In national news:

The Workers’ Compensation Research Institute (WCRI) released a new study, Will the Affordable Care Act Shift Claims to Workers’ Compensation Payors? The organization states the impetus for the study in its release explaining that, “although pundits have written about ‘cost shifting’ to workers’ compensation, ,a significant underappreciated effect of the ACA is ‘case-shifting’ from group health to workers’ compensation.” WCRI notes that the ACA’s goals to expand the use of ACOs over traditional fee for service, combined with the rise in “capitated” health plans (in which providers are paid a set premium per insured regardless of the number of services rendered) has led to “case-shifting.” The study found that a back injury was as much as 30 percent more likely to be called “work-related” if the patient’s group health insurance was capitated rather than fee for service. WCRI claims that the study results can be extrapolated by assessing the percentage of capitated plans in a particular state, and warns payors to look out for misclassification of soft tissue injuries.

Read more and purchase a copy of the study from WCRI here.

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