Clinics in occupational and environmental medicine
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Workers' compensation reform efforts respond to the competing interests of business, labor and insurers. Early reforms expanded programs in response to inadequate benefits and coverage while in the 1980s and 1990s states responded to increasing costs by tightening fee schedules, limiting physician choice, restricting eligibility,lowering benefits, and integrating managed care into workers' compensation. ⋯ Controlling costs alone, however, cannot solve other problems of workers' compensation. Future reform efforts will need to focus not only on the costs of the system but also its inclusiveness and support of the workers and their families it was intended to protect.
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The workers' compensation system in the United States, comprised of independent state based and national programs for federal workers, covers approximately 127 million workers and has evolved and grown since its inception in 1911. Coverage has significantly broadened in scope to allow for the inclusion of most occupational injuries and illnesses. The cost of workers' compensation care has also increased. ⋯ It is likely that managing workers' compensation costs will continue to be a challenge in the foreseeable future. The cost of workers' compensation care affects all stakeholders including workers, employers,providers, state workers' compensation regulators, legislatures,and insurers. A continued commitment to quality, accessibility to care, and cost containment, and being alert to emerging issues that can affect these elements, will help ensure that workers are afforded accessible, high quality, and cost-effective care.
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Clin Occup Environ Med · May 2004
ReviewManaging workers' compensation costs in the military setting: the Army's story.
Direct and indirect costs for the Army's workers' compensation payments have increased to more than 2 billion US dollars. Increasing attention is putting the spotlight on the problems at all levels, and a promising cooperative approach to injury prevention and case management is emerging. ⋯ Front-line managers bear the responsibility for educating the workforce and providing safe workplaces. Employees become the beneficiaries, not of medical and compensation benefits but of safe and healthy work environments.
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Clin Occup Environ Med · May 2004
ReviewThe Washington state workers' compensation system: a case study.
Washington State workers' compensation has researched applying managed care in workers' compensation through a series of research projects. In 1995 and 1996, the managed care project evaluated the impact of managed care on medical outcomes, patient satisfaction, and the cost control of medical care and disability. ⋯ Finally,the managed care project evaluated the satisfaction of the employer with managed care. The Department of Labor and Industries Centers of Occupational Health and Education project currently is evaluating the impact of an occupational medicine-directed,education-oriented, protocol-guided pilot project.
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This article presents several factors believed to have shaped the costs of workers' compensation. Of these factors, the most notable influence on claims severity is related to the way medical care is delivered to treat occupational injuries and illnesses. Although medical care providers may have some influence on the other factors responsible for increased claims severity, such as attorney costs and differences in state workers' compensation laws, they have a tremendous impact on the way medical care is delivered and its resultant costs. This places physicians, nurse practitioners,physical therapists, chiropractors, nurses, and physician assistants in a unique role of being able to assist US business in improving productivity through a reduction in workers' compensation costs.