NEW WCRI STUDY IDENTIFIES STATES WITH GOOD VALUE PROPOSITIONS FOR WORKERS AND EMPLOYERS

CAMBRIDGE, MA, June 15, 2007 – When employers pay more for the medical care of injured workers, workers should experience better outcomes. Otherwise,  the logical question becomes:  “Why are employers paying more?”

A new Workers Compensation Research Institute (WCRI) study, Comparing Outcomes for Injured Workers in Nine Large States, looked at how nine states compare within the context of this “key value proposition.” 

The study juxtaposed worker outcomes in each state within the areas of recovery  of health and functioning, return to work, access to medical care, and     satisfaction with medical care with data on the costs and utilization of workers’ compensation medical care.

Using overall characterizations of worker outcomes, along with the relative assessment of medical costs and utilization, WCRI, the Cambridge, Mass.-based research organization, categorized the nine states in the study – California, Connecticut, Florida, Massachusetts, North Carolina, Pennsylvania, Tennessee, Texas and Wisconsin – into three groups:  those that provide a “better,”  “moderate,” or “worse” value proposition for workers and employers. 

“Combined with other benchmarks of costs and medical utilization, these comparisons can allow public officials and system stakeholders to begin to focus on critical ‘win-win’ opportunities for workers and their employers – possible improvements in the system that can result in better worker outcomes without raising employers’ costs or, conversely, those that can lower costs without adversely affecting workers’ outcomes,” said Dr. Richard Victor, executive    director of WCRI.

The study reported a “better” value proposition – lower average medical costs and utilization as well as worker outcomes that were better than or in the middle of    the range –in Connecticut, Massachusetts, Pennsylvania and Wisconsin.

In these four states, employers paid less for medical care, yet workers achieved outcomes that were better than or in the middle of the range compared to workers in the other study states.

The study reported that workers in these states had generally better recoveries  after their injuries, were more likely to return to sustainable employment (and do   so more quickly), experienced more timely medical treatment from their primary providers,  experienced fewer problems accessing medical care, and were less likely to be dissatisfied with their care.

By contrast, a “worse” value proposition was found in California, Florida,  Tennessee and Texas, prior to the enactment of recent reforms to their workers’ compensation systems. 

In particular, medical costs and utilization in pre-reform California and pre-reform Texas were higher than in the other study states, while worker outcomes were generally in the middle of the range or worse in all categories. 

The study described these two states as having a “worse” value proposition for employers and injured workers because employers there paid much more for medical care compared to the seven other states studied, yet workers experienced worse outcomes (or, at best, outcomes in the middle of the range).

This included generally worse recoveries after injury; workers were also less likely to have substantial returns to work, were more likely to experience problems accessing medical care, and expressed higher rates of dissatisfaction with their medical care than workers in many of the other study states.

The study also characterized pre-reform Florida and pre-reform Tennessee as providing a “worse value proposition.” Despite costs that were in the middle of the range of study states, like pre-reform California and pre-reform Texas, outcomes   for injured workers in pre-reform Florida and pre-reform Tennessee were also generally in the middle or worse compared to the other states.

The study described North Carolina as having a “moderate” value proposition for employers and injured workers, where medical costs and utilization, as well as worker outcomes, were consistently in the middle of the range.

The study pointed out that while the costs that employers paid for medical care      in North Carolina were in the middle of the range, and outcomes also appeared to be in the middle, from a value perspective, there are opportunities to further   improve the system. 

This is evidenced by the fact that Connecticut, Massachusetts, Pennsylvania,    and Wisconsin have been able to achieve better outcomes for injured workers at    a lower cost than North Carolina.

The nine states in the study represent large and diverse systems with differences  in state laws and system features such as choice of provider, medical fee schedules, claim costs, and the payment of income benefits for permanent disabilities. They also differ in geographic location and characteristics as well as industry mix.

The Workers Compensation Research Institute is a nonpartisan, not-for-profit membership organization supported in its public policy research by employers, insurers, insurance regulators and state administrative agencies in the U.S., Canada, Australia and New Zealand, as well as several state labor organizations.

To purchase the report, visit WCRI’s web site at www.wcrinet.org