Health Reform To Impact Workers' Comp, One Expert Says

NU Online News Service, March 29, 11:26 a.m. EDT

The impact of the new federal health care law on workers' compensation insurance will be a mixed bag, with some positives for the industry, a managed care expert predicts.

"We're going to see significant indirect impact--some good, some not so good," forecast Joe Paduda, a principal in Health Strategy Associates in Madison, Wis., in an interview.

Mr. Paduda said one impact will come in changes to Medicare's reimbursement levels, which some states use to set price levels for workers' comp injury treatment reimbursement.

When Medicare changes its reimbursement mechanism, states that use that figure for setting comp levels of reimbursement "must figure out how to deal with it. Do they grandfather [the existing level] in, or do they adopt a new Medicare hospital reimbursement mechanism?"

Mr. Paduda also contemplates that insurers will see some reduced claim costs for workers who have a preexisting condition that the workers' comp system must deal with in the course of treating a workplace injury.

Currently, if a worker has a chronic medical condition that must be treated before they can have surgery to repair a job injury, the worker's comp system will pay for that treatment.

What will happen in the future, he said, is that with Medicaid insuring more people, that patient will now have insurance, "so the insurer won't have to pay those non-immediate ancillary medical bills."

Mr. Paduda said the effects of the health care law may also mean that "people long-term will be healthier. It will be easier to get them back to work. It will help reduce comp costs long-term because workers are going to be healthier."

Mr. Paduda also mentioned that Medicare would be changing reimbursement for hospitals to include more post-discharge services.

He said that based on his discussions with congressional lawmakers, he could dispel an "urban legend" that there is a desire for the federal government take over the workers' comp system.

"There's no interest on Capitol Hill in doing anything on workers' comp [concerning health care]," he related, adding that "one senator said to me, 'It's hard enough to get this [health care legislation] as it is."

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