Outpatient Hospital Costs Per Claim for Workplace Injuries in Florida Growing Rapidly

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The average cost per claim of outpatient hospital care for injured workers in the Florida workers’ compensation system continued to grow rapidly and was a main driver of growth in medical payments per claim in the state, according to a new study by the Workers Compensation Research Institute (WCRI).

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The study will help policymakers and other stakeholders understand how the Florida workers’ compensation system measures up with other states and serves as an invaluable tool in monitoring system improvements.

The average cost per claim of outpatient hospital care for injured workers in the Florida workers’ compensation system continued to grow rapidly and was a main driver of growth in medical payments per claim in the state, according to a new study by the Workers Compensation Research Institute (WCRI).

The report, Benchmarks for Florida, CompScope™14th Edition, states that the rapid growth in hospital outpatient payments per claim was driven by increases in the average payment per service for those services. These increases averaged 10 percent per year from 2005 to 2010.

WCRI observed that this trend may be related to some features in the percent-of-charge-based fee regulation in the state, compared with the fixed amount fee schedules that are in effect in many of the other 15 study states.

While outpatient hospital payments per claim rose, the study noted that medical payments per claim moderated after 2008, counterbalanced by other components of medical payments.

Among other major findings:

  •      Wage replacement benefits, called indemnity benefits, remained stable between 2008 and 2011, mainly driven by fairly stable wages and duration of temporary disability.
  •      Defense attorneys were involved more often in workers’ compensation claims and with higher payments per claim in Florida than in most of the other states studied.
  •      The speed of injury reporting in Florida was the fastest in the study states.

“The study will help policymakers and other stakeholders understand how the Florida workers’ compensation system measures up with other states and serves as an invaluable tool in monitoring system improvements,” said Ramona Tanabe, WCRI’s deputy director and counsel.

Click on the following link to purchase this study: http://www.wcrinet.org/studies/public/books/BMcscope_multi14_FL_book.html.

The Cambridge-based WCRI is an independent, non-partisan research center that is recognized as a leader in providing high-quality, objective information about public policy issues involving workers' compensation systems.

ABOUT WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Since 1983, WCRI has been a catalyst for significant improvements in workers' compensation systems around the world with its objective, credible, and high-quality research. WCRI's members include employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia and New Zealand.

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Andrew Kenneally
Workers Compensation Research Institute
+1 (617) 661-9274 Ext: 257
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