Do zero-cost workers' compensation medical claims really have zero costs? The impact of workplace injury on group health insurance utilization and costs.

Abstract

Previous research suggests that non-workers' compensation (WC) insurance systems, such as group health insurance (GHI), Medicare, or Medicaid, at least partially cover work-related injury and illness costs. This study further examined GHI utilization and costs. Using two-part model, we compared those outcomes immediately after injuries for which accepted WC medical claims made zero or positive medical payments. Controlling for pre-injury GHI utilization and costs and other covariates, our results indicated that post-injury GHI utilization and costs increased regardless of whether a WC medical claim was zero or positive. The increases were highest for zero-cost WC medical claims. Our national estimates showed that zero-cost WC medical claims alone could cost the GHI $212 million per year.