Comparing Outcomes for Injured Workers in Nine Large States

By Richard A. Victor, Sharon E. Belton, Te-Chun Liu

May 1, 2007 Related Topics: Access to Care, Outcomes for Injured Workers, Provider Choice, Return to Work, Utilization

One way to examine the performance of state workers’ compensation systems is in the context of a “key value proposition.” That is, when employers pay more for medical care, workers should experience better outcomes. Otherwise, the logical question becomes: Why are employers paying more? Similarly, if workers’ compensation medical costs are rising rapidly, workers’ outcomes should be improving.

This study examines how nine states compare on this key value proposition by juxtaposing 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. Information on worker outcomes can help policymakers address a wide range of issues, including whether state systems that have higher medical costs or utilization of medical care, for example, are associated with better outcomes for injured workers.

Comparing Outcomes for Injured Workers in Nine Large States is the fourth in a series of multistate studies that measures key outcomes for injured workers who receive medical care and income benefits from state workers’ compensation systems. 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 industry mix.

Among our findings:

  • Connecticut, Massachusetts, Pennsylvania, and Wisconsin provided a “better” value proposition for employers and injured workers. 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 other study states. Workers in these states had generally better recoveries, were more likely to return to sustainable employment (and do so more quickly), experienced more timely medical treatment, had fewer problems accessing their medical care, and were less likely to be dissatisfied with their care.
  • Medical costs and utilization in pre-reform California and pre-reform Texas were higher than in the other study states. Employers paid more for medical care compared to the seven other states studied, yet workers experienced worse outcomes (or, at best, outcomes that were in the middle of the range).These states are described as having a “worse” value proposition for employers and injured workers. We also describe pre-reform Tennessee and pre-reform Florida as providing a “worse” value proposition. Despite costs that were in the middle of the range, outcomes for injured workers (prior to reforms in Florida and Tennessee) were also generally in the middle or worse compared to the other states in the study. 
  • In North Carolina, medical costs and utilization, as well as worker outcomes, were consistently in the middle of the range (except with respect to access to care where higher percentages of workers were dissatisfied with their time to initial treatment by the primary provider). We describe North Carolina as having a “moderate” value proposition.

Comparing Outcomes for Injured Workers in Nine Large States. Sharon E. Belton, Richard A. Victor, Te-Chun Liu. May 2007. WC-07-14.

Copyright: WCRI

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