Cambridge, MA – The average medical payment per claim in Virginia decreased 13 percent between 2017 and 2018, after the state implemented a medical fee schedule on January 1, 2018, according to a recent study by the Workers Compensation Research Institute (WCRI).
This change was a main factor behind an 8 percent decrease in the total costs per claim in Virginia over the same time period for claims with 12 months of maturity. Benefit delivery expenses also decreased 11 percent, while indemnity payments per claim increased slightly.
“The decrease in medical payments per claim in Virginia in 2018 likely reflects the decrease in medical prices resulting from the implementation of the medical fee schedule,” said Ramona Tanabe, executive vice president and general counsel of WCRI. “In previous studies WCRI found that medical prices for nonhospital services in Virginia decreased 14 percent between 2017 and 2018, the first year that the fee schedule was in effect, although the price decrease varied across different services.”
Total payments per claim for claims with more than seven days of lost time in 2018 were typical of the study states. In prior years, Virginia was 18 percent higher than the 18-state median. Most components of the indemnity benefit in Virginia were in the middle group of the 18 states studied.
The study, CompScope Benchmarks for Virginia, 20th Edition, compared Virginia with workers’ compensation systems in 17 other states. For the study, WCRI analyzed workers’ compensation claims with experience through March 2019.
With many wondering about the impact the Coronavirus Disease 2019 (COVID-19) will have on state workers’ compensation systems, Tanabe says, “While the full impact is currently unclear, the CompScope™ studies will be a useful baseline to monitor the effects.”
The study was authored by Bogdan Savych.
To learn more or purchase a copy: WCRI: CompScope Benchmarks for Virginia, 20th Edition visit