The question we addressed in our study is to what extent do the financial incentives facing providers and their health care organizations that arise out of capitation influence whether or not a case is deemed to be work-related.
Cambridge, MA (PRWEB) November 23, 2015
Hundreds of millions of dollars could shift from group health to workers’ compensation as Accountable Care Organizations (ACOs) expand under the Affordable Care Act (ACA), according to a recent WCRI study―Will the Affordable Care Act Shift Claims to Workers’ Compensation Payors? Join WCRI’s president and CEO, Dr. Richard Victor, for a 45-minute webinar on Thursday, December 10, 2015 at 2 p.m. ET (1 p.m. CT, 12 noon MT, and 11 a.m. PT) as he discusses this new research and answers your questions.
Also joining Dr. Victor will be Joe Paduda who will be providing another perspective on the impact of the ACA on case shifting. Joe is the principal at Health Strategy Associates LLC and writes the ManagedCareMatters.com blog.
According to WCRI's research, although pundits have written about "cost-shifting" to workers' compensation, a significant underappreciated effect of the ACA is "case-shifting" from group health to workers' compensation. The ACA seeks to greatly expand the use of Accountable Care Organizations or ACOs----where providers are rewarded for meeting cost and quality goals. This will expand the use of "capitated" health insurance plans. Under these plans, providers are paid a fixed insurance premium per insured regardless of the amount of care provided to a given patient during the year. Under traditional fee-for-service insurance plans, providers are paid for each individual service rendered.
“The question we addressed in our study is to what extent do the financial incentives facing providers and their health care organizations that arise out of capitation, given that workers’ compensation pays fee- for -service, influence whether or not a case is deemed to be work-related,” said Dr. Victor.
- What is the difference between the care a patient receives under a capitated group health insurance plan vs. workers’ compensation?
- Do incentives exist for doctors to call an injury work related?
- If the share of capitated patients rises in a state, what impact does that have on the workers’ compensation system?
- In what states is case-shifting more likely to occur?
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: https://www.surveymonkey.com/r/wcri_webinar.
The Cambridge-based WCRI is recognized as a leader in providing high quality, objective information about public policy issues involving workers' compensation systems.
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.