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Workers Comp Medical Networks Reduce Costs – Or Do They Actually?


Workers Comp Medical Networks – Three Conflicting Studies

Most Workers Comp networks generate large claim payment reductions according to two studies.  Another study indicates no savings from these same Workers Comp medical networks.

One of my Six Keys To Saving On Workers Comp Costs involves medical control.   Since the late 1980’s I have tracked three variables which save on WC payouts.   One of the Six Keys is medical control or the use of medical networks created by the employer.

The others are ASAP First Reports and Return to Work programs.

diagram workers comp medical networks decision
jean paul alonso – Wikimedia Commons

In the 1990’s, I decided to see if my three financial keys affected the files as I had anticipated from the beginning.   I performed two studies on two very different groups of governmental WC claim files.     My theory on the financial keys sustained my theory all throughout the two sets of files.

Medical control by the employer reduced costs by 75%.   Each employer we have assisted in cutting workers comp costs saved premium or budget dollars when using medical control to direct their employees to certain physicians.    We stress to each client to have a medical network in place and not just have the company Doctor in place.

Study after study has shown that employees use the physicians that the employer recommends for initial and subsequent treatment for their work related injuries regardless of whether the employee or the employer has the medical treatment control.

Therefore my studies and experience say that medical control and medical networks save big workers comp money.   Additionally, the network or medical control provides good conservative care for injured employees.   The win-win-win situation creates a great bond between employer and employee.

NCCI Recent Press Release

Business People Workers Comp Medical Networks At Conference Room

NCCI, the largest rating bureau for Workers Comp released a study at their Annual State of The Line conference last week.  Their study on Workers Comp medical networks indicated much premiums are saved by using medical networks.

WCRI Recent Study Release 

WCRI (Workers Comp Research Institute) recently released a study that seems to contradict my findings along with NCCI.   WCRI and my findings have always agreed right down the line.  In fact most of the time, NCCI, WCRI, and I agreed on almost any aspect of Workers Comp.

For further reading,   the links below will take you to each study’s summary.   Unfortunately, my study was informal.  I do not keep all the data nor did I publish the study as it was a very ad-hoc analysis.

WCRI graciously supplied me with a copy of their study.   The summary/abstract is here.

The recent NCCI study has not been released yet.  It should be out shortly.   I will link to it when it appears on the NCCI website.

I try to write short articles so I will not comment on the NCCI or WCRI Studies yet.    I will comment on workers comp medical networks this week.

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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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