Earlier this week, the Workers’ Compensation Research Institute (WCRI), released a study that compared the outcomes for injured workers across 15 states. It can be purchased here.
Each state has a separate, multi-page report, so I requested a copy of the report for Florida, as that is where I currently reside (offers of employment elsewhere are greatly appreciated).
As this report has over 100 pages, it is reasonable to assume that 15 such reports would have a combined 1500 pages or more. So, I took the easy way and just looked at one state.
In the introduction to the report, there are two key dimensions of the performance of any workers’ comp system in the US:
- Post-injury outcomes achieved by injured workers and;
- Costs paid by employers.
The study measured the following worker outcomes:
- Recovery of physical health and functioning
- Return to work
- Earnings recovery
- Access to medical care
- Satisfaction with medical care
The study was also conducted in three phases:
- Phase 1: Eight states (IN, MA, MI, MN, NC, PA, VA, WI)
- Phase 2: Four states: (IA, AR, CT, TN)
- Phase 3: Three states: (FL, GA, KY)
The WCRI will collect data from other states and revisit states from earlier phases that implemented reforms to measure the impact of those reforms on outcomes in subsequent phases.
Key Findings for Florida
The WCRI found that workers in Florida reported outcomes that were similar to the median study on some of the key measures, but they reported somewhat higher rates of problems accessing desired services, accessing desired providers, and higher dissatisfaction with overall medical care.
For Recovery of physical health and functioning, they found that for Florida, it was similar to the other 14 states.
For Return to work, injured workers in Florida reported rates of return to work in the middle range of the study. 14% of Florida workers with more than seven days of lost time reported never having a return to work that lasted at least one month due to the injury as of three years’ post-injury; 17% reported no return to work within one year of injury. The median worker in Florida had a return to work about 12 weeks after injury.
For Earnings Recovery, 11% of Florida injured workers reported earning “a lot less” at the time of return to work; the median was 8%.
For Access to care, 21% of Florida injured workers reported they had “big problems” getting the services they or their provider wanted; 20% reported “big problems” getting the primary provider they wanted. Florida was among the states, the study reported, with higher rates of problems of access to care and providers, and higher or somewhat higher than in nine or eight other states.
For Satisfaction with care, the study found nearly three in four Florida workers were “somewhat” or “very” satisfied with their overall care (71%); however, 20% said they were “very dissatisfied”. This was higher than the median of the states, and higher than in 10 states.
Table 1 is a comparison of the medical costs and outcomes between Florida and the other 14 states in the WCRI study. What is interesting to note is that when compared to the other 14 states, Florida had similar outcomes in many of the measures, as the study suggested.
The study found that medical costs in Florida, recovery of health and functioning, rates of return to work, duration of time before return to work were typical, while problems with getting desired services, and providers were somewhat higher or higher. Satisfaction was lower, but dissatisfaction was higher.
What I found interesting, and perhaps a little disturbing, but not unexpected, was that with the exception of the percentage of satisfaction, all the figures were below 50%, and while the score mechanism for recovery of health and functioning is not further discussed in the Summary, but is mentioned in the notes, those also seem to be very low.
I am not surprised that Florida has a higher percentage of dissatisfaction with medical care, this despite the fact that everywhere you look in Florida cities and towns, there are hundreds of medical offices, clinics, and many hospitals; some large, some small.
What to make of this?
While it is too early to tell how these 15 states compare with the other 35 states, what we can gather from this data is that the workers’ comp systems in these states are falling far short of where they should be in almost all of the measures.
Satisfaction percentages, notwithstanding, there are real issues with the way injured workers are treated in these 15 states.
That Florida is similar to 14 other states in five outcome measures, and not even above 50%, tells me that the industry needs to stop kidding itself that everything is honky-dory. It’s not.
How worse do you think it would be if the only current alternative being suggested is the opt-out option? If workers are not getting back to work or getting better care or better health and functioning under the current state systems, how do you think it would be if states like FL, GA, KY, NC, TN and VA go to opt-out as ARAWC is trying to do?
And without going into the details of each states report, it is hard to know just how much of these outcomes are related to common workers’ comp surgeries that could be provided for by outside medical facilities in other nations in the Western hemisphere?
Denying injured workers, the access to the services and providers they want or need is not a sign that everything is okay, having long-delayed return to work three years after injury is not okay, and earning less after an injury is also not okay.
WHEN ARE YOU GOING TO WAKE UP OUT OF YOUR DREAMSTATES AND REALIZE THERE ARE MAJOR PROBLEMS HERE THAT ARE NOT BEING SOLVED?
WHEN ARE YOU GOING TO STOP LISTENING TO PEOPLE WHO DO NOT WANT TO IMPROVE THE SYSTEM BECAUSE IT ONLY SERVES TO MAKE THEM WEALTHIER OR SOMEONE ELSE WEALTHIER?
WHEN ARE YOU GOING TO REALIZE THAT AMERICAN PHYSICIANS ARE NOT THE ONLY ONES WHO CAN PRACTICE MEDICINE, AND MAY EVEN BE BETTER THAN THOSE HERE WHO ARE ONLY IN IT FOR THE MONEY?
No matter how many studies or reports the WCRI or NCCI, or anyone else issues, until you disavow yourselves of the notion that workers’ compensation is failing and that there are ways to fix it, it will just get worse, until one day it is no longer here for anyone.
I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.
Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.
I am also looking for a partner who shares my vision of global health care for injured workers.
I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.
Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: firstname.lastname@example.org.
Will accept invitations to speak or attend conferences.
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