Update on a systematic literature review on the effectiveness of experience rating

Objectives: The objective of this systematic review is to update the evidence on the effectiveness of experience rating of workers’ compensation insurance premiums in leading to improvements in workplace occupational safety and health performance. Methods: We update a review undertaken several years ago, using the same systematic review methodology. A rigorous and systematic literature search was completed. Studies that met subject matter and methods criteria underwent a quality assessment. Evidence from included studies was synthesised using a qualitative approach known as ‘best evidence’ synthesis. This approach ranks the strength of evidence based on the quantity, quality, and consistency of studies meeting the quality inclusion criteria. Results: In terms of the introduction of experience rating, based on six studies there was moderate evidence that its introduction is associated with a lower frequency of injuries. With respect to the degree of experience rating, based on seven studies there was also moderate evidence that a higher degree of experience rating is associated with a lower frequency and severity of injuries. The quality of more recent studies has increased, and there were fewer low-quality studies meeting subject matter inclusion criteria in this literature. As a result of the increase in the number of studies, we were able to undertake substrata analysis based on types of injury outcome considered in the analysis. Conclusions: Although there is still much to be explored in the area of premium-setting practices in workers’ compensation insurance and their impact on workplace health and safety performance, the most recent studies published on the topic are, on average, of a higher quality than the earlier literature. Recent studies also investigate a broader range of premium-setting features and behavioural incentives. Only a few new studies were identified, suggesting that access to administrative data from workers’ compensation authorities may still be a barrier to advancing the evidence base.