Tag Archives: obesity

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The Costs and Complications of The Other Disease on Workers’ Compensation Claims

Source: NCCI

Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.

Employers and their insurance companies are responsible for the treatment of all medical conditions that arise from an industrial accident or exposure. A recent study published by The National Council on Compensation Insurance (NCCI) concludes that costs are soaring as medical conditions become more complicated by other conditions known as comorbidity diagnoses. These conditions are frequently: obesity, hypertension, drug abuse, chronic pulmonary conditions, and diabetes.

While the average medical cost for a workers’ compensation claim is approximately $6,000, the medical cost of an individual claim can be a few hundred dollars or millions of dollars. In 2010, an NCCI study found that claims with an obesity comorbidity diagnosis incurred significantly higher medical costs than comparable claims without such a comorbidity diagnosis. Relative to that study, this study expands the number of comorbidities examined and provides additional information on both the types of claimants receiving comorbidity diagnoses and the types of providers submitting comorbidity diagnoses.”

KEY FINDINGS

  • The share of workers’ compensation claims with a comorbidity diagnosis nearly tripled from Accident Year 2000 to Accident Year 2009, growing from a share of 2.4% to 6.6%. Claims with a comorbidity diagnosis have about twice the medical costs of otherwise comparable claims.
  • Comorbidity diagnoses for hypertension are the most prevalent of those investigated.
  • The initial comorbidity diagnosis tends to occur early in the life of a claim.
  • Hospital and physician visits account for a majority of visits resulting in a recorded comorbidity diagnosis.
  • Only a small portion of visits result in the recording of a comorbidity diagnosis.

View complete report: Comorbidities in Workers Compensation

 

 

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The Obama Agenda: The Road to Workplace Wellness

Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.

As workers compensation programs are being diluted by soaring medical costs, The Obama Administration’s policy makers are taking a bold new step to focus on promoting wellness and disease-prevention efforts in the workplace.

Immediately following the presidential elction last November, the Department of Labor, International Revenue Service and the Department of Health and Human Services proposed regulations to enforce workplace wellness programs under the Affordable Care Act. The proposed regulations will stimulated employer programs to invite healthier workers and may go as far as penalizing those who maintian poor diets and inadequate exercise regiems.

… regulations would increase the maximum permissible reward under a health-contingent wellness program offered in connection with a group health plan (and any related health insurance coverage) from 20 percent to 30 percent of the cost of coverage. The proposed regulations would further increase the maximum permissible reward to 50 percent for wellness programs designed to prevent or reduce tobacco use. These regulations also include other proposed clarifications regarding the reasonable design of health-contingent wellness programs and the reasonable alternatives they must offer in order to avoid prohibited discrimination.”

One analysis of the proposal concludes……

“We are cautiously optimistic about the potential of workplace-wellness programs to help contain healthcare costs and to improve the health and well-being of millions of California’s workers. Preventing illness and injury through workplace-based strategies potentially benefits employees and their families, employers, and public and private insurance providers. There is emerging evidence about the effectiveness of WWPs in improving chronic disease outcomes, and a long history of occupational health and safety practices reducing workplace injury and death. Incentives in the ACA have the potential to serve as a catalyst for expanding WWP’s broadly in California. However, policy solutions need to respond to potential unintended consequences and account for the state’s incredibly diverse communities and businesses in order to make wellness programs work for all Californians.”

Read The Greenlining Institute’s report “Helth, Equity and the Bottom line: Workplace Wellness and California Business.

Comments are due on or before January 25, 2013.