Indiana Medical Payments per Workers’ Compensation Claim Higher Among 17 States, WCRI Study Says

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Medical payments per workers’ compensation claim in Indiana were higher and rising faster than in most states examined in a recent study, CompScope™ Medical Benchmarks for Indiana, 16th Edition, by the Workers Compensation Research Institute (WCRI).

Sample chart from the report.

Sample chart from the report.

In Indiana, utilization of medical care was somewhat lower, which tended to offset the higher prices paid.

Medical payments per workers’ compensation claim in Indiana were higher and rising faster than in most states examined in a recent study by the Workers Compensation Research Institute (WCRI).

The report, CompScope™ Medical Benchmarks for Indiana, 16th Edition, covers the period from 2008 to 2013, before the introduction of a hospital fee schedule enacted under House Enrolled Act (HEA) 1320, which was effective July 1, 2014.

“Before HEA 1320, Indiana had higher prices for medical care than most states, and prices were rising faster, situations our studies have found among states with no price regulation,” said Ramona Tanabe, executive vice president and counsel for WCRI. “In Indiana, utilization of medical care was somewhat lower, which tended to offset the higher prices paid.”

Information in the current study will serve as a baseline for Indiana, to compare with experience after the adoption of the hospital fee schedule.

The following are among the study’s findings:

  • Medical payments per claim with more than seven days of lost time rose 6 percent per year on average from 2008 to 2013 in Indiana, a faster rate than in most of the 17 states WCRI studied.
  • The percentage of medical payments for care within networks increased since 2010, which may have had a dampening effect on price increases. States that lack fee schedules tend to use medical networks frequently to help control medical costs through claims management and negotiated payment discounts.

WCRI studied medical payments, prices and utilization in 17 states, including Indiana, looking at claim experience through 2014 on injuries that occurred in 2013 and earlier. WCRI’s CompScope™ Medical Benchmark studies compare metrics of medical costs and care from state to state and across time.

To order a copy of this report, visit http://www.wcrinet.org/studies/public/books/csmed16_IN_book.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. 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
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