The Workers Compensation Research Institute is presenting a webinar early next month examining the impacts of the Affordable Care Act on the workers compensation line.
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, WCRI said in the announcement about the webinar, scheduled for Thursday, Dec. 10, 2015 at 2 p.m. ET.
WCRI has been studying whether financial incentives facing health care providers and health care organizations influence whether or not a case is deemed to be work-related, said Dr. Richard Victor, president and CEO of WCRI, who said that differences in fee-for-service plans like workers comp and “capitated” health insurance plans will also be examined during the webinar.
The ACA seeks to greatly expand the use of Accountable Care Organizations (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. In contrast, under traditional fee-for-service insurance plans, providers are paid for each individual service rendered.
Given that background, the upcoming webinar will address several questions:
- 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?
The Workers Compensation Research Institute is an independent, not-for-profit research organization based in Cambridge, Mass.
Webinar attendance is limited to 100 people.
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. To register, click here.