made from such procedures.

An even larger issue is maintaining the best doctors for workers’ compensation without overpaying for care. We already know that doctors have tried to “make up” revenues from workers’ comp to offset lower payments made by other programs such as Medicaid. In the same way, ObamaCare will also motivate doctors to look elsewhere, such as workers’ comp, to re-coop comp revenues.

“The problem with the health care debate is my cost savings is your lost income”
—- Ohio State University Professor Thomas Wickizer.

Public policy makers need to identify the unintended consequences in fee schedules and develop ways to keep quality medical care for injured workers so they to hasten recovery and encourage return to work. The answer might not be in increasing payments. Instead, comp administrators need to determine and address doctors’ pain points when covering injured workers. Some doctors respond well to reductions in required paperwork or being compensated for the extra admin costs associated with treating injured workers.

Washington state’s exclusive state fund developed a pilot program designed to attract the best doctors to its managed care program, insist on specific best practices and provide the already mentioned incentives to keep them, according to Ohio State University Professor Thomas Wickizer, who assisted with the program.

When comparing the results of the pilot program to the state program, the pilot showed a decline in disability days (16.9 compared to 20.2) and lower disability costs ($880 vs. $1,147) while the medical costs remained very close at $2,117 compared to 2,262 for non-pilot workers. This shows that medical care investments can save disability costs.

Back strain results were even more impressive. Disability days for pilot injured workers compared to non-pilot were 19.7 vs. 27.8; disability costs were $1034 vs. $1,576 and medical costs remained close at $2,678 vs. $2,869.

“The problem with the health care debate is my cost savings is your lost income,” Wickizer said.

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