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R&R Insurance Blog

ACA Impact: Prepare for Cost Shifting in the Worker’s Compensation System

Posted by Scott Shaver

Business OwnerQuite often, I’ll get questions from employers wondering what impact the ACA will have on worker’s compensation. A recent study by the Worker’s Compensation Research Institute (WCRI) helps shed some light on what employers can expect. It’s not encouraging news.


According to the recent WCRI study, hundreds of millions of dollars in insurance claims nationally could shift from health insurers to worker’s compensation carriers.


The concept is simple. The Affordable Care Act encourages health providers to form Accountable Care Organizations that shift payment from a traditional fee-for-service model to capitated or pre-paid health insurance. As you know through experience, most worker’s compensation treatment is based on fee-for-service.


The study suggests that providers may, in some cases, have a financial incentive to categorize an injury as being work-related. In States like Wisconsin and Pennsylvania where a large percentage of workers are enrolled in capitated health plans, this case shifting could be significant.


For more information on the report, click here.


If you would like assistance with evaluating your current worker’s compensation policies and procedures to see if there are ways to strength your program, please contact me.

Topics: Workers Compensation, Health Reform, Workers comensation, Business Insurance, healthcare reform, ACA