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Impact of PPACA on Workers Compensation

By August 14, 2014August 22nd, 2018

There has been a lot of talk in the news about the Patient Protection and Affordability Care Act (PPACA). At this point, no one can be sure of the impact of PPACA on Workers Compensation program costs or care delivery.

The best news from the implementation of PPACA will be more American’s having access to quality healthcare. At the same time, it also means that approximately 30 million more lives will go into an already strained system. According to the US Department of Health and Human Services, the number of insured Americans will increase 21% however the supply of doctors is predicted to increase only 7% between now and 2020.  Those are numbers that just don’t match up.

Some of the indicators we will be watching to determine the real impact of PPACA on Workers Compensation include:

1. More Patients, Fewer Doctors: A shortage of medical professionals could mean PPACA causes longer wait times for injured workers to receive medical treatment. Those delays could lead to higher emergency room utilization or delays in treatment which could hinder the most appropriate treatment plans.

2. Not Enough Time: With the influx of patients under PPACA physicians will have significant time constraints. Add in the paperwork requirements under Workers Compensation and doctors may determine that the extra paperwork to treat Workers’ Compensation cases while being paid less under a fee schedule isn’t worth their time.

3. Healthier Workers: On the positive side, PPACA can positively impact Workers Compensation because it stands to reason that American workers should be healthier which can mean a reduction in the time, extent, and ultimately the cost of claims. Chronic conditions such as obesity, heart disease, and diabetes can be better controlled which will make recovery faster and claims less expensive in the long run. It will also make Recovery at Work programs easier to implement because workers should be declared fit for duty more quickly.

4. Reduced Claims: PPACA could also see a reduction of workers who may attempt to file claims where injuries did not occur at the workplace since they will be fully insured. That will be a positive impact for employers experience modification factors and a reduction in Workers Compensation premium.

For more information on the potential impact PPACA may have on your Workers Compensation program, or if you have other questions about benefits or health insurance, call The Flanders Group at 800-462-6435.