Prestige Insurance Group, Inc.

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Prestige Insurance Group, Inc.

Health InsuranceSince the Affordable Care Act came to be, there's been some concern over how it might affect workers compensation claims and how they're paid. One of the biggest worries involves the increase in case shifting from group health insurance to workers compensation.

Accountable Care Organizations (ACOs) — networks of healthcare providers and hospitals that share responsibility for providing care to patients — have a financial incentive to produce better outcomes for patients. But can workers compensation be incorporated into ACOs to take advantage of the outcome-based focus?

A doctor can often determine if an injury or illness was caused by performing a job — especially an injury, like a laceration or broken bone. Under the right circumstances, a workers compensation claim may pay a higher rate for treatment than a group health insurance policy. Therefore, healthcare providers have an incentive to shift to treating patients who have filed a workers comp claim, or to encourage them to do so if necessary.

This type of cost shifting is most likely to occur with soft tissue injuries and in states that have a higher prevalence of capitated health insurance plans, in which doctors are reimbursed a flat rate per patient. There may also be an increase in cost shifting when an injured individual is covered under a group health insurance policy with a large deductible.

Looking at the topic from the consumer's perspective, what happens if a health plan provided by workers comp is ending? It's no longer legal to go uninsured, so you'll have to purchase your own health insurance policy if you don't already have one. In many similar cases, you'll have a 60 day window to get coverage once your workers comp plan ends.

Your health is important and as such, it's vital to take steps now to protect the wellness of yourself and your family.

Get the coverage you need. Call Prestige Insurance Group, Inc. at (888) 969-8778 for more information on Florida health insurance.
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