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Workers Comp Pays More Than Group Health

In a recent study released by the National Council on Compensation Insurance (NCCI), the authors describe a Workers Compensation system that pays more than Group Health to treat comparable injuries.

The September 2021 NCCI study found that for 12 common Workers Compensation injuries, the system paid more than Group Health for similar injuries.  Several key findings described by the authors include:

  • The most pronounced difference between Workers Compensation and Group Health is the greater quantity of physical medicine services in Workers Compensation
  • Utilization differences are much bigger than price differences for Workers Compensation relative to Group Health, explaining most of the cost difference
  • Utilization differences vary principally by type of injury. All selected injuries show a higher level of utilization for Workers Compensation than for Group Health
  • Price differences are more related to the jurisdiction than to the type of injury for Workers Compensation, due in part to the different state fee schedules that apply
  • Cost differences between states are more correlated with price differences than with utilization differences
  • Traumas to arms and legs consistently have smaller cost and utilization differences in Workers Compensation, while chronic pain‐related injuries, such as bursitis and back pain, have larger differences
  • A more expensive mix of procedures in complex Workers Compensation cases contributes to higher costs relative to Group Health, especially for referral‐based care, like radiology and surgery

To read the study packed with insights for risk, claim and other corporate benefit functions, please click here >> 

If you or your clients are interested in learning more about our products and services to support Enterprise Risk Management (ERM) and Claim Settlement Solution initiatives, please contact Robert J. Blackburn at This email address is being protected from spambots. You need JavaScript enabled to view it.  or 585-586-4530.

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By Robert J. Blackburn, Managing Principal, Blackburn Group, Inc., contact him at This email address is being protected from spambots. You need JavaScript enabled to view it..

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