WCRI Releases National Inventory of Cost Containment Initiatives

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As the cost of medical care for injured workers continues to grow, this study provides policymakers and system stakeholders with an inventory of the cost containment initiatives employed by all 50 states, the District of Columbia, and two U.S. Federal programs (Federal Employees' Compensation Act and the Longshore and Harbor Workers' Compensation Act).

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This study provides a basic understanding of the cost containment initiatives adopted nationally and provides additional references for those who want more detail.

With medical benefits representing the single largest cost component for many state workers’ compensation systems, the Workers Compensation Research Institute (WCRI) released its Workers’ Compensation Medical Cost Containment: A National Inventory, 2018 today.

“This study provides a basic understanding of the cost containment initiatives adopted nationally and provides additional references for those who want more detail,” said Ramona Tanabe, WCRI’s executive vice president and counsel.

According to the study, medical cost containment became a focus for many states in the early 1990s when the medical portion of the workers’ compensation benefit dollar began to grow more quickly than other claim costs. This led to growth in the adoption and variety of cost containment initiatives since the 1990s. Medical cost containment initiatives include price management methods, such as fee schedules and utilization management (e.g., utilization review or medical networks).

The inventory includes tables of statutory provisions, administrative rules, and administrative procedures used by all 50 states, the District of Columbia, and two U.S. Federal programs (Federal Employees' Compensation Act and the Longshore & Harbor Workers' Compensation Act).

The initiatives outlined in the study aim to curb the cost of a particular service or to reduce the amount of services provided. Cost containment regulatory initiatives entail a balancing act of limiting the cost of services and inappropriate or unnecessary treatment without negatively affecting the quality of treatment or access to care for injured workers.

For more information on this study or to purchase a copy, visit https://www.wcrinet.org/reports/workers-compensation-medical-cost-containment-a-national-inventory-2018.

The Cambridge-based WCRI is recognized as a leader in providing high-quality, objective information about public policy issues involving workers' compensation systems.

About WCRI

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in 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 (WCRI)
+1 617-661-9274 x 257 Ext: 257
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Workers Compensation Research Institute - WCRI
since: 06/2011
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