Virginia’s Average Medical Payments per Workers’ Compensation Claim Grew among the Fastest of the 18 States WCRI Studied

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This 17th edition of CompScope™ Medical Benchmarks provides information for Virginia policymakers and stakeholders on various components of workers’ compensation medical payments and on drivers of changes in medical costs per claim from 2009 to 2014 (evaluated in 2015).

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Virginia’s medical payments per claim increase reflected the state’s steady growth in medical prices. We observed this trend in Virginia prices for nonhospital and hospital outpatient services.

Virginia’s medical payments per workers’ compensation claim with more than seven days of lost time increased 26 percent for claims that occurred between 2009 and 2014, according to a recent study by the Workers Compensation Research Institute (WCRI).

This growth in medical payments per workers’ compensation claim in Virginia was among the fastest of the states included in CompScope™ Medical Benchmarks for Virginia, 17th Edition. The median growth rate of medical payments per workers’ compensation claim over the same period was 15 percent in the states WCRI studied.

“Virginia’s medical payments per claim increase reflected the state’s steady growth in medical prices. We observed this trend in Virginia prices for nonhospital and hospital outpatient services,” said Ramona Tanabe, WCRI’s executive vice president and counsel.

The following are among the findings from this study:

  •     Medical payments per workers’ compensation claim increased slightly more than 5 percent annually in Virginia for claims that occurred between 2009 and 2014.
  •     Medical prices for nonhospital services increased 20 percent between 2009 and 2014 in Virginia while increasing on average 4 percent in the 17 other states WCRI studied.
  •     The growth in hospital outpatient payments in Virginia was driven by the growing costs of treatment, operating, and recovery room services.

Virginia Governor Terry McAuliffe signed House Bill 378 into law this year, establishing maximum medical fee schedule reimbursement rates for workers’ compensation services. The Virginia Workers’ Compensation Commission must establish these rates by January 1, 2018.

WCRI studied medical payments, prices, and utilization in 18 states, including Virginia, looking at claim experience through 2015 on injuries that mainly occurred 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_VA_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
@WCRI
since: 06/2011
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