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Related Experiment Videos

Device evaluation and coverage policy in workers' compensation: examples from Washington State.

G M Franklin1, J Lifka, J Milstein

  • 1University of Washington School of Public Health and Community Medicine, Seattle, USA. meddir@u.washington.edu

The American Journal of Managed Care
|August 29, 1998
PubMed
Summary
This summary is machine-generated.

Workers' compensation covers medical, rehabilitation, and return-to-work costs for injured workers. Emerging technologies may increase costs without proven benefits, necessitating better oversight and data collection.

Related Experiment Videos

Area of Science:

  • Health Services Research
  • Occupational Health
  • Medical Technology Assessment

Background:

  • Workers' compensation benefits extend beyond general health coverage, encompassing lifelong medical, rehabilitation, and return-to-work costs.
  • Device coverage decisions in workers' compensation often involve complex challenges related to chronic musculoskeletal conditions.

Purpose of the Study:

  • To examine device evaluation and coverage policies within workers' compensation over a decade in Washington State.
  • To identify challenges in device coverage decision-making and their impact on costs and patient outcomes.

Main Methods:

  • Analysis of device evaluation and coverage policies over a 10-year period.
  • Identification and categorization of problems associated with device coverage decisions in workers' compensation claims.

Main Results:

  • Most device coverage requests pertain to chronic musculoskeletal conditions.
  • Identified issues include high-risk invasive devices, ineffective noninvasive devices, surrogate diagnostic billing, inadequate physician oversight, and insufficient efficacy data for insurers.

Conclusions:

  • Emerging technologies may escalate workers' compensation costs without clear health benefits for injured workers.
  • Recommendations include enhanced provider/patient education, state medical society involvement, and robust outcomes data collection to manage costs and ensure efficacy.