A new study (Do Higher Fee Schedules Increase the Number of Workers’ Compensation Cases?) from the Workers’ Compensation Research Institute (WCRI) explores to what extent higher workers’ compensation reimbursement rates influence the medical provider classification of an injury as work-related or not. Currently, 43 states have physician fee schedules that set maximum prices for health care providers to be paid, and the established fee schedule rates vary widely across states. Researchers found that “case shifting” from group health to workers’ comp was more common for soft tissue injuries for which causation is not certain, as compared to more straightforward injuries like fractures and lacerations. Louisiana, which has a fee schedule, fell about in the middle of the data in terms of reimbursement above Medicare (roughly 50 percent in 2011). Overall, the authors note that “20 percent growth in workers’ compensation payments for physician services associated with an office visit increases the likelihood of a soft tissue injury being called work-related by 6 percent.”
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