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Medicare Work-Related Injuries: Underutilization of Workers' Compensation Leads to Higher Out-of-Pocket Costs for
Matthew McFalls1, Beth A Virnig, Andrew Ryan
1From the Department of Environmental and Occupational Health, UC Irvine Joe C. Wen School of Population and Public Health, University of California, Irvine, Irvine, California (M.M., M.R.R.); Division of Health Policy & Management, School of Public Health, University of Minnesota Twin Cities, Minneapolis, Minnesota (M.M., B.A.V., S.L.J.); Division of Environmental Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, Minnesota (M.M., A.R., B.H.A., M.R.R.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota Twin Cities; Minneapolis, Minnesota (D.J.E.); and Office of the Dean, College of Public Health and Health Professions, University of Florida, Gainesville, Gainesville, Florida (B.A.V.).
Objective:
Older adults may pay healthcare-related costs for work injuries if Medicare covers claims over workers' compensation (WC). We assessed Medicare enrollee costs after a work-related injury by WC status.
Methods:
We longitudinally analyzed Medicare fee-for-service claims (2016-2019) for Medicare enrollees aged 65 years and older with work-related injuries, estimating WC effects on healthcare use and enrollee costs using difference-in-differences and quantile regression models.
Results:
WC covered at least one Medicare claim for 16% of the 13,039 enrollees with work-related injuries. Over 90 days, mean Medicare out-of-pocket costs were lower with WC ($447) than without ($778). With WC, enrollees owed $1432 at the 90th percentile compared to $2465 without, an adjusted difference of $600 (95% CL, -767, -432).
Conclusions:
Although WC covers some costs, Medicare claim billing increases after a work-related injury, often leading to substantial patient expenses.
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