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UNITED STATES DEPARTMENT OF LABOR

The impact of a state-based workers’ compensation insurer’s risk control services on employer claim frequency and cost rates (Wurzelbacher et al., 2022)

Review Guidelines

Causal Evidence Guidelines

Absence of conflict of interest.

Citation

Wurzelbacher, S. J., Bertke, S. J., Lampl, M. P., Bushnell, P. T., Robins, D. C., Naber, S. J., & Moore, L. L. (2022). The impact of a state-based workers’ compensation insurer’s risk control services on employer claim frequency and cost rates. Journal of Occupational and Environmental Medicine, 64(7), 562-572.

Highlights

  • The study's objective was to examine the impact of the risk control (RC) intervention on public benefits receipt, including workers’ compensation claim rate, workers’ compensation lost-time claim rate, and workers compensation’ paid cost rate.
  • The study used two different study designs: 1) a matched difference-in-differences study design to analyze the claim rate ratio, lost-time claim rate ratio, and costs paid rate ratio for the RC serviced employers compared to the non-serviced employers before and after service provision, and 2) a time-trend adjusted regression model among employers who ever received a visit. The primary data source was the Ohio Bureau of Worker’s Compensation (OHBWC) database that includes measures of employer level claims and policy information on who also had systematic centralized RC information from 2006-2017. The authors used a statistical model to compare the outcomes of treatment and comparison group members.
  • While the authors found no relationship between RC and workers’ compensation claim rates nor workers compensation lost-time claim rates, the authors did find a significant reduction in costs paid following an RC visit.
  • This study receives a low evidence rating because the study design does not allow for randomization of the treatment and comparison group and employers self-selected to receive RC services. This means we are not confident that the estimated effects are attributable to the intervention; other factors are likely to have contributed.

Intervention Examined

Risk Control Intervention

Features of the Intervention

The Ohio Bureau of Workers Compensation (OHBWC) Consultation Program is state-run and provides workers’ compensation (WC) insurance. Employers are informed of RC services and OHBWC offers a variety of prevention programs including employer safety councils, safety programs, and drug-free programs. The study evaluates the potential relationship between the WC insurer's onsite RC services and employers’ WC claim frequency and claim cost. The target population is Ohio employers served by the OHBWC program.

Features of the Study

The study uses two different study designs: 1) a matched difference-in-differences study design to analyze the claim rate ratio, lost-time claim rate ratio, and costs paid rate ratio for the RC serviced employers compared to the non-serviced employers before and after service provision, and 2) a time-trend adjusted regression model among employers who ever received a RC visit. In design 1, each employer was matched to another employer who was non-serviced and had a similar number of full-time equivalent (FTE) employees, 3-digit North American Industry Classification System (NAICS) industry code, and loss history. In design 2, authors analyzed quarter-to-quarter changes during the before period, intervention period, and subsequent after periods. 

In the matched study design, the sample included 4,178 matched pairs of employers (n=8,356). In the time-trend analysis, the sample included 4,606 employers that did not receive RC services through a Safety Intervention Grant (SIG) or participate Safety Council (SC) before 2006; had 10 or more FTE employees; completed NAICS industry information; did not have outlier employee counts and rates; and had sufficient data before the first RC visit. 

The primary data source was the OHBWC database that included measures of employer level claims and policy information on who also had systematic centralized RC information 2006-2017. This data also included information of the industry of the employer, quarterly employee counts, and program prevention, participation, and consultation services history.  The authors used a statistical model to compare the outcomes of treatment and control group members.

Findings

Public benefits receipt

  • The study found no significant relationship between RC visits and workers’ compensation claim rates, nor workers’ compensation lost-time claim rates. The study found a significant negative association between RC visits and workers’ compensation paid cost rate. 

Considerations for Interpreting the Findings

The treatment group was self-selected since RC onsite consultations were provided voluntarily to employers. This study therefore applies mainly to organizations with a vested interest in safety.

Causal Evidence Rating

This study receives a low evidence rating because the study design does not allow for randomization of the treatment and comparison groups and since employers self-selected to receive RC services. This means we are not confident that the estimated effects are attributable to the intervention; other factors are likely to have contributed.

Reviewed by CLEAR

December 2023