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Spending more on medical care for injured workers doesn't necessarily translate to better medical outcomes. That's one finding from a new study that compared key outcomes for injured workers in seven diverse states. The research showed that those with the best outcomes also had the lowest incurred medical costs. The outcomes were measured by factors such as patient satisfaction and return-to-work data.

The study by the Boston-based Workers Compensation Research Institute also showed that among seven states--Texas, California, Massachusetts, Pennsylvania, Florida, Tennessee and Wisconsin--California had the highest incurred medical costs, but was among those that listed the poorest worker outcomes.

In general, the WCRI brief, Comparing Outcomes for Injured Workers in Seven Large States, found workers in Massachusetts, Pennsylvania and Wisconsin reported better outcomes after their injuries than those in the remaining four, even though workers in those four generally had more visits with medical care providers and generated more medical costs.

The better outcomes included a higher perceived recovery of physical health and functioning; more frequent, faster and more sustainable returns to work; greater access to desired providers and services; and higher levels of worker satisfaction with their health care.

The three states with the best worker outcomes also recorded the lowest incurred medical costs, with Massachusetts at the low end at $5,924 and California at the top at $14,563. In between were Pennsylvania at $9,100; Wisconsin at $9,710; Texas at $12,265; Florida at $12,938; and Tennessee at $13,412.

Fox said this study did not go into what caused the high-cost, low-outcome situation. "It's likely the result of a combination of factors pertaining to the overall (workers' compensation) regulatory climate, things such as fee schedule, choice of provider regulations or other dynamics of the medical care delivery process that we didn't target in this particular report," she said.

Medical costs in the study reflected the total amount paid for medical services, as well as the total amount of reserves set aside for future payments. Because of potential differences across the states in how quickly employers and payers make payments, the figures were based on incurred data. "If we drew our conclusions on the basis of the paid data, we would conclude that Tennessee, Florida, Texas and Wisconsin had higher costs than California, Pennsylvania and Massachusetts," the brief said.

The WCRI study, the third in a series, was designed to help public officials and stakeholders identify critical win-win situations at a time when all states are under pressure to curtail workers' comp costs but maintain proper employee care.

The institute warned that policy-makers shouldn't regard its interstate comparisons as a basis for policy actions.

To complete the study, researchers conducted telephone interviews of 629 to 791 workers in each state who had received workers' compensation income benefits for injuries in periods ranging from 1998 through 2004.

April 15, 2006

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