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The share of claims with soft-tissue injuries decreased by 12% in industries with lower levels of health coverage with the implementation of the Affordable Care Act in California from 2013 to 2015, according to a study released Thursday by the Workers' Compensation Insurance Rating Bureau of California.
Researchers with the Oakland-based ratings agency examined injured workers’ access to care, fees for medical services, claim frequency in industries most affected by the ACA and change in diagnostic mix related to comorbidities from 2013 to 2015. The national health care reform package was implemented in 2010.
While the study showed that greater access to care had minimal effect on comp frequency, a look at certain industries with historically lower access to medical insurance, such as restaurants and hospitality, showed the greatest decline in work-related, soft-tissue injuries.
The study, however, showed an increase of 17.1% of soft-tissue injuries in industries with higher levels of health coverage. The study also found similar patterns when comparing small to large businesses: the share of soft-tissue claims in small businesses decreased by 1.9% from accident years 2013 to 2015, while the share of these claims in large businesses increased by 4.5%.
As for comorbidities in workers compensation, the study found a 3.6% decrease in the share of these claims from accident years 2013 to 2015 for industries with lower levels of health coverage, while no change was observed for industries with higher levels of coverage. The study focused on three specific comorbidities: obesity, diabetes and hypertension.
The study also stated that researchers found no “clear pattern in increased physician fees charged for workers compensation medical services after ACA implementation.”
Current market conditions are driving geography-based changes to California’s medical fee schedule for physicians treating injured workers in the state, the California Division of Workers Compensation announced Friday.