A Methodology for Predicting Provider Participation in Workers' Compensation Medical Fee Schedules

Researchers examine 1,676 providers in 19 states to determine if and why neurologists would accept workers' comp payments based on a fee schedule. This study by Steven E. Levine, M.D., Ph.D. and Ronald N. Kent, both California-based physicians, looks at medical practices in 19 states and finds that boycotting by specialists begins to spread when reimbursement, before any PPO discounts, is set low.

Their findings suggest that when rates dip below roughly 150 percent of Medicare, more than half the specialists drop out of treating work injuries. The point can be higher in states where the burden of dealing with workers' compensation regulations is more acute--which usually means a lot of utilization-review red tape

Find out why by accessing the researcher's conclusions on workers' comp acceptance rates. Also check out a chart that plots actual acceptance rates versus predicted rates.

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Drs. Levine & Kent had done an earlier study on provider participation levels in states with low-multiple fee schedules.

March 1, 2008

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