Monday, August 26, 2013

ACA's Impact on Comp - Lessons Learned

“You can be afraid of the health care regulation that is going to take place or you can take advantage of it," Dan Cacchione, senior vice president at AmTrust Underwriters, told audience members at the 68th Annual Workers' Compensation Educational Conference in Orlando last week.

A session was held on the Affordable Care Act at the conference sponsored by the National Association of Professional Employment Organizations.

Indeed, the ACA was a topic in several sessions at the conference, and most of the time the content was speculative on how the ACA was going to affect workers' compensation.

And most of the time the answer was resoundingly uncertain. A wait and see attitude on whether there would be cost shifting, physician shortage, or healthier workers seemed to be what was on the minds of various presenters.

But some executives were much more proactive and looking at how they could leverage the ACA for benefits to both injured workers and employers.

One Chief Claims Officer that I spoke with at length was engaged in devising strategy to enable sufficient premium in a settlement so that ACA care through an exchange for several years post work comp settlement could be purchased for the injured worker.

Another senior executive was optimistic about the ACA's health quality outcomes based standards and reward system spilling over into workers' compensation systems.

The general health system, for all of its costs and expense problems, has lead the workers' compensation system in several respects, and generally by years.

Examples include treatment guidelines and protocol, billing standards, electronic records and reimbursement systems, etc.

Several years ago, at this same Orlando conference, Dr. David Dietz, Chief Medical Officer for Liberty Mutual started off one of his presentations with a question to the audience, and I thought the response was profound.

Dietz asked if given the choice between general health and workers' compensation, how many would choose workers' compensation for their overall medical care.

Not one hand went up.

And that is telling of the confidence we have in our own system; a health care system that is so bad that we, in our own industry, wouldn't avail ourselves of it.

So what will the impact of the ACA be on workers' compensation? 

In terms of statistically relevant impact on costs and expenses, who knows.

But the eternal optimist in me says that there are a lot of lessons still to be learned from general health and that there is quite a bit of opportunity in the ACA for workers' compensation systems to learn and improve, and perhaps leverage, to make lives better for injured workers.

And incidentally these strategies and lessons will likely help control employer costs overall.

The ACA is here, it is going to stay despite the GOP's threats to either repeal it or defund it. We'll live with it. We'll learn from it. And in the end, hopefully, we'll be better off for it.

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