NCCI notes that if the Centers for Medicare & Medicaid Services reduces the payments, there may be a ripple effect in states that “utilize Medicare as a basis for the reimbursements in their state workers’ compensation fee schedules. This may affect both Physician Fee Schedules and Hospital Fee Schedules (Inpatient, Outpatient, and Ambulatory Surgical Centers).”

But, as NCCI points out, the magnitude and extent of the impacts on state workers’ compensation costs will depend on how and when the federal government makes modifications to Medicare payments, and how states adopt the revised Medicare payment formula for their workers’ compensation fee schedules. In other words: too many unknowns.

One popular area for speculation is the potential impact of increased healthcare coverage. Some observers are convinced workers without health insurance or with non-work-related preexisting conditions are exploiting workers’ compensation benefits. “Since the Health Care Bill expands the number of people covered and requires coverage for preexisting conditions, there may be a decline in workers’ compensation funding of treatments for preexisting nonwork-related conditions,” according to the NCCI.

Such musings bring a sharp rejoinder from Robert Reville, a labor economist and researcher at Rand known for his research in workers’ compensation. “Whether healthcare coverage encourages or discourages comp claims is something comp observers talk a lot about, but don’t have much evidence to go on,” he told Business Insurance.

“You need to look for critical mass (of evidence) and this is definitely not a literature (or subject) with critical mass,” he says. Joseph Paduda, principal, Health Strategy Associates, LLC and writer of the blog Managed Care Matters, says workers’ compensation will benefit from improvements in diagnosis and clinical care spurred by the stimulus bill, specifically by funding for electronic health records. “Providers will all have access to the same amount of information instantly,” he said, in a story by Insurance Journal.

The stimulus bill also calls for an estimated $1.3 billion investment in comparative effectiveness research; i.e. how effective is one procedure versus another in restoring functionality or improving quality of life. “In my view this is a strong positive for workers’ comp. A lot of medicine is more of an art than a science, so adding more science to medicine will dramatically improve outcomes and potentially reduce costs,” Paduda says.