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Get Help From our Michigan Workers’ Comp Lawyers Today
You’re not alone. Our Michigan workers’ comp lawyers have been called the best in the state, and we pride ourselves on providing you with care, trust, and responsiveness.

Capitated health insurance plans seen as a future cost driver for workers’ compensation and what this could mean for Michigan employers.

Business Insurance published a fascinating article about capitated health insurance plans. These types of flat-fee insurance plans are becoming more common under the Affordable Care Act and pay a fixed amount for each patient regardless of how much care is actually provided.

There is a concern that medical providers are going to game the system by classifying more soft tissue conditions as workers’ compensation. This would allow medical providers to get fee-for-service payments and higher amounts.

“Patients covered by capitated group health plans were 11% more likely to have their soft-tissue conditions called work-related,” according to a WCRI study. This could have a profound effect on states like Michigan where 22% of workers now have capitated group health insurance plans.

Our 2 cents

Cost-shifting and workers’ compensation is nothing new. A 2012 study published in the Journal of Occupational and Environmental Medicine found workers’ compensation premiums were artificially low. Almost 80% of costs are paid by group health insurance, Medicaid, Medicare, and other payers.

Our clients struggle everyday with getting reasonable and necessary medical treatment approved under workers’ compensation. Proving the injury is work-related can sometimes be a challenge. This is especially true with soft-tissue injuries that might not have been promptly reported to an employer.

We are skeptical that more capitated health insurance plans will truly lead to higher workers’ compensation costs in Michigan. Give us your thoughts in the comments below.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (855) 221-2667 for a free consultation today.

Related information:

Work Injury Costs: The Big Lie About Who Pays

Photos courtesy of Creative Commons, by Bill David Brooks.

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Author Bio Jeffrey Kaufman

Author
Jeffrey E. Kaufman
Michigan Workers Comp Attorney

Jeffrey E. Kaufman has extensive experience in workers compensation cases and has recovered millions of dollars in benefits for his clients. He believes all injured workers deserve to be on equal footing with insurance companies and employers, and fights tenaciously so their rights are secured and protected.


“Jeff also helped me with getting my Blue Cross bills paid. I would absolutely recommend him and the whole firm. Jeff and the firm did everything they were supposed to do for me and my case.”
Ricardo Perfetto

Hundreds of 5-Star Reviews

Related Blog Posts

Get Help From our Michigan Workers’ Comp Lawyers Today

You’re not alone. Our Michigan workers’ comp lawyers have been called the best in the state, and our clients love how they’re treated with care, respect, and responsiveness. We will give you the time you need, we will explain your legal rights, and we will always treat you with respect.

Our workers’ compensation and Social Security disability lawyers always put your needs first. Get to know your legal team.

Our attorneys post regularly about common issues related to workers’ comp, including common injuries, settlement calculations, laws, and more.

Injured? It’s Time to Get Some Answers

Don’t let the insurance adjuster push you around. Request your free consultation today.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Our attorneys post regularly about common issues related to workers’ comp, including common injuries, settlement calculations, laws, and more.

Our workers’ compensation and Social Security disability lawyers always put your needs first. Get to know your legal team.