Regarding access to care, Marsh notes that the law is designed to increase the number of individuals in the U.S. with health insurance, which “could put additional stress on a healthcare system that is already short on doctors.”

Marsh says this could particularly impact specialists, leading to delays in obtaining diagnostic tests and scheduling elective surgeries and other procedures. “Longer periods of disability and complications as a result of such delays would ultimately drive workers' compensation costs up,” says Marsh.

Employers, therefore, must develop medical networks “that focus on quality of care and outcomes—even if it means paying more on a fee-for-service basis.”

While the healthcare industry has traditionally focused on volume—more patient admissions, tests and procedures to drive higher revenues—Marsh notes that post-reform, the industry has shifted focus to improving standards of care and achieving better patient outcomes. Marsh says, “If this transition results in less emphasis on costly procedures, which often produce questionable results, workers' compensation costs could be reduced.”

The law also “provides for insurers to rebate premiums to employers that have better-than-expected performance with their healthcare programs,” says Marsh, which employers can either pass on to workers or use to offset future premiums.

Marsh warns though, that the National Council on Compensation Insurance (NCCI) has already “indicated that if premium refunds are given to employees, this would be considered payroll under the workers' compensation premium calculations.” As workers' comp premiums are tied to payroll, costs could rise for employers that pass the refunds on to workers.