Study: For Serious Back Injuries, Provider Choice Drives Costs Up


In an ideal world, it wouldn’t make any difference which doctor you went to — your treatment would be up to the same medical standards and would cost roughly the same. This is not an ideal world, but it’s closer than a lot of people might think.

At least, it is according to a study by the Workers Compensation Research Institute that was reported recently in Claims Journal. Since cost data is an important consideration for workers comp insurers, the study has some good news: Overall, provider choice doesn’t affect cost.

The study considered the relationship between the cost of workers comp claims and whether the injured person’s state law allowed them to choose their own doctor. Some states allow that, while others allow the employer to choose the doctor. Overall, the study found no major difference in cost between the different systems.

However, when it came to some of the most costly types of injuries — neck and back strains and sprains, neurologic spinal pain or non-specific pain — the cost of the claim was highest in the states offering the most provider choice to workers.

“The back-related injuries, which were relatively expensive, appear to at least partially account for higher indemnity costs, overall, in the most expensive cases in states where policies give workers the most control over the choice of provider,” wrote the authors.

The reason for the difference was not clear. Since overall the costs were not higher in provider-choice states, however, the authors suggest that fighting provider-choice laws will not be effective at reducing indemnity costs. Instead, they recommend that policymakers focus on reducing high-cost claims.

As we often find to be the case, fighting against giving injured people choice and control didn’t drive down claim costs. What drives down cost is having fewer and less serious claims, which means making that workers are injured less frequently and less seriously. The costs go down when an up-front investment is made in workplace safety.

If you have been injured at work, please don’t hesitate to have a workers comp lawyer look over your claim.

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