Doctors and specialists also typically tend to prefer a standard health care insurance provider over workers compensation cases. This is due heavily to the need for high levels of justification for treatments, multiple reports and other forms of paperwork, as well as the potential for having to supply testimony as to the treatments performed before they may be reimbursed for services rendered. In fact, these tend to be the most common reasons given as to why physicians turn down workers compensation related cases. Certainly, it can be surmised that more professionals in the medical community will welcome the transition from workers comp cases to standard health care related cases.
It is true that both copay requirements and deductibles could play a role in driving some workers back to relying on workers compensation claims in order to meet other healthcare issues. At the same time though the administrative issues that go along with utilizing workers comp will most likely play a role in discouraging this behavior. One issue that could have serious repercussions on workers comp costs however is the fact that there is a growing shortage of primary care doctors in the US. With less physicians acting as primary care providers, there could be longer wait times for medical evaluations which in turn could lengthen the time it takes for WC insurance providers to deny claims that are questionable or totally without merit. Even worse, this dearth of physicians could also slow the timely handling of workers compensation related medical issues. Most skilled claims professionals will tell you that a claim is usually defined by what happens during the first 90 days it is open. Slowed access to proper care can in turn lengthen the time an individual is on workers comp thus increasing the overall wage replacement and medical costs.
In the end while it is true that the Affordable Care Act did not directly target the medical costs that go along with workers compensation claims there continues to be the promise that a noticeable shift in paradigms and practices will take place especially once many of the major parts of the act come into effect. Most long term forecasts appear to support a shift of costs from workers comp claims and expenditures to those of the private health coverage market. With less workers attempting to use WC claims to help cover other medical conditions the cost of company workers compensation coverage will likely begin to go down to some degree. The added bonus will be that by more workers taking advantage of health insurance benefits they will likely begin to enjoy a better level of health meaning a potential drop in the number of injuries and the far shorter recuperation times that can accompany such improved health.
If you find that you still have questions on how the Affordable Care Act may affect your business and its insurance needs, workers compensation or otherwise, feel free to give us a call here at The Hoffman Agency. We are always happy to help answer any questions that you may have.
