Cambridge, MA – Medical payments per claim in Minnesota remained stable from 2012 to 2017, according to a recent study by the Workers Compensation Research Institute (WCRI).
The study, CompScope™ Medical Benchmarks for Minnesota, 20th Edition, compared Minnesota with workers’ compensation systems in 17 other states. This study also examined how the metrics of medical payments and care have changed over time. For the study, WCRI analyzed workers’ compensation claims with experience through 2018 for injuries up to and including 2017.
The average medical payment per claim with more than seven days of lost time in Minnesota changed within 1 percent per year since 2012 for claims at all maturities.
“Several trends offset to produce the stable results,” said Ramona Tanabe, executive vice president and counsel of WCRI. “For example, hospital inpatient payments per episode decreased, while there were increases in facility payments per claim at ambulatory surgery centers (ASCs) and at hospital outpatient departments.”
Hospital inpatient payments per episode in Minnesota had a sizable decrease in 2016, following the implementation of the new Medicare diagnosis-related group-based inpatient fee schedule. For 2016 claims with experience through March 2018, the average hospital inpatient payment per episode decreased 9 percent. Before this fee schedule change, this measure grew rapidly since 2008.
ASC facility payments per claim and hospital outpatient facility payments per claim in Minnesota grew 5–6 percent per year from 2012 to 2017 for claims at 12 months’ maturity, driven by rapid increases in payments per service. Future editions of the CompScope™ Medical Benchmarks study will monitor the impact of the October 2018 fee schedule changes on ASC facility and hospital outpatient facility payments.
Among the study’s other findings:
- The proportion of claims receiving inpatient care in Minnesota decreased from 2012 to 2017, another factor contributing to the overall stability in medical payments per claim during this period.
- For nonhospital professional services, overall prices paid in Minnesota remained fairly stable, and utilization of most these services changed little from 2012 to 2017.
- The average medical payment per claim in Minnesota was typical of the 18 study states for 2015 claims with more than seven days of lost time at 36 months’ maturity.
To purchase a copy: WCRI: CompScope Medical Benchmarks for Minnesota, 20th Edition