Comparing the Quantity and Prices of Physician Services Between Workers Compensation and Group Health

Commercial group health insurance dwarfs the workers compensation (WC) healthcare market. These two coverages have important similarities, but there are significant differences. While WC medical services are specifically geared to treating work-related injuries, WC must function within a much larger healthcare environment.

In this latest research brief, NCCI taps into data from employer-sponsored group health (GH) programs as a source of information that might be critical to maintaining a viable WC benefit delivery system.

Employing several advances in methodology and data analysis, this paper continues and extends a series of NCCI studies comparing costs for treating comparable injuries between WC and GH—research that goes back over the last 10 years.

In this latest study, those extensions include:

  • Using newer experience and including more jurisdictions
  • Analyzing differences between WC and GH for the cost of physician services by price and quantity
  • Refining the measurement of differences in quantity
  • Affirming that quantity of services continues to be the greatest driver pushing WC costs above GH
  • Looking at the impacts of technology and cost sharing on differences between WC and GH costs

Visit the INSIGHTS section of ncci.com to view the full collection of NCCI research.


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