Xuguang Tao

The Relationship Between Attorney Involvement, Claim Duration, and Workers' Compensation Costs

Objective: To determine the relationship between attorney involvement, claim duration and workers’ compensation claim costs. Methods: We identified and compared 738 claims with attorney involvement and 6191 claims without attorney involvement submitted by individuals injured between August 1, 2003 and July 31, 2004 whose claims were paid by the Louisiana Workers’ Compensation Corporation (LWCC). At the time of assessment (March 20, 2006), 97.7% of claims not involving attorneys and 57.5% of claims involving attorneys were closed (resolved). Results: After controlling for lost time (temporary/total days paid), attorney involvement was associated with consistently higher medical, indemnity and claims handling costs, as well as increasing claim duration (accident date to closing date). Conclusion: Attorney involvement in workers’ compensation claims is associated with increasing claims duration and costs.

A preliminary investigation of the effects of a provider network on costs and lost-time in Workers' Compensation

Objective:We sought to compare lost-time days and average and median workers’ compensation claims costs between injured workers managed by OMNET Gold (OG) physicians and those managed by physicians not participating in OG. OG is a statewide health care provider network coordinated by occupational medicine physicians and established by the Louisiana Workers’ Compensation Corporation (LWCC) to manage the medical care of injured workers. Methods:We identified and contrasted 158 lost-time claims managed by OG physicians and 1,323 claims managed by physicians not participating in OG during the first year of network operation (August 1, 2003 to July 31, 2004). Results:The average and median costs for a non-OG claim was

Monitoring Worksite Clinic Performance Using a Cost-Benefit Tool

12,542 and

A randomized clinical trial of continuous low-level heat therapy for acute muscular low back pain in the workplace.

5,793, whereas the average and median costs for an OG claim was

Temporal Relationship Between Lumbar Spine Surgeries, Return to Work, and Workers' Compensation Costs in a Cohort of Injured Workers

6,749 and

The relationship between a worksite wellness clinic and hospital emergency department visits.

3,015. The average and median number of lost-time days for an OG claim was 53.4 and 34.0 and 95.0 and 58.0 for a non-OG claim. The mean differences were statistically significant. Conclusions:A small network of physicians may have an effect on the duration of lost-time and workers’ compensation costs.

Is Obesity Associated with Adverse Workers' Compensation Claims Outcomes?

Objective: The purpose of this study was to explore the usefulness of continuously assessing the return on investment (ROI) of worksite medical clinics as a means of evaluating clinic performance. Methods: Visit data from January 1, 2007, to December 31, 2008, were collected from all the on-site clinics operated for the Pepsi Bottling Group. An average system-wide ROI was calculated from the time of each clinic’s opening and throughout the study period. A multivariate linear regression model was used to determine the association of average ROI with penetration/utilization rate and plant size. Results: A total of 26 on-site clinics were actively running as of December 2008. The average ROI at the time of start up was 0.4, which increased to 1.2 at ∼4 months and 1.6 at the end of the first year of operation. Overall, it seems that the cost of operating a clinic becomes equal to the cost of similar care purchased in the community (ROI = 1) at ∼3 months after a clinic’s opening and flattens out at the end of the first year. The magnitude of the ROI was closely related to the number of visits (a function of the penetration/utilization rate) and the size of the plant population served. Conclusion: Serial monitoring of ROIs is a useful metric in assessing on-site clinic performance and quantifying the effect of new initiatives aimed at increasing a clinic’s cost effectiveness.

Evaluation of a Bladder Cancer Cluster in a Population of Criminal Investigators with the Bureau of Alcohol, Tobacco, Firearms and Explosives—Part 1: The Cancer Incidence

Objectives: We sought to compare the therapeutic benefits of ThermaCare Heat Wrap combined with an education program to an education-only program on reducing pain and disability from acute work-related low back pain. Methods: Forty-three eligible patients, aged 20 to 62 years who presented to an occupational injury clinic, were randomized into one of two intervention arms: 1) education regarding back therapy and pain management alone or 2) education regarding back therapy and pain management combined with three consecutive days of topical heat therapy (104°F or 40°C for 8 hours). The primary endpoints in this trial were measures of pain intensity and pain relief levels obtained approximately four times per day for the three consecutive working days of treatment, followed by measures of pain intensity and pain relief levels obtained in three follow-up visits at day 4 and 14 from treatment initiation. The secondary measures were overall impairment due to injury and disability caused by low back pain assessed at Intake, Visit 2 (day 4), 3 (day 7), and 4 (day 14). Results and Conclusion: A total of 18 individuals enrolled in the education-only group and 25 in the treatment group completed the intervention and all follow-up visits. The general linear model adjusting for age, sex, baseline pain intensity, and pain medication indicated that the topical heat therapy had significantly reduced pain intensity, increased pain relief, and improved disability scores during and after treatment.

A New Method of Assessing the Impact of Evidence-Based Medicine on Claim Outcomes.

Objective: Determine the relationship between time to surgery, lost time, and insurance costs. Method: A cohort of 582 claimants undergoing lumbar spine surgery (1999 to 2002) in the state of Louisiana was observed for 7 years. Results: The shorter the time interval between injury and first lumbar surgery, the lower the cost and time lost from work. Average days lost from work and claim costs for 42% of those undergoing early lumbar surgery did not differ from injured workers who lost time from work for claims not involving lumbar surgery. Claim cost for the remaining 58% who had delayed surgery was 5.7 times greater than that for the early surgery cohort. Conclusion: The decision to perform lumbar surgery is not necessarily associated with high claim costs or longer time out from work, provided that the determination to operate is early.

A Seven-Year Longitudinal Claim Analysis to Assess the Factors Contributing to the Increased Severity of Work-Related Injuries

Objective: To assess the relationship between the provision of episodic medical care at the worksite and nonadmission emergency department (ED) visits. Methods: A historical cohort design was used to study the differences of nonadmission ED visits among insurance plan participants employed at two acute care hospitals, one with a worksite wellness clinic and one without over an 8-year period. Results: A significant reduction in the risk of an insurance plan member visiting the ED in the time period after the clinic was opened among plan members with access to a worksite wellness clinic was observed. No significant reduction was noted in ED visits for insurance plan members without access to a worksite clinic. Conclusions: A wellness clinic rendering episodic medical care is associated with significant reductions in ED visits and insured employees who use an ED.