Indiana Medical Payment Trend per Workers’ Compensation Claim Flattens After Years of Increases, Finds WCRI Study

Share Article

This recently released WCRI study examines medical payments, prices, and utilization in Indiana's workers' compensation system and compares them with 17 other states (Arkansas, California, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin).

Workers' Compensation Claims Form.

There were offsetting factors behind the flat trend. While prices and utilization by nonhospital providers increased, hospital outpatient payments per claim fell. The latter may be related to the fee schedule imposed by House Enrolled Act (HEA) 1320.

Medical payments per workers’ compensation claim in Indiana changed little from 2013 to 2014, a sharp contrast to the increases of the prior nine years, according to a new study by the Workers Compensation Research Institute (WCRI).

Before the recent flattening, Indiana’s medical payments per claim had been growing faster than in most of the 17 other states WCRI examined, according to the study CompScope™ Medical Benchmarks for Indiana, 17th Edition.

“There were offsetting factors behind the flat trend,” said Ramona Tanabe, WCRI’s executive vice president and counsel. “While prices and utilization by nonhospital providers increased, hospital outpatient payments per claim fell. The latter may be related to the fee schedule imposed by House Enrolled Act (HEA) 1320, which became effective in July 2014.”

HEA 1320 enacted a hospital fee schedule with reimbursement set at 200 percent of Medicare in an attempt to control hospital costs. The data in WCRI’s study reflect up to nine months of experience after the fee schedule took effect and may provide an early look at the post-fee-schedule experience.

Among the findings:

  • Before the recent trend, Indiana’s medical payments per claim were rising faster than the typical state studied.
  • Medical payments per claim in the state remained higher than the typical state studied. The main reason was higher and growing prices, as was the case in other states with no price regulation.

WCRI studied medical payments, prices, and utilization in 18 states, including Indiana, looking at claim experience through 2015 on injuries that occurred mainly from 2009 to 2014. WCRI’s CompScope™ Medical Benchmark studies compare payments from state to state and across time. Copies of this report can be ordered from the WCRI website: http://www.wcrinet.org/studies/public/books/csmed17_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. Since 1983, WCRI has been a catalyst for significant improvements in workers' compensation systems 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.

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Andrew Kenneally
Workers Compensation Research Institute - WCRI
since: 06/2011
Like >
WCRI

Follow us on
Visit website