If you have been out of work due to a serious injury you suffered on the
job, you may have already been through the wringer of our country’s
medical programs and workers’ compensation packages. From multiple
examinations that each seem identical to the last to numerous reviews
of your benefits coverage, you are probably getting pretty tired of being
passed between hands as you try to recuperate. One thing you probably have
not encountered, however, is an MRI or CT scan to pinpoint the source of your
ailments; despite the benefits of these technologies, they are dropping
in popularity, largely due to rising costs.
Supply and Demand, And Then Some
Doctors and physicians often rely on magnetic resonance imaging (MRI) and
computed tomography (CT) scans to easily identify the true source of a
patient’s illness or injury and decide what to do next. The technology
is so fast and effective, it has been heralded as one of the leading causes
of increased average lifespans, decreased need for exploratory surgery,
and an overall reduction of lengthy hospital stays. If it is so great,
then why is it being used less and less in treatments paid for by workers’
Back in the year 2000, Medicare clearly recognized the uses of MRI, CT,
and other similar advanced scanning technologies. From that year to 2006,
its spending on such treatments more than doubled, from $3.6 billion a
year to $7.6 billion. But the more they were using advanced scanning,
the more they were costing themselves. So in response to the raised costs,
they began to reimburse less and less for each incident of treatment,
putting more of the cost onto individuals. They also created intense review
processes that required patients to be examined thoroughly before permitting
an MRI or CT scan, hoping to only use it when it was “medically
necessary.” Not only did this inconvenience patients but it also
put their wellbeing at risk as their problems remained undiagnosed for longer.
Workers’ compensation programs had to follow the cost-cutting example
and soon started to decrease the frequency of their fee schedules for
MRI and CT options. A fee schedule determines how often and how much doctors
and physicians will be reimbursed by workers’ compensation and Medicare
for their services. Diminished fee schedules means doctors have less reason
to use this helpful technology and more reason to raise their prices when they do.
How Does All This Affect the Average Patient?
As medical industries raise their prices for MRI and CT scans, workers’
compensation packages will offer to cover smaller portions of the cost.
In effect, this causes two outcomes: patients are not being offered the
treatments they need when they need them, and they are paying too much
out of their own pockets when they do get them. In simplified terms, the
average American who relies on workers’ compensation benefits to
get by has been handed the short straw.
At Thomas F. Martin, PLC, our Orange County workers’ compensation
attorney has been fighting for injured worker’s rights in California
for more than 25 years. We do what we do not just because we’re
good at it but also because it
matters. We genuinely care about our clients and want to do everything in our
power to help them stand up to unfair business practices that are costing
them money and their health. If you believe you have been cheated, misled,
or otherwise damaged by your workers’ compensation benefits or costs,
please do not hesitate to call us at
714.594.5389 and schedule a
free case evaluation.