Controlling Medical Costs in Worker’s Compensation Controlling Medical Costs in Worker’s Compensation

Controlling Medical Costs in Worker’s Compensation

Nationally, worker’s compensation medical costs are increasing at an alarming rate.  Medical services account for 60% of worker’s compensation claim costs.[1]  Plus, worker’s compensation costs are 71% higher than care for similar injuries covered under group health costs.[2] Although it is not appropriate to second guess the authorized treating physician’s recommendations or try to direct care through utilization reviews, there are other things an employer or its insurer can do to control medical costs. 

  • Use generic drugs.  Check your records and talk with the authorized treating physician about prescribing generic drugs whenever possible.  For medical only claims, if the provider will prescribe an over-the-counter anti-inflammatory, rather than a prescription drug, you may also avoid an OSHA recordable. 
  • Negotiate rates.  In states where there are no fee schedules, negotiate with the authorized physicians to pay rates similar to those negotiated through group medical plans.  Developing certainty around billed rates may also help reduce provider fee disputes filed with the Board.
  • Work with your health care providers to schedule physical therapy visits outside of working hours to avoid paying lost wages.
  • Develop a return to work program.  Employees who return to work, even with restricted activity, are less likely to over utilize medical care than employees who are sitting at home. 
  • Create a positive, supportive work environment.  Listen sympathetically to injured employees’ concerns, make sure they feel like a valued part of the organization, and stay connected with them while they are not at work.  Disgruntled employees are more likely to over utilize medical care than happy employees.
For more information, contact Ann Stewart or any member of Ice Miller’s Worker’s Compensation Group.

This publication is intended for general information purposes only and does not and is not intended to constitute legal advice. The reader should consult with legal counsel to determine how laws or decisions discussed herein apply to the reader's specific circumstances.


[1] PropertyCasualty360.com
[2] https://www.ncci.com/pages/industry_information.aspx

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