Today’s issue of WorkCompRecap features the release of a new WCRI study that compared hospital outpatient payments across states and monitors the impact of fee schedule reforms. Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 5th Edition found that hospital outpatient payments per surgical episode varied significantly across states.
Key findings included that states without workers’ comp fee schedules for hospital outpatient reimbursement saw higher payments per episode compared to states with fixed-amount fee schedules, ranging from 63-150% higher than the median of fixed amount states. Additionally, in non-fee schedule states, workers’ comp paid between 166-378% more than Medicare for similar hospital outpatient services. Percentage-of-charge based based states also still paid at least 190% all the way up to 430% more than medicare rates.
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