Illinois Workers’ Compensation Reforms Showing Results; Costs of Medical Payments Continue To Fall, New Study Says

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A new study from the Workers Compensation Research Institute (WCRI) provides results of the 30 percent reduction in the Illinois fee schedule rates on prices paid as well as on overall medical payments per claim compared with 15 other states.

Sample chart from study.

Sample chart from study.

The decrease in medical payments per-claim was the sharpest of the 16 states WCRI studied.

Reforms enacted in 2011 continue to drive down the cost of medical care for injured workers in Illinois, according to a new study by the Workers Compensation Research Institute (WCRI).

According to the report, CompScope™ Medical Benchmarks for Illinois, 15th Edition, medical payments per claim fell 20 percent between 2010 and 2012. The decrease likely reflected the impact of a 30 percent reduction in fee schedule rates included in the reforms, effective for services provided after September 1, 2011.

The decrease in medical payments per-claim was the sharpest of the 16 states WCRI studied. Illinois medical payments per claim were closer to the median study state, where it had been among the highest of study states prior to the regulatory changes.

Medical payments per claim have two components: the price for each service provided and the number of services provided (utilization). In Illinois, prices paid for professional services decreased 27 percent between 2010 and 2012. Payments per service for hospital outpatient services decreased 16 percent. Utilization changed little, the report said.

In 2013, prices paid for professional services grew little, related to annual updates in the Consumer Price Index for Urban Consumers (CPI-U). The small increase is consistent with the design of the Illinois fee schedule to update fee schedule rates with the annual changes in CPI-U.

Other reforms passed in 2011 introduced preferred provider programs (PPPs) for selecting treating physicians. Utilization review, based upon recognized treatment guidelines and evidence-based medicine, was also required. The impact of these changes may be evident over the next several years, the study said.

The Cambridge-based WCRI is recognized as a leader in providing high-quality, objective information about public policy issues involving workers' compensation systems.

For more information about this study or to purchase a copy, visit http://www.wcrinet.org/result/csmed15_IL_result.html.

ABOUT WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes 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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