Workers’ comp study finds use of ERs for initial treatment varies state to state

Cambridge, MA — The percentages of injured workers who visited an ER – instead of physician offices or urgent care clinics, which are less costly alternatives – for their initial medical treatment varied across 28 states, according to a recent study from the Workers Compensation Research Institute.

Researchers looked at a sample of workers’ comp claims for private industry and local public employees, such as firefighters and police personnel, from the institute’s Detailed Benchmark/Evaluation database. The claims were made between 2019 and 2021.

The researchers found that 37% of claimants in Massachusetts went to ERs for their initial treatment. Delaware had then next highest percentage, at 30. At the other end of the spectrum, 14% of claimants in Arizona and California did the same.

“The variation was even larger for conditions like sprains and strains, for which there is a wider scope of shifting between office and [ER] settings,” WCRI says. “Some factors explaining this variation may include local norms of [ER] utilization and state-specific workers’ compensation system features. During the COVID-19 pandemic, [ER] utilization as the source of initial medical services tended to be lower when the COVID-19 caseload was higher.”

The study sample represents nearly 80% of the workers’ comp benefits paid in the United States.

“The substantial interstate variation in the use of [ERs] across states, even for the same injury type, raises questions about why we observe this variation and whether it comes from the design of workers’ compensation systems or other factors,” WCRI President and CEO John Ruser said in a press release. “In addition to documenting the variation, this study sheds light on some of the factors accounting for it.”