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Low Reimbursements, Price Freezes, Cuts Lead to "Perverse Effects," WCRI Says

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  • Topic: Top
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BOSTON – When it comes to workers’ compensation fee schedules, how low can you go? If s…

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Lisa Italia Nov 3, 2016 a 2:58 pm PDT

Here in California, it seems that we are reducing reimbursements to doctors as a means of addressing sharp increases in medical and overall claims costs. There is a saying that you get what you pay for. Doctors tell us they are less willing to go beyond the basic requirements because they are not getting paid enough to do so. WC is complex and interaction with the doctor is important to resolving issues and improving outcomes. We should be looking at the real reason costs are rising but we don't because it is difficult, logistically and politically. Cutting physician reimbursements is not the answer but it is easy.

Anne Bazel Nov 3, 2016 a 2:58 pm PDT

Not a big surprise, cut in reimbursement drives doctors out of the industry or changes his billing behavior. That's what SB863 did. More and more I am faced with not being able to find a specialist for a patient. Those who have sufficient volume of non-work comp business, turn away from it, since it became much more cumbersome to get things authorized with never ending RFA's and illogical UR's and the cost of providing care became not financially feasible. It makes no sense to equate WC fee to Medicare, where there's so much more involved in WC with all it's paperwork.


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