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What I learned about outcomes at WCRI

Patient satisfaction, return to work, and other outcomes were the subject of another presentation at WCRI. I can’t provide details as the actual material is embargo’ed, but here are the key points.

The net is this – states with high medical costs tended to have pretty poor outcomes, defined as longer absences from work and fewer injured workers getting back to their jobs, and low cost states tended to have much better outcomes.
As a frame of reference, workers comp medical costs in CT were among the lowest among the states studed at 30% below the median, and NC’s costs were about at the median of the studied states. And low costs did not appear to be based on low unit prices, but rather low utilization of medical services; my home state has one of the highest fee schedules in the nation.
According to WCRI’s statistics, workers returned to work faster after being injured in CT than in the median state, and the number of workers who did get back to their job was higher.
Another interesting point pertains to the utilization of non hospital medical services on lost time claims. CT’s utilization was about 17% below average while NC is right at median. NC has a higher surgery rate than the median at 35% of LT claims experiencing surgery, with CT at a 30% rate.
So, lower medical costs correlate with better outcomes, and higher fee schedules correlate with lower medical costs. (note – Massachusetts also has low medical costs, but the fee schedule is among the lowest in the nation. While this may seem to directly contradict the previous point, it is common practice in MA for insurers to pay providers above the fee schedule).

Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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