Some State Policy Changes Decreased Medical Payments per Workers’ Compensation Claim, Finds New WCRI Studies

Share Article

The studies, CompScope™ Medical Benchmarks, 18th Edition, examine the costs, prices and utilization of workers’ compensation medical care in 18 states.

News Image
This research can help policymakers and other stakeholders identify cost drivers and emerging trends in payments, prices, and utilization of medical providers. These reports also examine how these metrics of medical payments compared among the 18 study states.

Several states have seen decreases in medical payments per workers’ compensation claim, according to a series of new studies by the Workers Compensation Research Institute (WCRI).

The studies, CompScope™ Medical Benchmarks, 18th Edition, examine the costs, prices, and utilization of workers’ compensation medical care through March 2016 for injuries occurring mainly in 2010 to 2015.

Eighteen states were included in this research: Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin. There are individual reports for every state except Arkansas and Iowa.

“This research can help policymakers and other stakeholders identify cost drivers and emerging trends in payments, prices and utilization of medical providers,” said Ramona Tanabe, WCRI’s executive vice president and counsel. ”These reports also examine how these metrics of medical payments compared among the 18 study states.”

The following are sample findings from the studies:

  • California: Medical payments per claim with more than seven days of lost time decreased steadily after the enactment of the reform legislation in 2013. While California used to have higher-than-typical medical payments per claim, it ranked close to the median of the states studied for post-reform 2013 claims with experience through 2016.
  • Indiana: Medical payments per claim decreased 10 percent from 2014 to 2015, the first such decrease in more than a decade. The decrease follows the adoption of a hospital fee schedule in 2014.
  • North Carolina: Medical payments per claim decreased 6 percent per year from 2013 through 2015, more than in all other study states, largely reflecting the effects of fee schedule changes.

For more information about these studies or to purchase them, visit https://www.wcrinet.org/reports/compscope-medical-benchmarks-18th-edition.

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 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