Excess healthcare costs associated with prior workers' compensation activity

Abstract

The results reveal that individuals with prior WC claims had higher probability of filing a group health medical claim and higher average monthly medical costs in all sectors. This suggests that a part of employer liability costs related to WC gets shifted to the group health medical insurance system.

Do Zero-Cost Workers' Compensation Medical Claims Really Have Zero Costs? The Impact of Workplace Injury on Group Health Insurance Utilization and Costs

“…We used the same large-employer database as Bhattacharya and Park. 13 Nevertheless, our study differs from their study in at least two ways. First, their major objective was to examine excess GHI costs between workers with prior WC claims and workers without prior WC claims.…”

“…Medical costs not covered by WC were estimated at $14.22 billion covered by other insurance, $7.16 billion covered by Medicare, and $5.47 billion covered by Medicaid. In a study using a database of 16 large employers, Bhattacharya and Park 13 reported that workers with a history of prior WC claims were more likely to file group health medical claims and had higher average monthly medical costs over a 3-year period. In summary, it seems that non-WC insurance systems at least partially cover work-related injury and illness costs.…”

Impact of Occupational Injuries on Nonworkers’ Compensation Medical Costs of Patient-Care Workers

“…Our results were qualitatively similar to the results from Afsaw, Rosa, and Mao (20) but our odds ratios and estimated expenditures were higher than the results from Bhattacharya and Park, although they looked only at one month post-injury rather than three (18). We evaluated only patient care workers, a group with higher than average injury rates and presumably good access to care and were able to capture a wide array of injuries including those without worker’s compensation claims.…”

“…Each showed that workers’ compensation covers well under 100 percent of these costs with estimates ranging from 46 to 56 percent of medical costs of injured construction workers paid by workers’ compensation (16–18). Estimates for Hispanic construction workers, immigrant workers, and those with persistent disabilities were even lower (17–19).…”

“…Bhattacharya and Park (18) used Thomson Reuters MarketScan (workers’ compensation and group health insurance data from large employers) to determine whether a workers’ compensation claim was associated with subsequent increases in group health. Among those with any group medical expenditures, a prior workers’ compensation claim was associated with an 11 percent increase in those costs and an odds ratio of 1.25, [95% CI (1.23, 1.28)] for having any expenditures.…”