New Jersey Medical Payments per Workers’ Compensation Claim Stable after Rapid Growth in Earlier Years, WCRI Study Says

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This WCRI report, CompScope™ Medical Benchmarks for New Jersey, 16th Edition, examines medical payments, prices, and utilization in New Jersey compared with 16 other states.

Sample chart from the report.

Sample chart from the report.

From 2010 to 2013, medical payments per claim with more than seven days of lost time rose less than 2 percent per year in New Jersey. From 2008 to 2010, payments rose nearly 10 percent per year.

Medical payments per workers’ compensation claim in New Jersey were stable from 2010 to 2013, in contrast to rapid growth in the 2008 to 2010 period, according to a recent study by the Workers Compensation Research Institute (WCRI).

The report, CompScope™ Medical Benchmarks for New Jersey, 16th Edition, indicates results for New Jersey differed from those of other states WCRI studied, many of which experienced moderate to rapid growth in medical payments per claim.

The study found the following to be contributing factors:

  • Increased use of networks, which may be linked to a decrease in prices paid for nonhospital care. In recent years, two-thirds of total medical payments came from nonhospital services.
  • Flat or decreasing trends in utilization of many nonhospital services.
  • Slower growth in hospital outpatient payments per service.
  • A continued decrease in the percentage of claims that had hospital inpatient care.

“From 2010 to 2013, medical payments per claim with more than seven days of lost time rose less than 2 percent per year in New Jersey,” said Ramona Tanabe, executive vice president and counsel for WCRI. “From 2008 to 2010, payments rose nearly 10 percent per year.”

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

To purchase this study, visit http://www.wcrinet.org/studies/public/books/csmed16_NJ_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
+1 (617) 661-9274 Ext: 257
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Workers Compensation Research Institute - WCRI
since: 06/2011
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