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Workers Comp Medical Networks Keeping Costs in Check NCCI


Workers Comp Medical Networks = Cost Saving According to NCCI’s Barry Lipton

Workers Comp medical networks reduce costs in most instances.  At NCCI’s  2017 Annual Issues Symposium, Barry Lipton, Senior Actuary covered a very interesting topic – Medical Costs Then and Now <<slides available at this link.

I do recommend looking at the slides for a few minutes as they are beyond informative.

brain activity workers comp medical networks scan
Provided by US Government

One of the more important aspects of his presentation was that medical costs were decreasing due to the increase (almost 2/3) of physicians’ charges were network-based.   See slide 14 of the presentation.

Slide 13 of Mr. Lipton’s presentation shows that states without medical fee schedules dwindled down to just a very few (6 states).

Two of his conclusions stated

  • Most physician fee schedules have been in place since 2000
  • Higher provider network penetration reaps benefits of system efficiencies

The second bullet point used to be quite a concern with the employer clients that I consulted with to reduce WC costs.   The network penetration rates were never that high in many of the employer’s medical treatment networks.

Hand Presenting Percentage Workers Comp Medical Networks And Arrow Decrease

Slide 8 of his presentation points out the main reason for the reduction in costs.   Surprisingly, it is physician utilization per claim.   While the reduction only totaled 3%, one would have to say this is significant in a time of upward spiraling medical costs.

As stated in my last article, workers comp medical networks or medical control is the most significant way to reduce costs out of the Six Keys To Reducing Workers Comp Costs.

Slide 2 shows that Workers Comp medical increases on Lost Time claims grew much more slowly over the last five years.   In fact, the costs decreased in 2015.    However, costs increased quite a bit in 2016 compared to the last few years.

The NCCI analysis agreed with most of my findings on the importance of using workers comp medical networks.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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