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The impact of cost intensive physicians on workers' compensation
Edward J Bernacki1, Xuguang Tao, Larry Yuspeh
1Department of Medicine, Division of Occupational and Environmental Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287-1629, USA.
Objective:
To identify physicians linked to high-cost workers' compensation claims.
Methods:
Contrast the cost and duration of claims associated with cost intensive physicians (CIPs) and other physicians (OPs) on 5 years of closed claims paid by the Louisiana Workers' Compensation Corporation.
Results:
Identified 77 CIPs of 2034 physicians who treated Louisiana Workers' Compensation Corporation claimants. CIPs made up 3.8% of physicians but accounted for 72% of costs. CIP's treated 16 times more claimants, and their average claim cost was four times higher than the OPs ($46,239 vs $11,390, P < 0.01). CIP claims settled in 697 versus 278 days for OPs. Adjusted for age, sex, marital status, International Classification of Diseases, 9th revision group, and initial reserve, the odds ratio of CIP claims with a final cost of >$50,000 was 5.4.
Conclusion:
A small group of physicians (<4%) have a profound effect on overall workers' compensation costs.
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