Conservative medical decision-making could be unnecessarily running up the cost of workers' comp claims.

This possibility emerged from a study that analyzed the outcomes of more than 700,000 workers comp claims for four common injuries: ACL (anterior cruciate ligament) repair, knee meniscectomy, shoulder rotator cuff repair, and carpal tunnel injuries.

The research comes from Harbor Health Systems, developer of advanced technology to score treating physicians on their claim outcomes. The study was designed to determine the affect aggressive medical care, begun before guidelines might indicate, would have on outcomes. The findings support aggressive versus conservative, guidelines-driven care.

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Overall, the injury categories examined strongly supported early and aggressive treatment. Outcomes included:

  • Reductions in claim duration from 13 – 20 percent
  • Reductions in indemnity costs from 19 – 61 percent
  • Reductions in litigation from 7.2 – 16 percent

"Our objective was to investigate the differences in overall claims outcomes when comparing aggressive and conservative care in workers' compensation," said Greg Moore, president of Harbor Health. "We found that when knowledgeable and experienced physicians were allowed to perform some common specific surgical procedures prior to the recommendations of the guidelines, the outcomes improved."

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.