State plans may push injured workers toward emergency rooms: Study

Emergency room visits by injured workers showed “substantial variation” across 28 states, even for the same injuries, calling into question whether some state programs push the more expensive care at the onset of an injury regardless of medical necessity, according to a report released Monday by the Workers Compensation Research Institute.

In 2021, emergency room utilization for initial medical services ranged from 14% in Arizona to 37% in Massachusetts, with many states falling in the 20% to 25% range. WCRI found that the variation was even larger for conditions such as sprains and strains.

Some factors behind the variation “may include local norms of emergency room utilization and state-specific workers compensation system features,” WCRI said.

The pandemic also played a role: The study found that between 2020 and 2021 emergency room utilization for initial medical services tended to be lower when the COVID-19 caseload was higher.

“The substantial interstate variation in the use of (emergency departments) across states, even for the same injury type, raises questions about why we observe this variation and whether it comes from the design of workers compensation systems or other factors,” said John Ruser, president and CEO of WCRI, in a statement.

The states included in the study represent 79% of the workers compensation benefits paid in the United States, according to WCRI.

This article was first published in Business Insurance.

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