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Comp pays more than group health on similar medical services



Workers' compensation insurers pay more for medical services than for group health to treat comparable injuries, according to a research report released Friday by the National Council on Compensation Insurance.

In examining workers' experiences of NCCI's medical data calls, which capture details at the transaction level – service, fees, payments, procedures and diagnostic codes – on medical bills processed on or after July 1, 2010, for 35 states, researchers found that the costs for chronic injuries in comp are 235% higher and 160% higher for acute injuries.

Specifically, acute "trauma to the arms and legs consistently has smaller cost and use differences in toilets, while chronic pain-related injuries, such as bursitis and back pain," have larger differences, according to the report.

Also, a more expensive mix of procedures in complex workers' compensation cases contributes to higher costs in relation to group health, especially for referral-based care, such as radiology and surgery, according to the report.

For acute injuries, the number of posts accounts for almost 90% of the total cost difference between co-workers and group health and for chronic injuries, differences in quantity account for four-fifths of higher comp costs, according to the report.

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