At the 2019 WCRI Annual Conference, Dr. Olesya Fomenko, WCRI, discussed their study on how higher deductibles for group health plans may impact workers’ compensation claims activity.
According to a Kaiser Family Foundation study, the average group health plan deductible in 2008 was $765. In 2014 that number was $1217 and by 2017 that number was up to $1505, During that same time, the percentage of workers enrolled in group health plans with deductibles above $1000 increased from under 20% to over 50%.
The major findings of the WCRI study were:
- Patients do respond to cost sharing arrangements on their group health when making decisions about filing a workers’ compensation claim.
- The impact of high deductible plans is much larger on sot tissue claims. This makes sense because with soft tissue injuries the mechanism of injury is not always clear.
- In states where the injured worker had control over choice of medical provider in workers’ compensation, the increase in workers’ compensation filings due to the higher group health deductibles was higher.
- Due to growth in group health deductibles, workers’ compensation claims volume increased by 5% from 2008-2017.
- In worker medical choice states, the increase in workers’ compensation filings due to higher group deductibles was 10%.