Webinar on Regulating Medical Costs & Care: Unintended Consequences

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Join Workers Compensation Research Institute (WCRI) author and economist, Ms. Dongchun Wang, and senior public policy analyst and author, Dr. Rebecca Yang, for a one-hour webinar on Thursday, May 7, 2015 at 2 p.m. ET (1 p.m. CT, 12 noon MT, and 11 a.m. PT) to discuss how changes in reimbursement policies can have unintended consequences. The two researchers will share presentations they recently delivered at the WCRI’s annual conference.

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Setting a fee schedule level involves a delicate balance.

Join Workers Compensation Research Institute (WCRI) author and economist, Ms. Dongchun Wang, and senior public policy analyst and author, Dr. Rebecca Yang, for a one-hour webinar on Thursday, May 7, 2015 at 2 p.m. ET (1 p.m. CT, 12 noon MT, and 11 a.m. PT) to discuss how changes in reimbursement policies can have unintended consequences. The two researchers will share presentations they recently delivered at WCRI’s annual conference.

Ms. Wang will discuss major findings from WCRI’s study, Are Physician Dispensing Reforms Sustainable? After 18 states enacted reforms aimed at reducing the prices paid to doctors for prescriptions they write and dispense, some physician-dispensers in two large reform states, California and Illinois, found a new way to continue to charge and get paid much higher prices. The evidence of certain behavioral changes in response to the reforms raises a question about the effectiveness and sustainability of the reforms, which is important for all states with recent physician dispensing reforms.

Dr. Yang will discuss the presentation she gave at the WCRI’s conference, which pulls from various WCRI studies, and is entitled, The Perverse Effects of Low Fee Schedules. Since 2011, over 40 states have used some sort of medical fee schedule in workers' compensation. Setting a fee schedule level involves a delicate balance. If rates are set too high, savings will be negligible and the fee schedule will not achieve its cost containment goal. Conversely, setting rates too low makes treating injured workers uneconomical for providers and jeopardizes workers' access to quality care. Dr. Yang will share examples of how a low fee schedule may prompt providers to change billing or treatment patterns in several states.

Things you will learn:

  •     The nature of recent reforms on physician dispensing, and the impact of these reforms on the frequency and costs of physician-dispensed drugs.
  •     The new strengths of several common drugs and how these new strengths challenged the price-focused reforms.
  •     Evidence of substantial increase in physician dispensing of new strengths, in post-reform California and Illinois, and much higher prices paid for the new strengths compared to existing strengths of the same drug.
  •     Key factors to consider when determining whether a fee schedule is too low.
  •     Evidence of providers changing behavior to retain revenue in several states with low or frozen fee schedule rates, or price reduction following fee schedule reforms.

Attendance is limited to 100 people and all attendees receive a free copy of the slides. Webinars are $39 for WCRI members; $79 for non-members; and no charge for members of the press, legislators as well as their staff, and state public officials who make policy decisions impacting their state’s workers’ compensation system. Click on the following link to register now: http://www.wcrinet.org/05.07.15_webinar_reg.html.

ABOUT WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia and New Zealand.

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Andrew Kenneally
Workers Compensation Research Institute
+1 (617) 661-9274 Ext: 257
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Workers Compensation Research Institute - WCRI
since: 06/2011
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