Illinois’ Medical Payments per Workers’ Compensation Claim Rose Moderately From 2012 To 2014

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

Sample slide from study.

Sample slide from study.

Medical payments per workers’ compensation claim in Illinois remained higher than the other states we examined but have moved closer to the median study state, and the shift can be attributed in part to the state’s 2011 reforms.

Medical payments per workers’ compensation claim in Illinois increased annually an average of 3.1 percent between 2012 and 2014, driven primarily by higher payments to ambulatory surgery centers (ASCs), according to a recent Workers Compensation Research Institute (WCRI) study.

Illinois had the highest medical payments per workers’ compensation claim of all the states WCRI studied prior to 2011, the year in which Illinois reduced by 30 percent its fee schedule for all medical services, according to CompScope™ Medical Benchmarks for Illinois, 17th Edition.

“Medical payments per workers’ compensation claim in Illinois remained higher than the other states we examined but have moved closer to the median study state, and the shift can be attributed in part to the state’s 2011 reforms,” said Ramona Tanabe, WCRI’s executive vice president and counsel.

The following are among the report’s other findings:

  •     Medical payments per workers’ compensation claim for services provided by physicians, physical/occupational therapists, and chiropractors remained higher in Illinois than in other study states.
  •     Illinois had the highest utilization of medical services among the study states, driven by physical medicine services.
  •     Medical payments per claim to hospitals, for both outpatient and inpatient care, were similar in Illinois to other study states.

WCRI studied medical payments, prices, and utilization in 18 states, including Illinois, looking at claim experience through 2015 on injuries that occurred mainly in 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 web site: http://www.wcrinet.org/studies/public/books/csmed17_IL_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, Massachusetts. 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.

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