Today’s issue of WorkCompRecap features the release of the 6th edition of WCRI’s Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, which compares hospital payments for a group of common outpatient surgeries in workers’ comp across 35 states, representing 88% of the workers’ compensation benefits paid in the US.
Key findings from the latest edition included that that states with percent-of-charge-based fee regulations had substantially higher hospital outpatient payments per surgical episode than states with fixed-amount fee schedule: 37 to 151% higher than the median of the study states with fixed-amount fee schedules in 2015. States with no fee schedules also had 44 to 136% higher payments per episode. WCRI also noted that payments per episode in most states with percent-of-charge-based fee regulations or no fee schedules also grew faster than fixed-amount states. For context, the study also compares average workers’ comp payments and Medicare rates, and found “tremendous” variation between the two for a common group of arthroscopic procedures across states.
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