One way to examine the performance of a state workers’ compensation system is in the context of a key value proposition. That is, when employers pay more for medical care, workers should experience better outcomes for that higher expenditure. Otherwise, the logical question becomes: why are employers paying more?

In this framework, we found that Maryland’s workers’ compensation system provides a “better” value proposition for employers and injured workers. When we compared Maryland with nine other states in the areas of recovery of health and functioning, return to work, and access to and satisfaction with health care, injured workers generally reported outcomes that were similar to or better than outcomes reported by their counterparts in the other study states. Yet employers paid less for medical care. In Maryland, the average medical cost per claim with more than seven days of lost time was 31 percent lower than the average medical cost for the median of the10 states studied.

While Maryland generally provided a “better” value proposition, there is room for improvement. In both Massachusetts and Wisconsin, the average worker received fewer medical services and/or less intensive medical care (e.g., lowerutilization), but reported generally better than typical outcomes. These two states provided the best value proposition for injured workers and their employers—similar or lower than typical medical costs and similar or better than typical worker outcomes.

Comparing Outcomes for Injured Workers in Maryland is the fifth 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 ten states in the study (California, Connecticut, Florida, Massachusetts, Maryland, North Carolina, Pennsylvania, Tennessee, Texas, and Wisconsin) represent large and diverse systems with differences in state laws and system features such as choice of provider, medical fee schedules, costs per claim, and the payment of income benefits for permanent disabilities. They also differ in geographic location and industry mix.

Among our findings for Maryland:

• The vast majority of workers in Maryland reported that they were somewhat or very satisfied with the timeliness of their first visit to the initial and primary provider (82 percent for each measure). The percentage of workers reporting that they had problems accessing medical care was typical of the other study states. Twelve percent of workers reported they were very dissatisfied with how quickly they saw their primary provider; 11 percent said they had “big problems” getting the care they or their primary provider wanted. Only 8 percent of workers indicated they had “big problems” accessing the initial or primary provider they wanted. On this measure Maryland was better than all other study states except Wisconsin.
• Maryland had among the lowest percentage of workers who wanted to change their initial or primary provider due to dissatisfaction with care. Eighty-two percent, the vast majority, were somewhat or very satisfied with their workers’ compensation medical care. Although approximately 1 in 10 said they were very dissatisfied with their medical care, this is still in the middle of the range of states studied.
• When compared to the other nine study states, Maryland had typical return-to-work outcomes. As of 2½ years postinjury, 9 percent of workers reported never having returned to work and 15 percent reported never having a substantial return to work (one that lasted at least one month) predominately due to injury. Maryland workers typically returned to substantial employment within eight weeks.
• Recovery of physical health and functioning of injured workers in Maryland was in the typical range of the states studied. The average worker received a typical amount of medical care and reported a typical physical recovery after his or her injury.

Comparing Outcomes for Injured Workers in Maryland. Sharon E. Belton and Te-Chun Liu. June 2008. WC-08-15.

Copyright: WCRI