LAS VEGAS — The Patient Protection and Affordable Care Act makes little mention of workers compensation, but the law will indirectly affect workers comp systems nationwide in both negative and positive ways, one doctor said during the Disability Management Employer Coalition's conference in Las Vegas.
Since workers compensation regulations vary from state to state, the effects of the Affordable Care Act will look a little different everywhere, said Dr. David Deitz, national medical director of commercial insurance strategic practices at Liberty Mutual Insurance Co. in Boston.
Dr. Deitz spoke Thursday about the Affordable Care Act and how it will affect workers compensation and disability during the conference's closing keynote session and participated in a panel discussion with his Liberty Mutual colleagues Dr. Glenn Pransky, director of the insurer's Center for Disability Research, and Dr. Ed Crouch, national medical director of group benefits.
But with more people covered under the Affordable Care Act across the country, employers could see a general reduction in “the number of uninsured workers who are going to look for workers compensation because they have no other health coverage,” Dr. Deitz said. “We should begin to see some data around this point fairly soon. It's a little too early to tell whether this is going to have a positive impact or not.”
However, Dr. Deitz said that in an effort to avoid Affordable Care Act requirements and keep costs down, some employers might shift from hiring full-time workers to part-time workers. And as part-time workers typically have “higher rates of workers compensation filings and higher rates of injury,” there could be consequences, he added.
Access to care is also a concern — in some states more than others, Dr. Deitz said, depending on how each state reimburses doctors for treating comp patients.
“Fee schedules result in very different rates of payment for physicians depending on the state,” he said. “This, too, will affect how physicians approach workers compensation care in terms of whether they feel they want to practice it or not.”
The fact that specialty care for the most part is compensated at higher rates than primary care means “orthopedic surgeons in Georgia and Illinois will be very happy to see workers compensation patients for the foreseeable future, and we don't anticipate any access issues,” Dr. Deitz said. “But in situations such as those in Florida and perhaps California, where there have been some reductions in fee schedules, when there are access issues, workers compensation patients may not be preferred business.”
The issue of access to care could have a negative impact on very high-volume and low-severity cases, such as sprained ankles or finger cuts, Dr. Deitz said.
“The access issues may be a problem if there's no primary care physician available to deal with some of these minor injuries,” he added. “This may increase occupational disability, delay return to work, delay definitive resolution” and cause indemnity claim increases.
In the meantime, Dr. Deitz said employers can make sure their health plan will provide workers with access to both primary and specialty care, proactively address potential access issues, motivate workers to develop relationships with their primary care physicians and promote wellness.