May 21, 2018

WCRI Study Identifies Medical Cost Drivers, Trends, Effects of Regulatory Changes

Cambridge, MA – The cost drivers of medical care in state workers’ compensation systems; the effects of legislative and regulatory changes on medical costs; and trends in payments, prices and utilization of medical care for injured workers are examined in a new set of studies from the Workers Compensation Research Institute (WCRI).

The studies, CompScope™ Medical Benchmarks, 14th Edition, look at 16 different state workers’ compensation systems and provide a baseline of current medical costs and trends for state system stakeholders by documenting how medical payments per claim and their cost components compare with other states.

“The reports are designed to help policymakers and others benchmark the performance of state systems in providing medical care for injured workers,” said Ramona Tanabe, WCRI’s Deputy Director and Counsel. “The reports also provide an excellent baseline for tracking the effectiveness of policy changes and identifying important trends.”

The states in the study – Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Texas, Virginia, and Wisconsin – represent nearly 60 percent of the nation’s workers’ compensation benefit payments.

The following is a sample of the key findings found in the studies:

  • Medical payments per claim in Indiana were 17 percent higher than the 16-state median. Higher prices and inpatient payments were the main reasons for that result.
  • The average medical payment per claim in Louisiana was higher than the 16-state median, largely the result of much higher hospital outpatient payments per claim, which also contributed to the rapid growth rate.
  • Fee schedule increases in Texas following Medicare updates as required under HB 7 and the 2011 ban on informal networks drove an increase in prices─fueling the recent growth in medical payments. A decrease in utilization of nonhospital care slightly offset the increases in prices.
  • Major surgery was an important medical cost driver in New Jersey, mainly because of higher and growing prices paid for surgeon’s fees.

The reports present various measures in several areas, including medical costs, medical prices and utilization of services by provider and service type. For more information on the reports or how to purchase them, click here: WCRI CompScope Medical Benchmarks, 14th Edition

Source: WCRI

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