Increased Costs and Rates of Use in the California Workers' Compensation System as a Result of Self-Referral by Physicians

Abstract

This study demonstrates that self-referral increases the cost of medical care covered by workers' compensation for each of the three types of service studied.

Physical Therapist Practice and the Role of Diagnostic Imaging

“…Lehnert and Bree 37 found that 26% of hospitalbased outpatient imaging did not meet appropriateness criteria developed by a radiology benefit management program. Assessing the worker's compensation system of California, Swedlow et al 67 found that the use of imaging services was inappropriate in 38% of cases. In a review of a national employer-based health plan between 1999 and 2003, Gazelle et al 27 found imaging to be ordered 1.2 to 3.2 times more among practitioners who self-referred.…”

CJEM Debate Series: #Copayment – Medical insurance is for non-routine events

“…Also, physicians have strong incentives for greater volumes of care -to increase their own earnings, to decrease their own medical uncertainty, and to avoid making a mistake. Indeed, physicians are far more likely to order interventions that financially benefit them personally, [13][14][15][16][17] and acknowledge sometimes ordering medically unnecessary tests and treatments, because of malpractice concerns or the fear of being blamed if something goes wrong. 18,19 Cost-sharing is also patently unjust, as it hits hardest the pocketbooks of the poor and older adults.…”

Money and Medicine: Indivisible and Irreconcilable

“…Consider the matter of self-referral. The detrimental consequences of self-referral are well documented [21,22,[27][28][29][40][41][42][43][44]. However, opinions as to its value and its ethical implications remain as irreconcilable as ever [45].…”