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Few Doctors Account for Bulk of Workers' Comp Expenses, Says Study

Cheryl Clark, for HealthLeaders Media, January 12, 2010

A total of 3.8% of 2,034 Louisiana physicians who provided care to workers' compensation claimants accounted for 72% of the claim costs for those workers, according to a report from Johns Hopkins University School of Medicine.

But researcher Edward J. Bernacki, MD, says the amount those 77 high-cost doctors billed was not that different than what the 1,957 other doctors billed for similarly injured workers.

"It's just that the style of practice these physicians engaged in wasn't as efficient. They kept people out of work a lot longer, weren't efficient in getting the diagnosis, and getting their patients back to work," he says.

The average claim duration for the 77 higher cost physicians was 697 days, compared with 278 days for the other 1,957 physicians.

During the longer periods in which patients were out of work, the Workmen's Compensation Fund paid for their time off.

He adds, "No one was really lining their pockets. And I don't think the intent was to make more money and game the system. It's just that for these physicians, the style of practice was just different."

The report, by principal investigator Bernacki, director of the Division of Occupational Medicine, was published in the January issue of the Journal of Occupational and Environmental Medicine. It covered claims filed during a five year period, between 1998 and 2002 in Louisiana, and which were closed by Dec. 31, 2006.

Bernacki says Johns Hopkins has a research relationship with the state of Louisiana's workmen's compensation system, which presented an opportunity to investigate the costs. Nationally, the U.S. workers' compensation system costs $85 billion, which includes payment to workers during their time off as well as the costs of testing, drugs, and therapy.

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