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Nurses help lower the costs of workers compensation claims, according to a study released Wednesday by Liberty Mutual Insurance Co. and its third-party administrator, Helmsman Management Services L.L.C.
The study, “The N Factor: How Nurses Add Value to Workers Compensation Claims,” is based on medical billing and claims data from 42,000 workers compensation cases and measured the impact of a nurse's involvement by comparing the costs of claims with nurse involvement to the costs of claims without their involvement.
Overall, the study found that injured employees return to work faster once a nurse gets involved, with costs dropping 26% and claims resolutions happening 15% faster than without a nurse involved.
“When we analyzed a homogeneous set of claims, we saw that a nurse's involvement made a difference in the claim cost as well as returning the injured employee to work sooner,” the study states. “But that doesn't mean that involving a nurse in the treatment of every type of claim is going to produce the same results.”
Indeed, the study found that nurse involvement is most beneficial in complex cases involving comorbid conditions such as obesity and diabetes, or surgeries with lengthy recover times such as shoulder surgery.
In light of the survey results, Liberty Mutual and Helmsman created a tool that automatically notifies claim adjusters of those cases that would most benefit from a nurse's involvement.
“By understanding the return nurses provide on compensation claims, we were able to develop a tool that reviews more than 20 key variables — from the part of the body that was injured, to the presence of comorbid medical conditions — and alerts adjusters of those claims where nurses will have the most impact,” Glenn Shapiro, chief claims officer for commercial insurance with Liberty Mutual, said in a statement.
(Reuters) — Even the astronomical price markups that consumers regularly pay for, say, wine in restaurants pale beside those in some U.S. hospitals: The price for procedures is often 10 times the cost, according to a study published on Monday in the journal Health Affairs.