December 16, 2017

WCRI: IN Sees First Decline in a Decade in Medical Payments per Workers’ Comp Claim

Cambridge, MA – Medical payments per workers’ compensation claim in Indiana decreased from 2014 to 2015 for the first time in more than a decade, according to a new study by the Workers Compensation Research Institute (WCRI).

The study, CompScope™ Medical Benchmarks for Indiana, 18th Edition, examined medical payments per claim, prices, and utilization, comparing Indiana with 17 other states.

“This study provides a look at how medical payments per claim in the Indiana workers’ compensation system have changed following significant legislation in 2013 and 2014,” said Ramona Tanabe, WCRI’s executive vice president and counsel. “In particular, House Enrolled Act 1320 addressed hospital costs, which were a key driver of higher-than-typical medical payments in Indiana. The legislation enacted a hospital fee schedule with reimbursement set at 200 percent of Medicare.”

The following are among the study’s other findings:

· Medical payments per claim decreased 10 percent from 2014 to 2015, a larger decrease than in any other state studied.

· The decrease was driven by reduced payments per claim for hospital care, reflecting the adoption of a hospital fee schedule in 2014.

· The decrease was partly offset by growth in prices and utilization of nonhospital care.

Despite the recent decrease, medical payments per claim in Indiana were higher than the median of the 18 states studied.

WCRI studied medical payments, prices, and utilization in 18 states, including Indiana, looking at claim experience through 2016 on injuries that occurred mainly in 2010 to 2015. WCRI’s CompScope™ Medical Benchmarks studies compare metrics of medical costs from state to state and across time.

To purchase a copy of this report, visit https://www.wcrinet.org/reports/compscope-medical-benchmarks-for-indiana-18th-edition.

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