Rise in Medical Prices in Texas Contributed To Increase in Cost Per Claim of Medical Care for Injured Workers, Says New WCRI Study

This WCRI study, CompScope™ Medical Benchmarks for Texas 14th Edition, examines medical costs, prices, and utilization in Texas and compares them with 15 other states. It further examines how these metrics of medical costs and care have changed following the Texas reforms.

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Sample chart from the study.

Sample chart from the study.

Prior to the reforms in 2001 and 2005, Texas medical payments per claim were the highest of the study states. In recent years, however, they were lower than the typical state in the study.

CAMBRIDGE, MA (PRWEB) March 25, 2014

Payments per claim for the medical care of injured workers in Texas grew nearly 8 percent in 2011, largely the effect of price increases from earlier reforms, according to a 16-state study by the Workers Compensation Research Institute (WCRI).

The WCRI study, CompScope™ Medical Benchmarks for Texas 14th Edition, said the growth in medical payments per workers’ compensation claim in Texas was faster than in prior years and more rapid than in most other states in the study.

The study continues to monitor the impact of the series of reforms on medical costs, particularly House Bill (HB) 7, enacted in 2005, on prices and utilization of medical care for injured workers.

“Prior to the reforms in 2001 and 2005, Texas medical payments per claim were the highest of the study states. In recent years, however, they were lower than the typical state in the study,” said Ramona Tanabe, WCRI’s deputy director and counsel.

The study found fee schedule increases following Medicare updates as required under HB 7, and the 2011 ban on informal networks drove an increase in prices for medical services, fueling the recent growth in medical payments. A decrease in utilization of nonhospital care slightly offset the increases in prices.

Medical payments per claim were lower than the typical study state following the series of reforms, according to the study. That finding resulted from lower-than-typical prices paid for some medical care and large decreases in utilization of medical care.

Click on the following link to purchase a copy of this study: http://www.wcrinet.org/result/csmed14_TX_result.html.

The Cambridge-based WCRI 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.


Contact

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

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