Study Compares Outcomes for Injured Workers in Nine States

A new Workers Compensation Research Institute (WCRI) study compares outcomes for injured workers in nine states within the areas of recovery of health and functioning, return to work, access to medical care and satisfaction with medical care.

Using overall characterizations of worker outcomes, along with the relative assessment of medical costs and use, WCRI, the Cambridge, Mass.-based research organization, categorized the states -- California, Connecticut, Florida, Massachusetts, North Carolina, Pennsylvania, Tennessee, Texas and Wisconsin -- into three groups: those that provide a "better," "moderate" or "worse" value proposition for workers and employers.

"Combined with other benchmarks of costs and medical utilization, these comparisons can allow public officials and system stakeholders to begin to focus on critical 'win-win' opportunities for workers and their employers -- possible improvements in the system that can result in better worker outcomes without raising employers' costs or, conversely, those that can lower costs without adversely affecting workers' outcomes," said Dr. Richard Victor, executive director of WCRI.

The study, "Comparing Outcomes for Injured Workers in Nine Large States," reported a "better" value proposition -- lower average medical costs and use as well as worker outcomes that were better than or in the middle of the range -- in Connecticut, Massachusetts, Pennsylvania and Wisconsin.

In these four states, employers paid less for medical care, yet workers achieved outcomes that were better than or in the middle of the range compared to workers in the other study states.

The study reported that workers in these states had generally better recoveries after their injuries, were more likely to return to sustainable employment (and do so more quickly), experienced more timely medical treatment from their primary providers, experienced fewer problems accessing medical care and were less likely to be dissatisfied with their care.

By contrast, a "worse" value proposition was found in California, Florida, Tennessee and Texas, prior to the enactment of recent reforms to their workers' compensation systems.

In particular, medical costs and use in pre-reform California and pre-reform Texas were higher than in the other study states, while worker outcomes were generally in the middle of the range or worse in all categories.

The study described these two states as having a "worse" value proposition for employers and injured workers because employers paid much more for medical care compared to the seven other states studied, yet workers experienced worse outcomes (or, at best, outcomes in the middle of the range).

This included generally worse recoveries after injury; workers also were less likely to have substantial returns to work, were more likely to experience problems accessing medical care, and expressed higher rates of dissatisfaction with their medical care than workers in many of the other study states.

The study also characterized pre-reform Florida and pre-reform Tennessee as providing a "worse value proposition." Despite costs that were in the middle of the range of study states, like pre-reform California and pre-reform Texas, outcomes for injured workers in pre-reform Florida and pre-reform Tennessee were also generally in the middle or worse compared to the other states.

The study described North Carolina as having a "moderate" value proposition for employers and injured workers, where medical costs and utilization, as well as worker outcomes, were consistently in the middle of the range.

The study pointed out that while the costs that employers paid for medical care in North Carolina were in the middle of the range, and outcomes also appeared to be in the middle, from a value perspective, there are opportunities to further improve the system.

This is evidenced by the fact that Connecticut, Massachusetts, Pennsylvania and Wisconsin have been able to achieve better outcomes for injured workers at a lower cost than North Carolina.

The nine states in the study represent large and diverse systems with differences in state laws and system features such as choice of provider, medical fee schedules, claim costs and the payment of income benefits for permanent disabilities, WCRI officials said. They also differ in geographic location and characteristics as well as industry mix. For more information, contact WCRI at

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