Medical provider networks for workers compensation have become increasingly popular over the last two decades. In conjunction with increased market penetration, some MPNs have broadened their services: As a way to improve outcomes, they do not just provide medical care, they manage the medical services on a claim, including interacting with the patient.

A new report published by NCCI looked at the impact of MPNs on workers compensation claim costs for 10 common WC injuries.

Comparing claims managed in-network to claims managed out-of-network across states and for 10 common injuries:

— Average paid medical costs are higher in-network for the more costly back and shoulder injuries and lower for several less costly injuries.
— In-network cases have more and higher-level office visits,as well as more physical therapy modalities,than comparable out-of-network cases.
— Except for the more costly back injuries, in-network claims (as compared with out-of-network):
— — Are less likely to be admitted to a hospital.
— — Cost less for hospital outpatient services.
— — Cost more for physician services.
— For all 10 injuries and for both permanent partial and temporary total claims, the average total incurred cost per claim for in-network claims is lower than, or about the same as, that for out-of-network claims.
— In-network claims are more likely to have permanent injury awards than out-of-network claims; selection bias may play a role here
— WC medical costs for physician services are higher than comparable Group Health costs. The main driver of this difference is higher utilization of services to treat WC cases.
— For all but a few injuries with comparatively small numbers of cases, greater MPN penetration in a state is associated with greater MPN utilization of physician services in the state.

Differences at a state level may be considered in a follow-up study performed later.