Costs of Medical Care per Claim for Injured Workers in New Jersey Stabilized, but Were Higher Than Many in 16-State Study

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In this 14th edition CompScope™ Medical Benchmarks study, we examine medical costs, prices, and utilization in New Jersey, compared with 15 other states in the CompScope™ Medical benchmarking studies. This WCRI study also examines how these metrics of medical costs and care have changed from 2006 to 2011 (evaluated in 2012).

Sample chart from the study.

Sample chart from the study.

The study noted major surgery was an important medical cost driver in New Jersey, mainly because of higher and growing prices paid for surgeons’ fees.

Growth in payments per claim for the medical care of injured workers in New Jersey stabilized after years of growth, but these costs remained higher than many other states in a 16-state study by the Workers Compensation Research Institute (WCRI).

The WCRI study, CompScope™ Medical Benchmarks for New Jersey 14th Edition, reported that medical payments per workers’ compensation claim in New Jersey rose only 1.5 percent from 2010 to 2011, following growth of nearly 8 percent per year from 2006 to 2010.

The study said a decrease in utilization of many nonhospital services, fairly stable prices for those services, and a continued decrease in the percentage of claims with hospital inpatient services contributed to the moderation of growth in medical payments.

Although growth in medical payments per claim stabilized, medical payments per claim in New Jersey were 20 percent higher than the median of the states in the study. Underlying that result were higher prices paid for many nonhospital services, more visits per claim for physical medicine services, and lower hospital outpatient payments per service.

The study noted major surgery was an important medical cost driver in New Jersey, mainly because of higher and growing prices paid for surgeons’ fees. “Those results may reflect the lack of regulation of prices, as well as lower provider network participation by surgeons in New Jersey,” said Ramona Tanabe, WCRI’s deputy director and counsel.

The Cambridge-based WCRI is recognized as a leader in providing high-quality, objective information about public policy issues involving workers' compensation systems. Click on the following link to purchase a copy of this study:


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
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since: 06/2011
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