Dataset Information

The Effects of Provider Choice Policies on Workers' Compensation Costs.

ABSTRACT:

Objective

To examine the effects of provider choice policies on workers' compensation medical and indemnity costs.

Data sources/study setting

Pooled cross-sectional analysis of administrative claims records for workers with work-related injuries primarily in 2007-2010 across 25 states (n = 4,489,729).

Study design

We used linear and quantile regression analyses to evaluate differences in claim costs (medical and indemnity) based on whether policies give employers or injured workers control over the choice of provider.

Principal findings

We find no difference in average medical costs by provider choice policies, although a distributional analysis indicates higher developed medical costs for the costliest back injury cases in states where workers control provider choice. The evidence for indemnity costs is similar, although the point estimates also indicate (statistically insignificantly) higher average costs when policies give workers more control of the choice of provider.

Conclusions

Our nuanced evidence suggests that policymakers seeking to reduce workers' compensation costs may need to focus on the highest cost cases in states where policy gives workers more control over the choice of provider, rather than the simpler and broader issue of whether policy gives workers or employers more control.

SUBMITTER: Neumark D

PROVIDER: S-EPMC6232414 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Publications

The Effects of Provider Choice Policies on Workers' Compensation Costs.

Neumark David D Savych Bogdan B

Health services research 20180911 6

<h4>Objective</h4>To examine the effects of provider choice policies on workers' compensation medical and indemnity costs.<h4>Data sources/study setting</h4>Pooled cross-sectional analysis of administrative claims records for workers with work-related injuries primarily in 2007-2010 across 25 states (n = 4,489,729).<h4>Study design</h4>We used linear and quantile regression analyses to evaluate differences in claim costs (medical and indemnity) based on whether policies give employers or injured ...[more]

PMID: 30206935

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Project description:BackgroundUnderstanding how much physiotherapy people receive before lumbar spine surgery could give insight into what people and clinicians consider an adequate trial of non-operative management. The aim of this study was to investigate physiotherapy utilisation and costs before lumbar spine surgery under a workers' compensation claim in New South Wales (NSW), Australia.MethodsUsing data from the NSW State Insurance Regulatory Authority, we audited physiotherapy billing codes used before surgery for people who received lumbar spine surgery from 2010 to 2018. We summarised, separately for fusion and decompression, the time from initiation of physiotherapy to surgery, number of physiotherapy sessions people received before surgery, total cost of physiotherapy before surgery, and time from injury date to initiation of physiotherapy. All analyses were descriptive.ResultsWe included 3070 people (800 had fusion, 2270 decompression). Mean age (standard deviation, SD) was similar between those who received fusion and decompression [42.9 (10.4) vs. 41.9 (11.6)]. Compared to people who had fusion, those who had decompression were more likely to not have any physiotherapy before surgery (28.4% vs. 15.4%), received physiotherapy for a shorter duration before surgery [median (interquartile range, IQR): 5 (3 to 11) vs. 15 (4-26) months], were less likely to have physiotherapy for ≥2 years before surgery (5.6% vs. 27.5%), had fewer physiotherapy sessions before surgery [mean (SD): 16 (21) vs. 28 (35) sessions], were less likely to have > 50 physiotherapy sessions before surgery (6.8% vs. 18.1%), and had lower total physiotherapy-related costs [mean (IQR): $1265 ($0-1808) vs. $2357 ($453-2947)]. Time from injury date to first physiotherapy session was similar between people who had fusion and decompression [median (IQR): 23 (9-66) vs.19 (7-53) days].ConclusionsThere is variation in physiotherapy utilisation and costs before lumbar spine surgery for people funded by NSW Workers' Compensation. Some people may not be receiving an adequate trial of physiotherapy before surgery, particularly before decompression surgery. Others may be receiving an excessive amount of physiotherapy before surgery, particularly before fusion.

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Dataset Information

The Effects of Provider Choice Policies on Workers' Compensation Costs.

Objective

Data sources/study setting

Study design

Principal findings

Conclusions

Publications

The Effects of Provider Choice Policies on Workers' Compensation Costs.

Similar Datasets

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