The Increasing Blur Between Healthcare and Workers’ Compensation

Workers' Compensation Claims and Cost |
Written by Dell Dorn

Corporate America has long known there are two sides to worker health: Standard health insurance and workers’ compensation. The former is primarily for routine healthcare, whereas the latter covers employees in case of on-the-job injuries. For better or for worse, healthcare and workers’ compensation have been in separate silos. As one article described it, the message is confused: “We tell employees that we have a great healthcare system set up for them, encourage them to choose the best physician to meet their needs and to get regular checkups. However, if an employee gets injured, we have a separate system with a separate set of doctors and a separate set of rules.”

We are finding more and more that “viewing these programs — along with their corresponding components, such as safety, wellness, disability and leave management — as competing concerns in separate silos is short-sighted and counterproductive.”

Many employees and employers want a more holistic package that bundles health insurance with workers’ comp. Why separate healthcare into two distinct functions when they both address the same wellness needs? The main barrier to this is “the patchwork quilt of state laws that in many places prevent the use of narrow provider networks… Many states regulate whether carriers and employers can offer direct care for injured workers and have mandated workers’ comp fee schedules.” Nonetheless, the lines are blurring and many companies are starting to merge healthcare with workers’ compensation in effective ways.

As health insurance and workers’ compensation blend together more and more, another healthcare facet on the rise is wellness programs. The majority of today’s companies provide some form of wellness program, and it is important to remember that prevention is the best medicine. General health and wellness are clearly linked to the likelihood of injury in the workplace. For example, smokers and obese workers are significantly more likely to suffer a workplace injury than their leaner and nonsmoking co-workers.

Wellness programs cover a range of functions and styles, and help encourage employees to live a healthier lifestyle – both at work and at home. Whether by providing valuable information on healthy eating or by getting employees involved in physical activity tracked by wearables, wellness programs help employees lead healthier lives with fewer illnesses and injuries. This leads to costs savings.

Costs of both workers’ comp and health insurance have risen dramatically over the last five years. As companies look for ways to cut costs, combining health insurance with workers’ compensation would actually produce not only savings, but also improved, streamlined employee healthcare. Likewise, wellness programs offset the occurrence of injuries in the first place, leading to further savings.

Combining wellness programs, health insurance, and workers’ compensation into one healthcare package is the trend we are seeing as their lines naturally blur. Holistic care is becoming a reality, and “it makes sense to treat the person as they are – as a whole person. It is very important to try to get all of the systems to work together to treat the employee as one person.”

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About the Author

Dell Dorn

Dell Dorn is the founder of DORN Companies. He started DORN in 1998 to help employers save money on workers' compensation claims and reduce OSHA recordables. Today, DORN customers realize the immense cost of employee pain and the enormous impact our service has on employee morale and their bottom line.
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