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Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0000000000000030
Original Articles

Do Zero-Cost Workers' Compensation Medical Claims Really Have Zero Costs? The Impact of Workplace Injury on Group Health Insurance Utilization and Costs

Asfaw, Abay PhD; Rosa, Roger PhD; Mao, Rebecca MPH

Continued Medical Education
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Objective: Previous research suggests that non–workers' compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs.

Methods: Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments.

Results: Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims.

Conclusion: Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year.

Copyright © 2013 by the American College of Occupational and Environmental Medicine


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