Preauthorization Lowers Medical Costs Without Hurting Injured Workers’ Return To Work, New WCRI Study Finds

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In a recent study, preauthorization was found to lower medical costs without hurting injured workers’ return to work.

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In a recent study, Impact of Preauthorization on Medical Care in Texas, the Workers Compensation Research Institute (WCRI) found preauthorization lowered medical costs without hurting injured workers’ return to work.

The study reviewed the effects of three reforms enacted in Texas between 2001 and 2005 which required preauthorization by the payer of workers’ compensation benefits for physical and occupational therapy services, spinal surgery, and work hardening and work conditioning services.

The study reported that preauthorization had a seven percent reduction in the number of injured workers receiving physical medicine and occupational therapy and a 39 percent reduction in the number of visits per worker. Preauthorization was especially impactful in reducing the number of patients who received more than 15 visits for physical medicine services.

Other outcomes from the study include:

  •     Return to work did not change significantly over the time period for injured workers who received physical medicine services.
  •     Time to surgery was shorter among injured workers who received spinal surgery after preauthorization was effective.
  •     There was a 21 percent reduction in the number of injured workers receiving work hardening and work conditioning services, but not significant changes in the number of visits and services per visit.

WCRI is based in Cambridge, MA and is a nonpartisan, not-for-profit public policy research organization supported by employers, insurers, insurance regulators and state regulatory agencies, managed care companies, health care providers, as well as several state labor organizations. For more information, visit: http://www.wcrinet.org.

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Andrew Kenneally
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