Today’s issue of WorkCompRecap features WCRI’s recent release of another edition of its CompScope Medical Benchmarks reports, which examined the Texas system and found that medical payments per claim with more than seven days of lost time were lower in Texas than the typical state.
WCRI noted that medical payments per claim were lower than typical for both hospital and nonhospital care and were stable overall from 2014-2019. Payments per claim increased between 2017 and 2019, driven mainly by hospital payments per inpatient episode. Hospital outpatient payments per claim were stable over the entire period. Also of note was that stability since 2014 masked offsetting trends within the period as claims at 12 months of experience, for example, medical payments per claim decreased about 4% per year from 2014-2017, driven mainly by nonhospital payments, and then increased almost 6% per year from 2017-19.