CAMBRIDGE, MA, December 10, 2010 – Medical payments per workers’ compensation claim in Maryland were among the lowest of 15 states for claims with more than seven days of lost time and at 12 months of maturity due to lower payments per claim for both nonhospital and hospital services, according a study by the Workers Compensation Research Institute (WCRI).
The WCRI study, CompScopeTM Medical Benchmarks for Maryland, 10th Edition reported that nonhospital payments per claim in Maryland were 26 percent lower than the median study state. Hospital outpatient payments per claim were 43 percent lower and inpatient payments per claim were also 9 percent lower than the median study state.
Findings from another WCRI study Comparing Outcomes for Injured Workers in Michigan found that Maryland had a better value proposition for workers and employers. Maryland was typical compared to other study states in worker outcome measures, suggesting that lower medical costs per claim did not adversely affect workers in their reported overall satisfaction with medical treatment, access to care, or return to work.
The Cambridge, Mass.-based WCRI reported that one driver of Maryland’s lower medical costs per claim was lower prices paid for major nonhospital services. Maryland has historically had a lower fee schedule compared to other states and the 2004 and 2006 changes did not alter that ranking, according to another WCRI study.
The study also found that Maryland was 13 percent lower for hospital payments per inpatient episode compared to the median state, based on claims with 24 months of experience and more than seven days of lost time.
In addition, the study found that Maryland had higher utilization of physical medicine services but typical utilization of other nonhospital services.
A key driver of the higher utilization of nonhospital physical medicine services was more visits per claim. Maryland had an average of 20 visits per claim compared to the median state which had 18 visits per claim, according to WCRI.
In analyzing trends for Maryland, the WCRI study also found growth of five percent per year in medical costs per claim from 2002 to 2007, similar to the growth rate in the median study state. Major components driving medical cost per claim also grew five percent per year on average across the study period.
The study also found that from 2006 to 2007, the percentage of claims with nonhospital physical medicine services rose 3 percent in Maryland. The increase was driven mainly by growth in claims with nonhospital physical medicine services provided by physicians. Furthermore, there was slight, fairly steady growth in nonhospital physical medicine visits per claim from 2002 to 2007. However, 2007 showed a small decrease in number of nonhospital physical medicine visits per claim compared to 2006, due primarily to a decline in visits to chiropractors.The Workers Compensation Research Institute is a nonpartisan, not-for-profit membership organization conducting public policy research on workers’ compensation, healthcare and disability issues. Its members include employers, insurers, insurance regulators and state administrative agencies in the U.S., Canada, Australia and New Zealand as well as several state labor organizations.
955 Massachusetts Avenue Cambridge, Massachusetts 02139 617-661-WCRI (9274)