A new Workers Compensation Research Institute (WCRI) study found that vertical integration results in more medical care, higher claim costs, and longer recovery among workers injured on the job.
“Supporters of vertical integration argue care can be delivered more efficiently and this translates into improved outcomes. Opponents argue that the rising concentration of medical providers may lead to higher payments for medical care, due to lack of competition, without improvements in outcomes. This study addresses these important issues,” said Ramona Tanabe, president and CEO of WCRI.
This study, Impact of Vertical Integration in Workers’ Compensation, examines how claim costs, disability duration, and the nature of care change when patients see newly integrated medical providers relative to non-integrated providers.
The following are some questions the study addresses:
- Did workers who were treated by vertically integrated providers have higher medical payments per claim and longer duration of temporary disability?
- Were the patterns and quantity of care impacted by the vertical integration status of the treating providers?
- How did the impact of vertical integration vary across main groups of injuries?
The analysis focuses on care provided to workers in 34 states who suffered a work-related injury between 2012 and 2018. It covers the main specialties of medical professionals who treat a large share of workers with injuries, including physicians and non-physicians.
For more information about this report or to download a copy, visit https://www.wcrinet.org. The report was authored by Bogdan Savych and Olesya Fomenko.
ABOUT WCRI
The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI’s diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia, and New Zealand.