Barriers to Use of Workers' Compensation for Patient Care at Massachusetts Community Health Centers

Objectives To examine barriers community health centers ( CHC s) face in using workers' compensation insurance ( WC ). Data Sources/Study Setting Leadership of CHC s in M assachusetts. Study Design We used purposeful snowball sampling of CHC leaders for in‐depth exploration of reimbursement policies and practices, experiences with WC , and decisions about using WC . We quantified the prevalence of perceived barriers to using WC through a mail survey of all CHC s in Massachusetts. Data Collection/Extraction Methods Emergent coding was used to elaborate themes and processes related to use of WC . Numbers and percentages of survey responses were calculated. Principal Findings Few CHC s formally discourage use of WC , but underutilization emerged as a major issue: “We see an awful lot of work‐related injury, and I would say that most of it doesn't go through workers' comp.” Barriers include lack of familiarity with WC , uncertainty about work‐relatedness, and reliance on patients to identify work‐relatedness of their conditions. Reimbursement delays and denials lead patients and CHC s to absorb costs of services. Conclusion Follow‐up studies should fully characterize barriers to CHC use of WC and experiences in other states to guide system changes in CHC s and WC agencies. Education should target CHC staff and workers about WC .